Prediabetes
Conditions
Keywords
Veterans, Type 2 Diabetes Mellitus, Prediabetes, Decision-making, Motivation, Health Promotion, Prevention and Control
Brief summary
This study will evaluate the effects of screening for type 2 diabetes mellitus (T2DM) and brief counseling about screening test results on weight and key health behaviors among Veterans with risk factors for T2DM. Study participants will be randomly assigned to one of two study groups: (1) Blood Test Group or (2) Brochure Group. Participants in the Blood Test Group will complete a blood test called hemoglobin A1c (HbA1c) which measures average blood sugar levels. Participants will receive brief counseling about the results from their primary care provider or someone authorized to speak on their behalf. Participants randomly selected for the Brochure Group will review a handout from the VA National Center for Health Promotion and Disease Prevention (NCP) on recommended screening tests and immunizations. All participants will be asked to complete a survey prior to study group assignment, immediately after a Primary Care appointment, 3 months after enrollment, and 12 months after enrollment.
Detailed description
An essential step in designing effective strategies to improve patient engagement in behavior change is to better understand their current levels of engagement in these behaviors and determine which factors most influence their engagement. Within and outside the Veterans Health Administration (VHA), little is known about how patients with risk factors for T2DM view their risk of developing T2DM, what these patients understand about strategies to reduce this risk, and to what degree at-risk patients are currently engaging in behaviors to prevent T2DM. This project will generate important new data in these areas and will improve the investigators' understanding of the effects of a prediabetes diagnosis and brief counseling on engagement in behaviors to prevent T2DM and mediators of these behaviors.
Interventions
BEHAVIORALBlood Test Group Intervention
Patients randomly assigned to the Blood Test Group will complete an HbA1c blood test around the time of their next primary care appointment. Following the HbA1c test, their VA primary care provider will be notified of the test result and will be provided with a detailed interpretation of the result. Trained study staff will then provide brief counseling by phone and written information by mail about their test result. The brief counseling and written information will be based on the American Diabetes Association and National Diabetes Prevention Program guidelines and will emphasize the risk of progression to type 2 diabetes mellitus and the rationale for preventive strategies, encourage aerobic exercise and a calorie-restricted diet to promote and maintain weight loss, and set a goal of achieving and sustaining a weight loss of at least 5% of body weight.
BEHAVIORALBrochure Group Intervention
Participants will be asked to review a handout from the National Center for Health Promotion and Disease Prevention (NCP) on recommended screening tests and immunizations on or around the same date as their next primary care appointment.
Sponsors
VA Ann Arbor Healthcare System
VA Office of Research and Development
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
Yes
Inclusion criteria
The investigators will recruit 315 non-diabetic Veterans receiving primary care at the Ann Arbor VA Medical Center who meet the following inclusion criteria: * willing to complete a HIPAA authorization form * no HbA1c results in previous 12 months * due for VA Primary Care appointment approximately 12 weeks of sending a recruitment letter and who have a body-mass index (BMI) 30 kg/m2 * or BMI 25 kg/m2 with \> 1 obesity-related condition such as: * hypertension * hyperlipidemia * Hypoalphalipoproteinemia * Coronary Artery Disease * Peripheral Vascular Disease * Hypertriglyceridemia * past hemoglobin A1c (HbA1c) of 5.7 - 6.4 * past diagnosis of Impaired Fasting Glucose (IFG) * or Impaired Glucose Tolerance (IGT) * or Polycystic Ovary Syndrome (PCOS)
Exclusion criteria
* The investigators will exclude patients who are \> 75 years of age * are receiving chemotherapy for cancer, or have: * dementia * diabetes * dementia * New York Heart Association Class III or IV congestive heart failure * pregnancy * Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage 4 Chronic Obstructive Pulmonary Disease (COPD) * end-stage renal disease (ESRD) * cirrhosis * or have been hospitalized or received rehab for stroke or myocardial infarction within the past 6 months
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Weight Change From Baseline to 12 Months | 12 months | The primary outcome will be weight change 12 months after an HbA1c test and brief counseling or review of health promotion literature. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Changes in Participation in a Weight Management Program | 3 months and 12 months | The investigators will use survey data to evaluate changes in participation in a weight management program after an HbA1c test and brief counseling or review of health promotion literature. |
