Diabetes, Type 2
Conditions
Keywords
Diabetes, Decision Aid, AntiHyperglycemic Medication, Tailored health information, Medication information
Brief summary
Two of AHRQ 's consumer-focused guides, Pills for Type 2 Diabetes and Premixed Insulin for Type 2 Diabetes could be of great use to underserved ethnic and racial minority adults. The presentation of content and delivery mechanisms of these Guides, however, needs to be modified to increase their use and impact among these difficult-to-reach populations. To achieve this goal, a long-standing collaboration among African American and Latino community organizations, health care centers and systems, public health organizations, and academics (the REACH Detroit Partnership) is joining with leading experts in the development of personally and culturally tailored health decision aids (University of Michigan's Center for Health Communications Research \[CHCR\] and Center for Behavioral and Decision Sciences in Medicine \[CBDSM\]). The investigators will develop and evaluate a computer tailored online diabetes medication decision aid that will enable community health workers (CHWs) to provide personalized patient education materials to underserved diabetic African American and Latino adults in Detroit, Michigan.
Detailed description
The Specific Aims of this study are: Aim 1: To use the information in the two diabetes medications consumer CERSGs to build an interactive, computer tailored diabetes medication guide that will enable patients to assess their treatment goals, personal preferences, and side-effect concerns and generate a personally tailored assessment of their current diabetes treatments with, as appropriate, options for improving their diabetes care; Aim 2: To determine the extent to which this personally tailored diabetes medication guide compared with the print consumer guides reduces Latino and African American diabetes patients' decisional conflict, through improved knowledge of anti-hyperglycemic medications and satisfaction with information received. Aim 3: To examine the computer tailored program's effects on participants' changes in medications (medication intensification), self-reported medication adherence and beliefs and A1C levels between baseline and follow-up compared to participants receiving the print consumer guides.
Interventions
BEHAVIORALCommunity Health Worker Diabetes Education: Print media
Providing information to patients about potential benefits, harms, costs, and burdens of medications and discussing patients' treatment preferences.
BEHAVIORALCHW Diabetes Education: tailored web site
Providing tailored and interactive information to patients about potential benefits, harms, costs, and burdens of medications and discussing patients' treatment preferences.
Sponsors
Agency for Healthcare Research and Quality (AHRQ)
University of Michigan
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
21 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* type 2 diabetes * stated concern about diabetes and diabetes treatment * poor glycemic control * over 21 years of age
Exclusion criteria
* blind, deaf, otherwise unable to use the telephone or visual resources * pregnant * currently enrolled in other REACH Detroit research study * in hospice care * current radiation or chemotherapy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Changes in decisional conflict | baseline and 3 month post intervention | We will be measuring subjects' perceptions of: a) uncertainty in choosing options; b) modifiable factors contributing to uncertainty such as feeling uninformed, unclear about personal values and unsupported in decision making; and c) effective decision making such as feeling the choice is informed, values-based, likely to be implemented and expressing satisfaction with the choice. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Medication adherence and intensification | baseline and 3 month post intervention | Self-reported medication adherence will be assessed through three well-validated measures. We will assess changes in anti-hyperglycemic medication dosages and/or numbers of medications by patient report and medical record review. |
Countries
United States
Outcome results
None listed