Diabetes, Hypertension, Overweight and Obesity, Pre-diabetes
Conditions
Keywords
CEAL-DMV, Community Engagement Alliance, Diabetes, Hypertension, Pre-diabetes
Brief summary
The Community Engagement Alliance against Disparities - Washington District of Columbia, Maryland, Virginia (CEAL DMV), is a multi-community and multi-university consortium. Through collaboration and shared leadership, the CEAL-DMV the consortium- comprising five institutions: George Washington University, Howard University, Johns Hopkins University, Morgan State University, and the University of Maryland, Baltimore-has established a regional structure for bi-directional community involvement to engender trust and foster communication. Each site builds on thriving community partnerships, which have been instrumental in enhancing trust, community capacity, and readiness to reduce health disparities.
Detailed description
The investigators propose to evaluate the effect of a multi-level, community-digital health promotion intervention, compared to delayed control intervention, at improving health and social service utilization, and the prevention and management of hypertension, diabetes, overweight and obesity. The evidence-based intervention is based on substantial evidence supporting the role of Community Health Workers in health promotion and reduction of risks associated with chronic diseases. Studies have demonstrated community health worker (CHW) intervention success at improving chronic disease risks and management, including for hypertension and diabetes, through support in implementing clinical recommendations, overcoming barriers to lifestyle behavior change, achieving personal goals, and preventing complications. Additionally, there is substantial evidence supporting digital approaches for the prevention and management of cardiometabolic diseases. The proposed intervention and methods also build on almost three years of CEAL DMV collaboration with community partners. At the community level, core activities will focus on capacity building to ensure the trusted community-based organization partners are fully supported in the implementation of community-digital strategies to address hypertension, diabetes, overweight and obesity.
Interventions
BEHAVIORALMulti-level, community-digital health promotion intervention
Community level activities: 1. Capacity building for community-based organizations, and 2. Community health workers will facilitate linkage to community resources, including health/social service access referrals and client social support. Individual level activities: 1. Goal setting and self-monitoring, 2. Tailored feedback, 3. Personalized lifestyle coaching, health and social service referral support, and 4. Digital access and digital health literacy skills building Social network: 1. Social network-based activities, and 2. Digital health literacy skills building
Sponsors
Johns Hopkins University
Baltimore CONNECT
Coaching Salud Holistica
La Clinica del Pueblo
Rivera Group
The Medi Inc.
Westat
Study design
Allocation
RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
Randomized delayed control group with phased recruitment design
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Self-identify as Black or Latino * Age 18 years or older * Reside in defined geographic area * Diagnosis of one or more target conditions: Prediabetes/Diabetes (HbA1c 5.7%), Hypertension (≥130/80 mm Hg), Overweight/obesity (BMI \>25 kg/m\^2)
Exclusion criteria
* Unable to provide informed consent * No access to phone/internet
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Service utilization as assessed by the number of participants who use referral services | 6 and 9 months | Utilization will be calculated by the total number of participants who use services referred to by the community health workers. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Satisfaction with health and health-related social services as assessed by a 3-point Likert Scale | 6 and 9 months | Participants who utilize health and/or social services will be asked if satisfied with services received from health workers (i.e health care providers, mental health professionals and community health workers) using a a 3 point likert scale ranging from 1-3. Higher values would imply higher satisfaction). |
| Body mass index (BMI) in kg/m^2 | 6 and 9 months | Body mass index (BMI) in kg/m\^2 as assessed by weight-to-height ratio |
| Blood pressure | 6 and 9 months | Systolic and diastolic blood pressure (mmHg) |
| Hemoglobin A1c (HbA1c) levels | 6 and 9 months | Pre-diabetes and diabetes management as assessed by Hemoglobin A1c levels |
| Trust in health research and information sources as assessed by the Trust in Medical Research Survey | 6 and 9 months. | Trust in Medical Research Survey, distrust sub-scale ranges from 0 to 20 with lower scores indicating better trust; trust sub-scale ranges from 0 to 24, higher scores mean better trust |
| Social determinants of health as assessed by the Health Related Social Needs Tool | 6 and 9 months. | Health Related Social Needs Tool, scores ranging from 0 to 36; higher scored indicate higher need |
| Self-reported exercise frequency | 6 and 9 months | Exercise frequency will be assessed by number of days per week a participant engages in moderate to strenuous exercise |
| Self-reported intake of regular soda or pop that contains sugar. | 6 and 9 months | Participants will report the frequency of consumption of regular soda or pop that contains sugar each week. Higher number of times/week represents a worse outcome. |
| Self-reported sweetened fruit drinks intake | 6 and 9 months | Participants will report the number of times they consumed sweetened fruit drinks per week. Higher number of times/week represents a worse outcome. |
| Self-reported fruit intake | 6 and 9 months | Participants will report the frequency of consumption of fruits per week. Higher number of times/week represents a better outcome. |
| Self-reported intake of green leafy or lettuce salad | 6 and 9 months | Participants will report the frequency of consumption of green leafy or lettuce salad each week. Higher number of number of times/week represents a better outcome. |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORCheryl Himmelfarb, PhD, MSN, BS
Johns Hopkins University
Outcome results
None listed