| Changes in Perception for Risk for T2DM | Baseline, 2 weeks, 3 months, and 12 months | The investigators will use survey data to evaluate changes in perception of risk for T2DM after an HbA1c test and brief counseling or review of health promotion literature. The Adriaanse T2DM Risk Perception Scale, which was included in the survey, measured self-assessed risk perception from 0 denoting no choice of developing T2DM to 100 denoting absolute confidence in developing T2DM. |
| Changes in Knowledge of Strategies to Prevent T2DM | 2 weeks, 3 months, and 12 months | The investigators will use survey data to evaluate changes in knowledge of strategies to prevent T2DM after an HbA1c test and brief counseling or review of health promotion literature. Respondents were given 3 open-ended questions to report things they could do to prevent T2DM. Each respective response to the 3 questions were coded and scored according to whether they indicated engagement in the following activities: weight loss, physical activity, use of metformin, or enrollment into a diabetes prevention program. Each question denoted with a positive response were coded with 1 whereas those that did not were coded as a 0. The three questions were summed into a final score ranging from 0 (no report of engagement in the aforementioned healthy activities) with the worst outcome to 3 (a report of 3 of the 4 aforementioned healthy activities) with the best outcome. |
| Change in Use of Medication for T2DM Prevention | 3 and 12 months | The investigators will use medical record data and survey data to evaluate changes in use of medication for T2DM prevention after an HbA1c test and brief counseling or review of health promotion literature. |
| Changes in Self-efficacy to Engage in Behaviors to Prevent T2DM | Baseline, 3 months and 12 months | The investigators will use survey data to evaluate changes in self-efficacy to engage in behaviors to prevent T2DM after an HbA1c test and brief counseling or review of health promotion literature. The Perceived Competence Scale was used to measure respondent self-efficacy from 1 (lowest) to 7 (highest). |
| Change in Physical Activity | Baseline, 3 months and 12 months | The investigators will use survey data to evaluate changes in physical activity after an HbA1c test and brief counseling or review of health promotion literature. The International Physical Activity Questionnaire - Short Form (IPAQ-SF) was used to measure physical activity change. Respondents were asked to report how many hours and minutes within the past week they completed of vigorous physical activity, moderate physical activity, and brisk walking. The total sum of minutes for these three questions were subsequently coded into a yes/no binary variable for whether respondents met a recommended 150 minutes of overall physical activity within 7 days of being assessed. The values provided reflect a proportion of respondents that met or exceeded the 150 minute threshold of overall physical activity based on the newly generated variable that combined total minutes of vigorous physical activity, moderate physical activity, and brisk walking. |
| Change in Mental Health | Baseline, 2 weeks, 3 months, and 12 months | The investigators will use survey data to evaluate changes in SF-12 mental health scores after an HbA1c test and brief counseling or review of health promotion literature. The SF-12 provides a calculation of (1) a physical score (PCS-12) generated from a subset of questions focused on physical health and (2) a mental health score (MCS-12) generated from a subset of questions focused on mental health. The data provided represent the mean score of the PCS-12 and MCS-12. Scores range from 0 to 100, where a zero score indicates the lowest level of physical/mental health measured by the scales and 100 indicates the highest level of physical/mental health. |
| Changes in Motivation to Prevent T2DM | Baseline, 2 weeks, 3 months, and 12 months | The investigators will use survey data to evaluate changes in motivation to prevent T2DM after an HbA1c test and brief counseling or review of health promotion literature. The Treatment Self-Regulation Questionnaire (TSRQ) was included in the survey and respondents were asked about their level of motivation from 1 (Not at all motivated) to 10 (Highly motivated). |
Countries
United States
Participant flow
Recruitment details
Veterans that met preliminary study eligibility criteria were mailed a letter about the study and were contacted by a Research Assistant 10 days later by phone to gauge their participation interest. Recruitment was conducted between December 2015 and February 2017.
Pre-assignment details
Participants that met study criteria and had an upcoming primary care appointment were sent a Baseline Survey to complete as a requirement for randomization. Those that did not complete the Baseline Survey or whose primary care appointments were cancelled and not rescheduled were not randomized and thus excluded from analysis.
Participants by arm
| Arm | Count |
|---|---|
| Blood Test Group Patients will complete an HbA1c test and then receive brief counseling and written information about their test result based on the American Diabetes Association and National Diabetes Prevention Program guidelines.
