Overweight (BMI > 25), Obesity
Conditions
Keywords
diabetes screening
Brief summary
Approximately 130 million Americans have prediabetes or type 2 diabetes (T2D) but remain unscreened and/or unaware of their diagnosis. While prediabetes/T2D screening, also known as glycemic screening, is endorsed in national guidelines, there is almost no research on how to increase screening rates, or evaluations of interventions testing the effectiveness of screening promotion strategies. The American Medical Association has published prediabetes quality measures that apply to UCLA Health as well as all other health systems, specifically tracking the percentage of adult patients with risk factors for T2D due for glycemic screening for whom the screening process was initiated. However, there is no current systemic effort underway at UCLA, or most other health systems, to encourage glycemic screening. We are proposing a pilot trial of the first SMART (Sequential Multiple Assignment Randomized Trial) for glycemic screening. Our SMART experiment will provide preliminary feasibility and acceptability data for a larger, multisite trial that will provide vital guidance to optimize screening approaches for a growing number of screening-eligible patients so that they may seek earlier detection, treatment, and/or access to lifestyle programs and interventions for T2D or prediabetes.
Interventions
BEHAVIORALText message
Participants receive a text message encouraging glycemic screening
BEHAVIORALPatient portal message
Participants receive a patient portal message encouraging glycemic screening
BEHAVIORALMailed letter
Participants receive a mailed letter encouraging glycemic screening
Sponsors
University of California, Los Angeles
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
SCREENING
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
35 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Overweight or obese
Exclusion criteria
* Existing type 2 diabetes, A1c drawn within past 3 years
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Hemoglobin A1c | 90 days | Receipt of hemoglobin A1c screening for dysglycemia |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Acceptability Survey | 90 Days | The survey contained 5 questions, in Likert response format, and possible total scores ranged from 0 - 24 , with higher scores indicating better satisfaction. 1. How did you feel about the messages recommending that you come in for a blood test to check your hemoglobin A1c (blood sugar) level - Likert responses (Very positive, positive, neutral, negative, very negative) 2. How clear were the messages recommending that you come in for a blood test to check your hemoglobin A1c (blood sugar) level - Likert responses (Very clear, somewhat clear, neutral, somewhat unclear, very unclear) 3. Did the messages affect the chances that you would get the hemoglobin A1c (blood sugar) level - Likert responses (Major effect, moderate effect, neutral, minor effect, no effect) 4. Did the messages cause you any anxiety or stress - Likert responses (To a great extent, somewhat, very little, not at all) 5. How concerned were you that the messages were from scammers not associated with |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORObidiugwu K Duru, MD, MS
University of California, Los Angeles
Participant flow
Pre-assignment details
PCPs requested that we not enroll 12 potential participants, so while we recruited 113 participants only 102 received the intervention. Because this intervention was consistent with standard of care, we had IRB approval to waive informed consent. Therefore, we sent messages to all 102 individuals who were approved to participate by their PCP
Baseline characteristics
| Characteristic | — |
|---|---|
| Age, Categorical <=18 years | 0 Participants |
| Age, Categorical >=65 years | 0 Participants |
| Age, Categorical Between 18 and 65 years | 96 Participants |
| Race/Ethnicity, Customized Asian | 4 Participants |
| Race/Ethnicity, Customized Black | 1 Participants |
| Race/Ethnicity, Customized White, Hispanic | 2 Participants |
| Race/Ethnicity, Customized White, Non-Hispanic | 64 Participants |
| Sex: Female, Male Female | 6 Participants |
| Sex: Female, Male Male | 11 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk | EG004 affected / at risk |
|---|---|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 16 | 0 / 17 | 0 / 17 | 0 / 18 | 0 / 34 |
| other Total, other adverse events | 0 / 16 | 0 / 17 | 0 / 17 | 0 / 18 | 0 / 34 |
| serious Total, serious adverse events | 0 / 16 | 0 / 17 | 0 / 17 | 0 / 18 | 0 / 34 |
Outcome results
None listed