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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT04347291
Other study ID # 200398
Secondary ID R01DK119282
Status Completed
Phase N/A
First received
Last updated
Start date April 28, 2020
Est. completion date February 17, 2023

Study information

Verified date December 2023
Source Vanderbilt University Medical Center
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This study evaluates a mobile phone-delivered intervention (FAMS 2.0; Family/friend Activation to Motivate Self-care) designed to help adults with type 2 diabetes set and achieve self-care goals and improve the quality of family/friend support for their goals. The investigators hypothesize that FAMS 2.0 will improve glycemic control and reduce diabetes distress among patients and reduce support burden and diabetes distress in enrolled support persons. The investigators hypothesize the mechanisms by which FAMS 2.0 will affect these outcomes for the patient include (a) increased helpful and reduced harmful family/friend involvement, (b) increased self-care (i.e., diet, physical activity, medication adherence), and (c) increased diabetes self-efficacy.


Description:

The 9-month FAMS 2.0 intervention is an expansion and improvement of a previously evaluated intervention (FAMS; NCT02481596). FAMS components include: - Monthly coaching sessions (20-30 minutes each) with patient participants by phone focusing on helpful/unhelpful/desired family and friend behaviors relevant to the patients' self-identified diet, exercise, and/or stress management goal - Daily one-way and interactive text messages to the patient to support him/her in meeting the identified daily goal and medication adherence - Weekly interactive text messages asking the patient to reflect on goal progress followed by personalized feedback from the coach - The option to invite an adult support person to receive text messages (3 one-way per week and one interactive text per week) encouraging the support person to discuss the patient's self-care goal to provide opportunities for the patient to practice skills discussed during phone coaching Participants will be randomized in a parallel design to either FAMS 2.0 or an active control. Our target enrollment is N=334 dyads (patient participants and support persons). Patients are encouraged to invite a support person, but it is not required. Patients and their support person will be randomized together (if enrolled). The study is powered to detect a 0.5% reduction in hemoglobin A1c. Analyses will examine effects at 9 months (post-intervention) and 15 months (sustained effects). The investigators will impute missing data, including all participants completing at least two data collection periods in analyses. Participants will be analyzed as randomized regardless of withdrawal from the intervention (i.e., intention-to-treat principals).


Recruitment information / eligibility

Status Completed
Enrollment 638
Est. completion date February 17, 2023
Est. primary completion date February 17, 2023
Accepts healthy volunteers No
Gender All
Age group 18 Years to 75 Years
Eligibility Inclusion Criteria: PATIENTS: - Speaks and reads in English - 18-75 years old - Diagnosed with type 2 diabetes - Receiving outpatient care from a partnering clinic - Community dwelling (e.g., not in a nursing facility) - Prescribed at least one daily diabetes medication - Owns a mobile phone SUPPORT PERSONS: - Speaks and reads in English - 18 years or older - Owns a mobile phone Exclusion Criteria: PATIENTS: - Unable to communicate by phone - Pregnant currently - Currently undergoing treatment for cancer (e.g., radiation, chemotherapy) - Diagnosed with end-stage renal disease - Receiving hospice services - Diagnosed with congestive heart failure - Diagnosed with dementia - Diagnosed with schizophrenia - Reported current abuse during screening - Demonstrates inability to receive and respond to a text - Does not take medication on his/her own/medication administered by someone else SUPPORT PERSONS: - Demonstrates inability to receive and respond to a text

Study Design


Related Conditions & MeSH terms


Intervention

Behavioral:
FAMS 2.0
FAMS components include monthly phone coaching following a semi-structured protocol plus daily automated text message support to the patient participant and less frequent automated text messages to their support person, if enrolled.
Print Materials
Quality print materials about diabetes management provided upon enrollment and in quarterly study newsletters.

Locations

Country Name City State
United States Vanderbilt University Medical Center Nashville Tennessee

Sponsors (2)