Blood Test Group Intervention: Patients randomly assigned to the Blood Test Group will complete an HbA1c blood test around the time of their next primary care appointment. Following the HbA1c test, their VA primary care provider will be notified of the test result and will be provided with a detailed interpretation of the result. Trained study staff will then provide brief counseling by phone and written information by mail about their test result. The brief counseling and written information will be based on the American Diabetes Association and National Diabetes Prevention Program guidelines and will emphasize the risk of progression to type 2 diabetes mellitus and the rationale for preventive strategies, encourage aerobic exercise and a calorie-restricted diet. | 253 |
| Brochure Group (Usual Care) Patients will not complete an HbA1c test and will instead receive brief counseling and written information about recommended screenings and immunizations.
Brochure Group Intervention: Participants will be asked to review a handout from the National Center for Health Promotion and Disease Prevention (NCP) on recommended screening tests and immunizations on or around the same date as their next primary care appointment. | 62 |
| Total | 315 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Death | 2 | 2 |
| Overall Study | Protocol Violation | 2 | 0 |
| Overall Study | Withdrawal by Subject | 1 | 0 |
Baseline characteristics
| Characteristic | Blood Test Group | Total | Brochure Group (Usual Care) |
|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 120 Participants | 150 Participants | 30 Participants |
| Age, Categorical Between 18 and 65 years | 133 Participants | 165 Participants | 32 Participants |
| Age, Continuous | 61.01 Years STANDARD_DEVIATION 10.89 | 60.98 Years STANDARD_DEVIATION 11.06 | 60.87 Years STANDARD_DEVIATION 11.83 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 7 Participants | 8 Participants | 1 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 244 Participants | 304 Participants | 60 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 2 Participants | 3 Participants | 1 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 4 Participants | 6 Participants | 2 Participants |
| Race (NIH/OMB) Asian | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Black or African American | 17 Participants | 19 Participants | 2 Participants |
| Race (NIH/OMB) More than one race | 23 Participants | 25 Participants | 2 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 3 Participants | 9 Participants | 6 Participants |
| Race (NIH/OMB) White | 206 Participants | 256 Participants | 50 Participants |
| Region of Enrollment United States | 253 Participants | 315 Participants | 62 Participants |
| Sex: Female, Male Female | 22 Participants | 27 Participants | 5 Participants |
| Sex: Female, Male Male | 231 Participants | 288 Participants | 57 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 2 / 253 | 2 / 62 |
| other Total, other adverse events | 3 / 253 | 1 / 62 |
| serious Total, serious adverse events | 0 / 253 | 0 / 62 |
Outcome results
Primary
Weight Change From Baseline to 12 Months
The primary outcome will be weight change 12 months after an HbA1c test and brief counseling or review of health promotion literature.
Time frame: 12 months
Population: The population consisted of Veterans ages 75 and younger, who were due for an HbA1c lab, and met inclusion and exclusion criteria at the time of enrollment.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Blood Test Group (Normoglycemia) | Weight Change From Baseline to 12 Months | -.995535 Pounds | Standard Deviation 15.39902 |
| Brochure Group (Usual Care) | Weight Change From Baseline to 12 Months | -2.1333341 Pounds | Standard Deviation 12.697408 |
| Blood Test Group (Prediabetes) | Weight Change From Baseline to 12 Months | .039778 Pounds | Standard Deviation 12.69741 |
| Blood Test Group (Diabetes) | Weight Change From Baseline to 12 Months | -4.17 Pounds | Standard Deviation 9.906009 |
Secondary
Change in Mental Health
The investigators will use survey data to evaluate changes in SF-12 mental health scores after an HbA1c test and brief counseling or review of health promotion literature. The SF-12 provides a calculation of (1) a physical score (PCS-12) generated from a subset of questions focused on physical health and (2) a mental health score (MCS-12) generated from a subset of questions focused on mental health. The data provided represent the mean score of the PCS-12 and MCS-12. Scores range from 0 to 100, where a zero score indicates the lowest level of physical/mental health measured by the scales and 100 indicates the highest level of physical/mental health.
