Cardiovascular Risk Factor, Diabetes Mellitus Risk, Obesity
Conditions
Keywords
diabetes, prevention, risk, obesity, weight loss, community based
Brief summary
(Sisters Health And Primary CarE Uniting and Preventing Diabetes; aka SHAPE UP) will consist of: 1) Neighborhood DPP Intervention: group DPP sessions and individual coaching; 2) Preventive Care Coordination to FQHC: referral, navigation assistance, patient activation, linkage to primary care (community initiated referrals) and linkage to DPP program (FQHC initiated referrals)
Detailed description
SHAPE-UP we will use a randomized between groups wait-list design wherein the experimental treatment will be compared to best practices FHCN/FQHC services waitlist control (with an educational supplement for control). At the 24-week point, the waitlist control participants will be invited to receive the intervention. This combines a between groups RCT design with a phase change/within-group design for maximum efficiency with a limited N. Randomization will occur at the level of the individual participant. To sustain participant interest and to address obesity-related needs, control arm participants will receive Best Practices services including 1) Individual counseling about pre-diabetes risk at baseline; 2) mailed written materials at weeks 6, 12, 18; and 3) As needed additional FQHC Primary Care services (as mentioned, referral to the DPP obesity intervention and FHCN/FQHC primary care services will be bidirectional. The RE-AIM framework will guide process and impact evaluation measures of this intervention.
Interventions
BEHAVIORAL24 week community based DPP Group Lifestyle Balance Program
a) 12 weekly peer group (adapted Group Lifestyle Balance Program) sessions followed by 3 monthly group maintenance sessions held in Public Housing locations; b) Individual coaching and patient activation during 24 week period; 2) Community Outreach Care Coordination: Referral, navigation assistance, patient activation, and cross-linkage to FQHC services.
BEHAVIORALWait-List Control community based DPP Group Lifestyle Balance Program
Control arm participants will receive: 1) Usual care in FQHC/primary care clinic 2) Individual counseling about pre-diabetes risk at baseline; mailed written NIDDK patient education materials (weight loss, physical activity, nutrition) at weeks 6, 12, 18; 2) At the end of the 24 week intervention, the wait list control arm will be invited to participate and receive the group based DPP sessions.
Sponsors
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Medical University of South Carolina
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
PREVENTION
Masking
DOUBLE (Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
21 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
1. 21 years of age or older 2. Body-mass index of \> 25 kg/m2 or waist circumference \>35 inches 3. ADA diabetes risk assessment \> at risk for pre-diabetes 4. Casual capillary blood glucose \> 110 mg/dl \<200 5. Access to phone 6. Resident in or surrounding partnering Public Housing neighborhood and eligible for FHCN services
Exclusion criteria
1. Exclusions for diseases likely to limit lifespan and/or increase risk of interventions: a) Cancer requiring treatment in the past 5 years; b) Cardiovascular disease: Yes response to any item on the modified Physical Activity Readiness Questionnaire; Uncontrolled hypertension: SBP \>180 mmHg or DBP \>105 mmHg; Heart attack, stroke, or transient ischemic attack in the past 6 months; c) Lung disease: Chronic obstructive airways disease or asthma requiring home oxygen 2. Exclusions related to metabolism: a) Diabetes at baseline; b) Casual capillary blood glucose \>200 mg/dl; c) History of anti-diabetic medication use (oral agents or insulin) except during gestational diabetes; d) Pregnant female; e) Self-report of disease associated with disordered glucose metabolism: Cushing's syndrome; acromegaly; pheochromocytoma; chronic pancreatitis 3. Exclusion for conditions or behaviors likely to affect the conduct of the study: a) Unable or unwilling to provide informed consent; b) Unable to read written English
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in BMI | Wk. 12 and 24 | weight and height will be combined to report BMI in kg/m\^2) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Diet and exercise Behaviors | Wk 12 and 24 | Assessed by the Health Promoting Lifestyle Profile II |
| Change in Waist circumference | Wk 12 and 24 | waist (abdominal) circumference in centimeters |
| Change in Lipids (LDL, HDL, Total Cholesterol and Triglycerides) | Wk. 12 and 24 | Measured using a capillary blood sample Cholestech LDX |
| Change in A1C | Wk 12 and 24 | Measured using a capillary blood sample DCA 2000 analyzer |
Outcome results
None listed