Obesity Clinical Trial
Official title:
Evaluation of a Letter Intervention Among At-risk Adults Promoting a Plant-based Diet Using a Combination of Provider Testimonials, the Forks Over Knives Documentary, and Commitment- or Prevention-focused Behavioral Nudges
NCT number | NCT03880838 |
Other study ID # | 2019-0179 |
Secondary ID | |
Status | Completed |
Phase | N/A |
First received | |
Last updated | |
Start date | June 20, 2019 |
Est. completion date | June 30, 2022 |
Verified date | October 2023 |
Source | Geisinger Clinic |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
The researchers' mission is to promote healthier eating behavior and to reduce costs associated with healthcare. The purpose of this study is to evaluate the effects of mailing randomly selected participants a letter promoting a plant-based diet. Depending on the experimental condition, participants may additionally receive a free documentary, Forks Over Knives, and they may also get letters which use commitment- or prevention-focused messages to encourage watching the documentary and changing their eating behavior. The researchers hypothesize that receiving the documentary will be associated with lower insurance claims and improved health outcomes one and two years later. The researchers also hypothesize that using either commitment- or prevention-focused messages will also contribute to lower insurance claims and improved health outcomes compared to experimental conditions where materials did not include these messages. This study will help the researchers design evidence-supported programs that can improve people's health.
Status | Completed |
Enrollment | 11234 |
Est. completion date | June 30, 2022 |
Est. primary completion date | June 30, 2020 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - Has two out of the three following conditions: - Body mass index over 30 - Diagnosis of type 2 diabetes (specifically with at least one medication) - Diagnosis of cardiovascular disease - Has health insurance through Geisinger Health Plan (is an active member with a full 12-month enrollment in the previous year) under one of the following categories: - Medicare with required primary care provider - Medicaid - Individual policy under the Affordable Care Act - Has visited their primary care provider in the past 12 months Exclusion Criteria: - Is institutionalized - Has active cancer, cirrhosis, renal failure, dementia, or active psychosis - Is in the same household as another selected participant |
Country | Name | City | State |
---|---|---|---|
United States | Geisinger Health System | Danville | Pennsylvania |
Lead Sponsor | Collaborator |
---|---|
Geisinger Clinic |
United States,
Milkman KL, Beshears J, Choi JJ, Laibson D, Madrian BC. Using implementation intentions prompts to enhance influenza vaccination rates. Proc Natl Acad Sci U S A. 2011 Jun 28;108(26):10415-20. doi: 10.1073/pnas.1103170108. Epub 2011 Jun 13. — View Citation
Tversky A, Kahneman D. The framing of decisions and the psychology of choice. Science. 1981 Jan 30;211(4481):453-8. doi: 10.1126/science.7455683. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Medical Cost in US Dollars From One Year Before to One Year After Intervention | Total annual amount of medical and pharmacy costs (sum) as reported by Geisinger Health Plan. General linear models are used to model change between the data from the year before the intervention and the data from one year after intervention. Lower costs is the desirable outcome. | 2 years | |
Primary | Number of Visits From One Year Before to One Year After Intervention | Total number of primary care physician and specialist visits (sum) as reported by Geisinger Health Plan. General linear models are used to model change between the data from the year before the intervention and the data from one year after intervention. Fewer visits is the desirable outcome. | 2 years | |
Primary | Number of Prescriptions From One Year Before to One Year After Intervention | Total number of prescriptions (fills) as reported by Geisinger Health Plan. General linear models are used to model change between the data from the year before the intervention and the data from one year after intervention. Fewer prescriptions is the desirable outcome. | 2 years | |
Primary | Number of Unique Prescribed Medication From One Year Before to One Year After Intervention | Total number of unique prescribed medication in the past year as reported by Geisinger Health Plan. General linear models are used to model change between the data from the year before the intervention and the data from one year after intervention. Less unique prescribed medication is the desirable outcome. | 2 years | |
Primary | Body Mass Index From One Year Before to One Year After Intervention | Taken from annual checkup with primary care provider. Computed from height (in meters) and weight (in kilograms) data with the formula kilograms/meters^2. General linear models are used to model change between the data from the year before the intervention and the data from one year after intervention. A body mass index between the range of 18.5 to 25 is the desirable outcome. | 2 years | |
Primary | Systolic Blood Pressure From One Year Before to One Year After Intervention | Taken from annual checkup with primary care provider. General linear models are used to model change between the data from the year before the intervention and the data from one year after intervention. Systolic blood pressure that is 120 millimeters of mercury (mmHg) or less is the desirable outcome. | 2 years | |
Primary | Diastolic Blood Pressure From One Year Before to One Year After Intervention | Taken from annual checkup with primary care provider. General linear models are used to model change between the data from the year before the intervention and the data from one year after intervention. Systolic blood pressure that is 80 millimeters of mercury (mmHg) or less is the desirable outcome. | 2 years | |