Lead Sponsor Collaborator
Vanderbilt University Medical Center National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Other Change in Diabetes Self-efficacy (Patient Participants - Outcome & Mediator) as assessed by the Perceived Diabetes Self-Management Scale with scores ranging 8 to 40 with higher scores indicating more self-efficacy (better) Baseline and 6 and 9 months post-baseline
Other Change in Dietary Behavior (Patient Participants - Outcome & Mediator) as assessed by Personal Diabetes Questionnaire, Use of Information for Decision Making Scale with scores ranging 1-6 where higher scores indicate more use of dietary information for decision making (better) Baseline and 6, 9, and 15 months post-baseline
Other Change in Dietary Behavior (Patient Participants - Outcome & Mediator) as assessed by Personal Diabetes Questionnaire, Problem Eating Behavior scale with scores ranging 1-6 where higher scores indicate more problem eating behaviors (worse) Baseline and 6, 9, and 15 months post-baseline
Other Change in Physical Activity (Patient Participants - Outcome & Mediator) as assessed by a modified Rapid Assessment of Physical Activity with scores ranging 0 to 6533 with higher scores indicating more physical activity (better) Baseline and 6, 9, and 15 months post-baseline
Other Change in Diabetes Medication Adherence (Patient Participants - Outcome & Mediator) as assessed by the Summary of Diabetes Self-Care Activities medications subscale with scores ranging 0 to 7 representing days in the prior week with perfect adherence (higher better) Baseline and 6, 9, and 15 months post-baseline
Other Change in Diabetes Medication Adherence (Patient Participants - Outcome & Mediator) as assessed by the Adherence to Refills and Medications in Diabetes scale, with scores ranging 11-44 with higher scores indicating more problems with adherence (worse) Baseline and 6, 9, and 15 months post-baseline
Other Change in Helpful Diabetes-specific Family/Friend Involvement (Patient Participants - Outcome & Mediator) as assessed by the Helpful Involvement scale of Family/friend Involvement in Adults' Diabetes with scores ranging 1 to 5 with higher scores indicating more helpful involvement (better) Baseline and 6, 9, and 15 months post-baseline
Other Change in Helpful Diabetes-specific Family/Friend Involvement (Patient Participants - Outcome & Mediator) as assessed by the Important Others Climate Questionnaire, specific to diabetes management, with scores ranging 1 to 5 with higher scores indicating more autonomy supportive communication (better) Baseline and 6, 9, and 15 months post-baseline
Other Change in Harmful Diabetes-specific Family/Friend Involvement (Patient Participants - Outcome & Mediator) as assessed by the Harmful Involvement scale of Family/friend Involvement in Adults' Diabetes with scores ranging 1 to 5 with higher scores indicating more harmful involvement (worse) Baseline and 6, 9, and 15 months post-baseline
Other Change in Harmful Diabetes-specific Family/Friend Involvement (Patient Participants - Outcome & Mediator) as assessed by the criticism items from the Family Emotional Involvement and Criticism Scale, specific to diabetes management, with scores ranging 0 to 16 with higher scores indicating more perceived criticism (worse) Baseline and 6, 9, and 15 months post-baseline
Other Change in Helpful Support Person Involvement (Support Person Participants - Outcome & Mediator) as assessed by the Helpful Involvement scale of Family/friend Involvement in Adults' Diabetes - support person version. Scores ranging 1 to 5 with higher scores indicating more helpful involvement (better) Baseline and 6, 9, and 15 months post-baseline
Other Change in Harmful Support Person Involvement (Support Person Participants - Outcome & Mediator) as assessed by the Harmful Involvement scale of Family/friend Involvement in Adults' Diabetes - support person version. Scores ranging 1 to 5 with higher scores indicating more harmful involvement (worse) Baseline and 6, 9, and 15 months post-baseline
Other Change in Support Person Involvement Alignment (Support Person Participants - Outcome & Mediator) as assessed by items from the Family Experience of Patient Involvement measure from the Diabetes Attitudes Wishes and Needs Study-2 (DAWN2). Scores range 0 to 4 where a score of 2 indicates alignment between the support person's current level of involvement and their desired level of involvement. We will report change in the % aligned (reporting a 2) across conditions. Baseline and 6, 9, and 15 months post-baseline
Primary Change in Glycemic Control (Patient Participants) During Intervention Period Hemoglobin A1c assessed by mail-in A1c kits from CoreMedica and/or taken from electronic health record (venipuncture or point-of-care) where higher values indicate worse glycemic control Baseline and 6 and 9 months post-baseline
Primary Change in Glycemic Control (Patient Participants) Sustained Post-intervention Effects Hemoglobin A1c assessed by mail-in A1c kits from CoreMedica and/or taken from electronic health record (venipuncture or point-of-care) where higher values indicate worse glycemic control Baseline and 12 and 15 months post-baseline
Primary Change in Diabetes Distress (Patient Participants) During Intervention Period Assessed by the Problem Areas in Diabetes (PAID-5) with scores ranging 0-100 where higher scores indicate more distress (worse) Baseline and 6 and 9 months post-baseline
Primary Change in Diabetes Distress (Patient Participants) Sustained Post-intervention Effect Assessed by the Problem Areas in Diabetes (PAID-5) with scores ranging 0-100 where higher scores indicate more distress (worse) Baseline and 15 months post-baseline
Primary Change in Psychosocial Well-being (Patient Participants) During Intervention Period Assessed by the World Health Organization - Five Well-Being Index (WHO-5) with scores ranging 0 to 100 where higher scores indicate more well-being (better) Baseline and 6 and 9 months post-baseline
Primary Change in Psychosocial Well-being (Patient Participants) Sustained Post-intervention Effect Assessed by the World Health Organization - Five Well-Being Index (WHO-5) with scores ranging 0 to 100 where higher scores indicate more well-being (better) Baseline and15 months post-baseline
Secondary Change in Diabetes Distress (Support Person Participants) During Intervention Period as assessed by the Problem Areas in Diabetes (PAID-5) Family Member Version. Scores range 0-100 where higher scores indicate more diabetes distress experienced by the support person (worse) Baseline and 6 and 9 months post-baseline
Secondary Change in Diabetes Distress (Support Person Participants) Sustained Post-intervention Effect Assessed by the Problem Areas in Diabetes (PAID-5) Family Member Version. Scores range 0-100 with higher scores indicate more diabetes distress experienced by the support person (worse) Baseline and 15 months post-baseline
Secondary Change in Support Burden (Support Person Participants) During Intervention Period as assessed by the Impact of Diabetes Profile-Family Members from the Diabetes Attitudes Wishes and Needs Study-2 (DAWN2). Scores range 0 to 4 where higher scores indicate greater support burden (worse) Baseline and 6 and 9 months post-baseline
Secondary Change in Support Burden (Support Person Participants) Sustained Post-intervention Effect as assessed by the Impact of Diabetes Profile-Family Members from the Diabetes Attitudes Wishes and Needs Study-2 (DAWN2). Scores range 0 to 100 where higher scores indicate greater support burden (worse) Baseline and 15 months post-baseline
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