Time frame: Baseline, 2 weeks, 3 months, and 12 months
Population: The population consisted of veterans ages 75 and younger, who were due for an HbA1c lab, met inclusion and exclusion criteria at the time of enrollment, and had data available for this assessment.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Blood Test Group (Normoglycemia) | Change in Mental Health | Baseline | 44.995 Score on a scale | Standard Error 9.63 |
| Blood Test Group (Normoglycemia) | Change in Mental Health | 2 weeks | 46.366 Score on a scale | Standard Error 1.018 |
| Blood Test Group (Normoglycemia) | Change in Mental Health | 3 months | 45.347 Score on a scale | Standard Error 1.037 |
| Blood Test Group (Normoglycemia) | Change in Mental Health | 12 months | 47.082 Score on a scale | Standard Error 1.082 |
| Brochure Group (Usual Care) | Change in Mental Health | 2 weeks | 46.389 Score on a scale | Standard Error 1.496 |
| Brochure Group (Usual Care) | Change in Mental Health | 3 months | 48.249 Score on a scale | Standard Error 1.531 |
| Brochure Group (Usual Care) | Change in Mental Health | 12 months | 47.308 Score on a scale | Standard Error 1.37 |
| Brochure Group (Usual Care) | Change in Mental Health | Baseline | 44.264 Score on a scale | Standard Error 1.43 |
| Blood Test Group (Prediabetes) | Change in Mental Health | 3 months | 46.926 Score on a scale | Standard Error 1.095 |
| Blood Test Group (Prediabetes) | Change in Mental Health | 2 weeks | 46.512 Score on a scale | Standard Error 1.071 |
| Blood Test Group (Prediabetes) | Change in Mental Health | 12 months | 47.58 Score on a scale | Standard Error 1.066 |
| Blood Test Group (Prediabetes) | Change in Mental Health | Baseline | 45.373 Score on a scale | Standard Error 1.086 |
| Blood Test Group (Diabetes) | Change in Mental Health | 12 months | 40.085 Score on a scale | Standard Error 4.352 |
| Blood Test Group (Diabetes) | Change in Mental Health | 2 weeks | 44.806 Score on a scale | Standard Error 2.548 |
| Blood Test Group (Diabetes) | Change in Mental Health | Baseline | 37.926 Score on a scale | Standard Error 2.291 |
| Blood Test Group (Diabetes) | Change in Mental Health | 3 months | 48.703 Score on a scale | Standard Error 3.139 |
Secondary
Change in Physical Activity
The investigators will use survey data to evaluate changes in physical activity after an HbA1c test and brief counseling or review of health promotion literature. The International Physical Activity Questionnaire - Short Form (IPAQ-SF) was used to measure physical activity change. Respondents were asked to report how many hours and minutes within the past week they completed of vigorous physical activity, moderate physical activity, and brisk walking. The total sum of minutes for these three questions were subsequently coded into a yes/no binary variable for whether respondents met a recommended 150 minutes of overall physical activity within 7 days of being assessed. The values provided reflect a proportion of respondents that met or exceeded the 150 minute threshold of overall physical activity based on the newly generated variable that combined total minutes of vigorous physical activity, moderate physical activity, and brisk walking.
Time frame: Baseline, 3 months and 12 months
Population: The population consisted of veterans ages 75 and younger, who were due for an HbA1c lab, met inclusion and exclusion criteria at the time of enrollment, and had data available for this assessment.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Blood Test Group (Normoglycemia) | Change in Physical Activity | 12 months | .489 Proportion of Respondents | Standard Error 0.043 |
| Blood Test Group (Normoglycemia) | Change in Physical Activity | 3 months | .45 Proportion of Respondents | Standard Error 0.042 |
| Blood Test Group (Normoglycemia) | Change in Physical Activity | Baseline | .542 Proportion of Respondents | Standard Error 0.044 |
| Brochure Group (Usual Care) | Change in Physical Activity | 12 months | .5 Proportion of Respondents | Standard Error 0.063 |
| Brochure Group (Usual Care) | Change in Physical Activity | 3 months | .517 Proportion of Respondents | Standard Error 0.063 |
| Brochure Group (Usual Care) | Change in Physical Activity | Baseline | .5 Proportion of Respondents | Standard Error 0.066 |
| Blood Test Group (Prediabetes) | Change in Physical Activity | Baseline | .495 Proportion of Respondents | Standard Error 0.047 |
| Blood Test Group (Prediabetes) | Change in Physical Activity | 3 months | .438 Proportion of Respondents | Standard Error 0.047 |
| Blood Test Group (Prediabetes) | Change in Physical Activity | 12 months | .457 Proportion of Respondents | Standard Error 0.047 |
| Blood Test Group (Diabetes) | Change in Physical Activity | 12 months | .364 Proportion of Respondents | Standard Error 0.145 |
| Blood Test Group (Diabetes) | Change in Physical Activity | 3 months | .091 Proportion of Respondents | Standard Error 0.087 |
| Blood Test Group (Diabetes) | Change in Physical Activity | Baseline | .273 Proportion of Respondents | Standard Error 0.138 |
Secondary
Change in Use of Medication for T2DM Prevention
The investigators will use medical record data and survey data to evaluate changes in use of medication for T2DM prevention after an HbA1c test and brief counseling or review of health promotion literature.