Secondary | Triglyceride Levels From One Year Before to One Year After Intervention | One component of cholesterol, used if data is on health record. A triglyceride level of 150 milligrams per deciliter (mg/dl) or lower is the desirable outcome. | 2 years | |
Secondary | Low-density Lipoprotein (LDL) Levels From One Year Before to One Year After Intervention | One component of cholesterol, used if data is on health record. An LDL level of 100 milligrams per deciliter (mg/dl) or lower is the desirable outcome. | 2 years | |
Secondary | Five Years Before to Two Years After Intervention in Depressed Mood and Anhedonia as Assessed by the Patient Health Questionnaire-2 (PHQ-2) (Extended Time Frame) | Assesses depressed mood and anhedonia in the past two weeks; used if data is on health record. The sum of two items (each scored 0-3) is computed with a total score range of 0-6. A lower score is the desired outcome. | 7 years | |
Secondary | Hemoglobin A1c (hbA1c) From Five Years Before to Two Years After Intervention (Extended Time Frame) | Test for diabetes, used if data is on health record. Percentage score reflects blood-glucose levels. An hbA1c level of 5.7% and below is the desirable outcome. | 7 years | |
Secondary | Low-density Lipoprotein/High-density Lipoprotein (LDL/HDL) Ratios From Five Years Before to Two Years After Intervention (Extended Time Frame) | Computed as the ratio of LDL/HDL. An LDL/HDL ratio of 3 or less for men and 2.5 or less for women is the desirable outcome. | 7 years | |
Secondary | High-density Lipoprotein (HDL) Levels From Five Years Before to Two Years After Intervention (Extended Time Frame) | One component of cholesterol, used if data is on health record. An HDL level of 60 milligrams per deciliter (mg/dl) or higher is the desirable outcome. | 7 years | |
Secondary | Low-density Lipoprotein (LDL) Levels From Five Years Before to Two Years After Intervention (Extended Time Frame) | One component of cholesterol, used if data is on health record. An LDL level of 100 milligrams per deciliter (mg/dl) or lower is the desirable outcome. | 7 years | |
Secondary | Triglyceride Levels From Five Years Before to Two Years After Intervention (Extended Time Frame) | One component of cholesterol, used if data is on health record. A triglyceride level of 150 milligrams per deciliter (mg/dl) or lower is the desirable outcome. | 7 years | |
Secondary | Diastolic Blood Pressure From Five Years Before to Two Years After Intervention (Extended Time Frame) | Taken from annual checkup with primary care provider. Systolic blood pressure that is 80 millimeters of mercury (mmHg) or less is the desirable outcome. | 7 years | |
Secondary | Systolic Blood Pressure From Five Years Before to Two Years After Intervention (Extended Time Frame) | Taken from annual checkup with primary care provider. Systolic blood pressure that is 120 millimeters of mercury (mmHg) or less is the desirable outcome. | 7 years | |
Secondary | Body Mass Index From Five Years Before to Two Years After Intervention (Extended Time Frame) | Taken from annual checkup with primary care provider. Computed from height (in meters) and weight (in kilograms) data with the formula kilograms/meters^2. A body mass index between the range of 18.5 to 25 is the desirable outcome. | 7 years | |
Secondary | Number of Unique Prescribed Medication From Five Years Before to Two Years After Intervention (Extended Time Frame) | Total number of unique prescribed medication in the past year as reported by Geisinger Health Plan. Less unique prescribed medication is the desirable outcome. | 7 years | |
Secondary | Number of Prescriptions From Five Years Before to Two Years After Intervention (Extended Time Frame) | Total number of prescriptions (standard unit is prescription per number of days supplied) as reported by Geisinger Health Plan. Fewer prescriptions is the desirable outcome. | 7 years | |
Secondary | Number of Visits From Five Years Before to Two Years After Intervention (Extended Time Frame) | Total number of primary care physician and specialist visits (sum) as reported by Geisinger Health Plan. Fewer visits is the desirable outcome. | 7 years | |
Secondary | Medical Cost in US Dollars From Five Years Before to Two Years After Intervention (Extended Time Frame) | Total annual amount of medical and pharmacy costs (sum) as reported by Geisinger Health Plan. Lower costs is the desirable outcome. | 7 years | |
Secondary | Values From One Year Before to One Year After Intervention of Depressed Mood and Anhedonia as Assessed by the Patient Health Questionnaire-2 (PHQ-2) | Although originally listed as secondary, this outcome measure was intended to be exploratory. Due to the largely null pattern of results on the primary outcomes, it was decided to forgo additional analysis at this time. | 2 years | |
Secondary | Hemoglobin A1c (hbA1c) From One Year Before to One Year After Intervention | Test for diabetes, used if data is on health record. Percentage score reflects blood-glucose levels. An hbA1c level of 5.7% or lower is the desirable outcome. | 2 years | |
Secondary | Low-density Lipoprotein/High-density Lipoprotein (LDL/HDL) Ratios From One Year Before to One Year After Intervention | Computed as the ratio of LDL/HDL. An LDL/HDL ratio of 3 or less for men and 2.5 or less for women is the desirable outcome. | 2 years | |
Secondary | High-density Lipoprotein (HDL) Levels From One Year Before to One Year After Intervention | One component of cholesterol, used if data is on health record. An HDL level of 60 milligrams per deciliter (mg/dl) or higher is the desirable outcome. | 2 years |
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