Using Practice Facilitation and Operationalizing Referral Information Technology to Increase DSMES Utilization

NCT05472142 | Completed Results

• 2 other identifiers: 75928R34DK132548
• Study Type: interventional
• Target: 22
• Locations: 1 country
• Sites: 1

Brief Summary

This is a pilot and feasibility study of a pragmatic cluster randomized trial that utilizes health information technology and practice facilitation to address referral barriers and increase clinician awareness and motivation to refer patients with diabetes to diabetes self-management education and services (DSMES).

Conditions

Diabetes

Keywords

diabetes self-management education and support (DSMES); implementation science; practice facilitation; health information technology; evidence-based practice; rural clinics

Outcome Measures

Primary Outcomes (1)

• Diabetes Self-Management Education and Support (DSMES) Referrals

  DSMES referrals will be measured as the referral rate at baseline, the end of the active intervention and the end of the follow-up period. The outcome will be assessed through clinic electronic health record data.

  Baseline, End of active intervention (month 9), End of follow-up (month 15)

Secondary Outcomes (2)

• Diabetes Self-Management Education and Support (DSMES) Attendance

  Baseline, End of active intervention (month 9), End of follow-up (month 15)

• Percent of Patients With A1c >9%

  Baseline, End of active intervention (month 9), End of follow-up (month 15)

Study Arms (2)

Control Cluster

ACTIVE COMPARATOR

Clinics in the control group will only be provided with health information technology; they will not participate in the 12-month intervention which incorporates health information technology and practice facilitation.

Other: UP FOR IT - health information technology

Intervention Cluster

EXPERIMENTAL

Clinics in the intervention group will participate in the 12-month intervention which incorporates health information technology and practice facilitation.

Other: UP FOR IT - practice facilitation; Other: UP FOR IT - health information technology

Interventions

UP FOR IT - practice facilitation OTHER

Using Practice Facilitation and Operationalizing Referral Information Technology (UP FOR IT) involves incorporation of health information technology and practice facilitation. The practice facilitation collaborative trains and supports clinical teams to use the Model for Improvement to make "breakthrough" improvements in diabetes care and DSMES utilization by recognizing barriers and changing clinical systems and care practices.

Intervention Cluster

UP FOR IT - health information technology OTHER

Using Practice Facilitation and Operationalizing Referral Information Technology (UP FOR IT) involves incorporation of health information technology and practice facilitation. The health information technology component provides the scaffolding for quality improvement efforts by automating patient identification and enabling bi-directional referral communication between providers and diabetes self-management education and services (DSMES) programs.

Control Cluster; Intervention Cluster

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

Sponsors & Collaborators

• Mary Lacy: lead
• National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK): collaborator

Study Sites (1)

University of Kentukcy

Lexington, Kentucky, 40536, United States

Location

Related Publications (1)

• Lacy ME, Elliott J, Drakeford V, Wright L, McKune B, Douthitt KC, Kruse-Diehr AJ, Keck JW. Increasing Uptake of Diabetes Self-Management Education and Support (DSMES) in Rural Kentucky Primary Care Clinics: Findings From a Pilot Pragmatic Cluster-Randomized Trial. J Prim Care Community Health. 2026 Jan-Dec;17:21501319261428883. doi: 10.1177/21501319261428883. Epub 2026 Mar 10.

  PMID: 41805383 DERIVED

MeSH Terms

Conditions

Diabetes Mellitus

Condition Hierarchy (Ancestors)

Glucose Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases; Endocrine System Diseases

Results Point of Contact

• Title: Mary E. Lacy, PhD, Study PI
• Organization: University of Kentucky

mary.lacy@uky.edu

8595621126

Study Officials

• Mary Lacy

  University of Kentucky

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Assistant Professor

Study Record Dates

• First Submitted: July 21, 2022
• First Posted: July 25, 2022
• Study Start: May 30, 2023
• Primary Completion: October 30, 2024
• Study Completion: October 30, 2024
• Last Updated: December 9, 2025
• Results First Posted: December 9, 2025

Record last verified: 2025-11

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)