Time frame: 3 and 12 months
Population: The population consisted of veterans ages 75 and younger, who were due for an HbA1c lab, met inclusion and exclusion criteria at the time of enrollment, and had data available for this assessment
| Arm | Measure | Group | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|---|
| Blood Test Group (Normoglycemia) | Change in Use of Medication for T2DM Prevention | 12 months | No Metformin Use | 132 Participants |
| Blood Test Group (Normoglycemia) | Change in Use of Medication for T2DM Prevention | 3 months | No Metformin Use | 134 Participants |
| Blood Test Group (Normoglycemia) | Change in Use of Medication for T2DM Prevention | 12 months | Metformin Use | 2 Participants |
| Blood Test Group (Normoglycemia) | Change in Use of Medication for T2DM Prevention | 3 months | Metformin Use | 0 Participants |
| Brochure Group (Usual Care) | Change in Use of Medication for T2DM Prevention | 3 months | No Metformin Use | 59 Participants |
| Brochure Group (Usual Care) | Change in Use of Medication for T2DM Prevention | 12 months | No Metformin Use | 59 Participants |
| Brochure Group (Usual Care) | Change in Use of Medication for T2DM Prevention | 3 months | Metformin Use | 3 Participants |
| Brochure Group (Usual Care) | Change in Use of Medication for T2DM Prevention | 12 months | Metformin Use | 3 Participants |
| Blood Test Group (Prediabetes) | Change in Use of Medication for T2DM Prevention | 3 months | No Metformin Use | 106 Participants |
| Blood Test Group (Prediabetes) | Change in Use of Medication for T2DM Prevention | 12 months | Metformin Use | 2 Participants |
| Blood Test Group (Prediabetes) | Change in Use of Medication for T2DM Prevention | 3 months | Metformin Use | 0 Participants |
| Blood Test Group (Prediabetes) | Change in Use of Medication for T2DM Prevention | 12 months | No Metformin Use | 104 Participants |
| Blood Test Group (Diabetes) | Change in Use of Medication for T2DM Prevention | 12 months | No Metformin Use | 9 Participants |
| Blood Test Group (Diabetes) | Change in Use of Medication for T2DM Prevention | 3 months | No Metformin Use | 8 Participants |
| Blood Test Group (Diabetes) | Change in Use of Medication for T2DM Prevention | 12 months | Metformin Use | 2 Participants |
| Blood Test Group (Diabetes) | Change in Use of Medication for T2DM Prevention | 3 months | Metformin Use | 3 Participants |
Secondary
Changes in Knowledge of Strategies to Prevent T2DM
The investigators will use survey data to evaluate changes in knowledge of strategies to prevent T2DM after an HbA1c test and brief counseling or review of health promotion literature. Respondents were given 3 open-ended questions to report things they could do to prevent T2DM. Each respective response to the 3 questions were coded and scored according to whether they indicated engagement in the following activities: weight loss, physical activity, use of metformin, or enrollment into a diabetes prevention program. Each question denoted with a positive response were coded with 1 whereas those that did not were coded as a 0. The three questions were summed into a final score ranging from 0 (no report of engagement in the aforementioned healthy activities) with the worst outcome to 3 (a report of 3 of the 4 aforementioned healthy activities) with the best outcome.
Time frame: 2 weeks, 3 months, and 12 months
Population: The population consisted of veterans ages 75 and younger, who were due for an HbA1c lab, met inclusion and exclusion criteria at the time of enrollment, and had data available for this assessment.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Blood Test Group (Normoglycemia) | Changes in Knowledge of Strategies to Prevent T2DM | 12 months | 1.03 Score on a scale | Standard Deviation 0.72 |
| Blood Test Group (Normoglycemia) | Changes in Knowledge of Strategies to Prevent T2DM | 3 months | 1.04 Score on a scale | Standard Deviation 0.64 |
| Blood Test Group (Normoglycemia) | Changes in Knowledge of Strategies to Prevent T2DM | 2 weeks | 1.03 Score on a scale | Standard Deviation 0.7 |
| Brochure Group (Usual Care) | Changes in Knowledge of Strategies to Prevent T2DM | 3 months | 1.01 Score on a scale | Standard Deviation 0.67 |
| Brochure Group (Usual Care) | Changes in Knowledge of Strategies to Prevent T2DM | 2 weeks | 1.10 Score on a scale | Standard Deviation 0.65 |
| Brochure Group (Usual Care) | Changes in Knowledge of Strategies to Prevent T2DM | 12 months | 0.97 Score on a scale | Standard Deviation 0.68 |
| Blood Test Group (Prediabetes) | Changes in Knowledge of Strategies to Prevent T2DM | 2 weeks | 1.34 Score on a scale | Standard Deviation 0.77 |
| Blood Test Group (Prediabetes) | Changes in Knowledge of Strategies to Prevent T2DM | 3 months | 1.08 Score on a scale | Standard Deviation 0.66 |
| Blood Test Group (Prediabetes) | Changes in Knowledge of Strategies to Prevent T2DM | 12 months | 1.08 Score on a scale | Standard Deviation 0.69 |
| Blood Test Group (Diabetes) | Changes in Knowledge of Strategies to Prevent T2DM | 3 months | 1.09 Score on a scale | Standard Deviation 0.83 |
| Blood Test Group (Diabetes) | Changes in Knowledge of Strategies to Prevent T2DM | 12 months | 1.18 Score on a scale | Standard Deviation 0.87 |
| Blood Test Group (Diabetes) | Changes in Knowledge of Strategies to Prevent T2DM | 2 weeks | 1.09 Score on a scale | Standard Deviation 0.7 |
Secondary
Changes in Motivation to Prevent T2DM
The investigators will use survey data to evaluate changes in motivation to prevent T2DM after an HbA1c test and brief counseling or review of health promotion literature. The Treatment Self-Regulation Questionnaire (TSRQ) was included in the survey and respondents were asked about their level of motivation from 1 (Not at all motivated) to 10 (Highly motivated).
Time frame: Baseline, 2 weeks, 3 months, and 12 months
Population: The population consisted of veterans ages 75 and younger, who were due for an HbA1c lab, met inclusion and exclusion criteria at the time of enrollment, and had data available for this assessment.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Blood Test Group (Normoglycemia) | Changes in Motivation to Prevent T2DM | Baseline | 6.618 Score on a scale | Standard Error 0.239 |
| Blood Test Group (Normoglycemia) | Changes in Motivation to Prevent T2DM | 2 weeks | 6.558 Score on a scale | Standard Error 0.24 |
| Blood Test Group (Normoglycemia) | Changes in Motivation to Prevent T2DM | 3 months | 6.471 Score on a scale | Standard Error 0.229 |
| Blood Test Group (Normoglycemia) | Changes in Motivation to Prevent T2DM | 12 months | 6.793 Score on a scale | Standard Error 0.234 |
| Brochure Group (Usual Care) | Changes in Motivation to Prevent T2DM | 2 weeks | 7.246 Score on a scale | Standard Error 0.321 |
| Brochure Group (Usual Care) | Changes in Motivation to Prevent T2DM | 3 months | 7.018 Score on a scale | Standard Error 0.323 |
| Brochure Group (Usual Care) | Changes in Motivation to Prevent T2DM | 12 months | 6.981 Score on a scale | Standard Error 0.371 |
| Brochure Group (Usual Care) | Changes in Motivation to Prevent T2DM | Baseline | 7.237 Score on a scale | Standard Error 0.358 |
| Blood Test Group (Prediabetes) | Changes in Motivation to Prevent T2DM | 3 months | 7.442 Score on a scale | Standard Error 0.221 |
| Blood Test Group (Prediabetes) | Changes in Motivation to Prevent T2DM | 2 weeks | 7.67 Score on a scale | Standard Error 0.215 |
| Blood Test Group (Prediabetes) | Changes in Motivation to Prevent T2DM | 12 months | 7.207 Score on a scale | Standard Error 0.236 |
| Blood Test Group (Prediabetes) | Changes in Motivation to Prevent T2DM | Baseline | 6.676 Score on a scale | Standard Error 0.272 |
| Blood Test Group (Diabetes) | Changes in Motivation to Prevent T2DM | 12 months | 6.889 Score on a scale | Standard Error 0.897 |
| Blood Test Group (Diabetes) | Changes in Motivation to Prevent T2DM | 2 weeks | 7.9 Score on a scale | Standard Error 0.432 |
| Blood Test Group (Diabetes) | Changes in Motivation to Prevent T2DM | Baseline | 6.455 Score on a scale | Standard Error 0.627 |
| Blood Test Group (Diabetes) | Changes in Motivation to Prevent T2DM | 3 months | 7 Score on a scale | Standard Error 0.537 |
Secondary
Changes in Participation in a Weight Management Program
The investigators will use survey data to evaluate changes in participation in a weight management program after an HbA1c test and brief counseling or review of health promotion literature.
Time frame: 3 months and 12 months
Population: The population consisted of veterans ages 75 and younger, who were due for an HbA1c lab, met inclusion and exclusion criteria at the time of enrollment, and had data available for this assessment.
| Arm | Measure | Group | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|---|
| Blood Test Group (Normoglycemia) | Changes in Participation in a Weight Management Program | 3 months | Participated in weight management program | 17 Participants |
| Blood Test Group (Normoglycemia) | Changes in Participation in a Weight Management Program | 3 months | Did not participate in weight management program | 117 Participants |
| Blood Test Group (Normoglycemia) | Changes in Participation in a Weight Management Program | 12 months | Participated in weight management program | 20 Participants |
| Blood Test Group (Normoglycemia) | Changes in Participation in a Weight Management Program | 12 months | Did not participate in weight management program | 114 Participants |
| Brochure Group (Usual Care) | Changes in Participation in a Weight Management Program | 3 months | Did not participate in weight management program | 54 Participants |
| Brochure Group (Usual Care) | Changes in Participation in a Weight Management Program | 12 months | Participated in weight management program | 10 Participants |
| Brochure Group (Usual Care) | Changes in Participation in a Weight Management Program | 12 months | Did not participate in weight management program | 52 Participants |
| Brochure Group (Usual Care) | Changes in Participation in a Weight Management Program | 3 months | Participated in weight management program | 8 Participants |
| Blood Test Group (Prediabetes) | Changes in Participation in a Weight Management Program | 12 months | Participated in weight management program | 8 Participants |
| Blood Test Group (Prediabetes) | Changes in Participation in a Weight Management Program | 3 months | Did not participate in weight management program | 98 Participants |
| Blood Test Group (Prediabetes) | Changes in Participation in a Weight Management Program | 12 months | Did not participate in weight management program | 98 Participants |
| Blood Test Group (Prediabetes) | Changes in Participation in a Weight Management Program | 3 months | Participated in weight management program | 8 Participants |
| Blood Test Group (Diabetes) | Changes in Participation in a Weight Management Program | 12 months | Did not participate in weight management program | 9 Participants |
| Blood Test Group (Diabetes) | Changes in Participation in a Weight Management Program | 3 months | Did not participate in weight management program | 9 Participants |
| Blood Test Group (Diabetes) | Changes in Participation in a Weight Management Program | 3 months | Participated in weight management program | 2 Participants |
| Blood Test Group (Diabetes) | Changes in Participation in a Weight Management Program | 12 months | Participated in weight management program | 2 Participants |
Secondary
Changes in Perception for Risk for T2DM
The investigators will use survey data to evaluate changes in perception of risk for T2DM after an HbA1c test and brief counseling or review of health promotion literature. The Adriaanse T2DM Risk Perception Scale, which was included in the survey, measured self-assessed risk perception from 0 denoting no choice of developing T2DM to 100 denoting absolute confidence in developing T2DM.
Time frame: Baseline, 2 weeks, 3 months, and 12 months
Population: The population consisted of veterans ages 75 and younger, who were due for an HbA1c lab, met inclusion and exclusion criteria at the time of enrollment, and had data available for this assessment.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Blood Test Group (Normoglycemia) | Changes in Perception for Risk for T2DM | Baseline | 20.775 Score on a scale | Standard Error 1.84 |
| Blood Test Group (Normoglycemia) | Changes in Perception for Risk for T2DM | 2 weeks | 16.356 Score on a scale | Standard Error 1.704 |
| Blood Test Group (Normoglycemia) | Changes in Perception for Risk for T2DM | 3 months | 19 Score on a scale | Standard Error 1.738 |
| Blood Test Group (Normoglycemia) | Changes in Perception for Risk for T2DM | 12 months | 18.947 Score on a scale | Standard Error 1.943 |
| Brochure Group (Usual Care) | Changes in Perception for Risk for T2DM | 2 weeks | 23.684 Score on a scale | Standard Error 2.519 |
| Brochure Group (Usual Care) | Changes in Perception for Risk for T2DM | 3 months | 26.667 Score on a scale | Standard Error 3.036 |
| Brochure Group (Usual Care) | Changes in Perception for Risk for T2DM | 12 months | 23.585 Score on a scale | Standard Error 3.265 |
| Brochure Group (Usual Care) | Changes in Perception for Risk for T2DM | Baseline | 21.724 Score on a scale | Standard Error 2.611 |
| Blood Test Group (Prediabetes) | Changes in Perception for Risk for T2DM | 3 months | 35.851 Score on a scale | Standard Error 2.377 |
| Blood Test Group (Prediabetes) | Changes in Perception for Risk for T2DM | 2 weeks | 36.327 Score on a scale | Standard Error 2.41 |
| Blood Test Group (Prediabetes) | Changes in Perception for Risk for T2DM | 12 months | 32.5 Score on a scale | Standard Error 2.504 |
| Blood Test Group (Prediabetes) | Changes in Perception for Risk for T2DM | Baseline | 27.596 Score on a scale | Standard Error 2.554 |
| Blood Test Group (Diabetes) | Changes in Perception for Risk for T2DM | 12 months | 43.333 Score on a scale | Standard Error 7.183 |
| Blood Test Group (Diabetes) | Changes in Perception for Risk for T2DM | 2 weeks | 56 Score on a scale | Standard Error 6.452 |
| Blood Test Group (Diabetes) | Changes in Perception for Risk for T2DM | Baseline | 35.455 Score on a scale | Standard Error 6.112 |
| Blood Test Group (Diabetes) | Changes in Perception for Risk for T2DM | 3 months | 51.25 Score on a scale | Standard Error 6.031 |
Secondary
Changes in Self-efficacy to Engage in Behaviors to Prevent T2DM
The investigators will use survey data to evaluate changes in self-efficacy to engage in behaviors to prevent T2DM after an HbA1c test and brief counseling or review of health promotion literature. The Perceived Competence Scale was used to measure respondent self-efficacy from 1 (lowest) to 7 (highest).
Time frame: Baseline, 3 months and 12 months
Population: The population consisted of veterans ages 75 and younger, who were due for an HbA1c lab, met inclusion and exclusion criteria at the time of enrollment, and had data available for this assessment.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Blood Test Group (Normoglycemia) | Changes in Self-efficacy to Engage in Behaviors to Prevent T2DM | Baseline | 4.869 Score on a scale | Standard Error 0.134 |
| Blood Test Group (Normoglycemia) | Changes in Self-efficacy to Engage in Behaviors to Prevent T2DM | 12 months | 5.07 Score on a scale | Standard Error 0.134 |
| Blood Test Group (Normoglycemia) | Changes in Self-efficacy to Engage in Behaviors to Prevent T2DM | 3 months | 4.926 Score on a scale | Standard Error 0.125 |
| Brochure Group (Usual Care) | Changes in Self-efficacy to Engage in Behaviors to Prevent T2DM | Baseline | 5.082 Score on a scale | Standard Error 0.172 |
| Brochure Group (Usual Care) | Changes in Self-efficacy to Engage in Behaviors to Prevent T2DM | 12 months | 5.31 Score on a scale | Standard Error 0.195 |
| Brochure Group (Usual Care) | Changes in Self-efficacy to Engage in Behaviors to Prevent T2DM | 3 months | 5.005 Score on a scale | Standard Error 0.192 |
| Blood Test Group (Prediabetes) | Changes in Self-efficacy to Engage in Behaviors to Prevent T2DM | 3 months | 4.826 Score on a scale | Standard Error 0.148 |
| Blood Test Group (Prediabetes) | Changes in Self-efficacy to Engage in Behaviors to Prevent T2DM | Baseline | 4.747 Score on a scale | Standard Error 0.152 |
| Blood Test Group (Prediabetes) | Changes in Self-efficacy to Engage in Behaviors to Prevent T2DM | 12 months | 4.832 Score on a scale | Standard Error 0.151 |
| Blood Test Group (Diabetes) | Changes in Self-efficacy to Engage in Behaviors to Prevent T2DM | Baseline | 4.341 Score on a scale | Standard Error 0.445 |
| Blood Test Group (Diabetes) | Changes in Self-efficacy to Engage in Behaviors to Prevent T2DM | 12 months | 4.75 Score on a scale | Standard Error 0.57 |
| Blood Test Group (Diabetes) | Changes in Self-efficacy to Engage in Behaviors to Prevent T2DM | 3 months | 4.906 Score on a scale | Standard Error 0.432 |