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Micro-Clinic Obesity and Metabolic Risk Prevention Program

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01651065
Recruitment Status : Completed
First Posted : July 26, 2012
Last Update Posted : March 17, 2016
Bell County Department of Health, Kentucky
Information provided by (Responsible Party):
Microclinic International

Brief Summary:
The purpose of this randomized trial is to study the efficacy of a novel social propagation intervention which integrates social network induction with health education for weight and metabolic control among patients with type 2 diabetes, BMI of 25-30+, and cardiovascular disease. The intervention takes place in the form of a community health program, where participants who enroll in this program will be asked if they would like to take part in the study to evaluate its efficacy. Thus, the investigators will study the efficacy of social networks in propagating changes in lifestyle factors for diabetes and chronic disease management

Condition or disease Intervention/treatment Phase
Diabetes Mellitus, Type II Heart Disease Obesity Hypertension Dyslipidemia Behavioral: Microclinic Diabetes Education Program Behavioral: Control Not Applicable

Detailed Description:

The potential to harness the propagating power of social networks for chronic disease treatment and management, such as for diabetes and obesity, is an emerging area in epidemiology and clinical research. Social induction for disease management has been effectively leveraged for disease management, but we have not carefully disaggregated of different layers and modalities of social network effects in this context. This study will test and demonstrate this through a novel randomized trial.

The randomized design is comprised of 2 arms. 1) Intervention Group: This arm takes part in a 10-month (9-month for Phase 2, cycles 1 and 2) diabetes, weight, and cardiovascular disease education and management program in combination with the microclinic social support model. A microclinic is a support group of 2-6 individuals from the same social network who learn how to manage their disease together. 2) Control Group: This is a control arm with observational parallel assessments of metabolic and lifestyle risk factors alone (implemented in Phase 1 and 2, cycles 1 and 2). Each arm will take part in a 6-month follow-up. The investigators also aim to study the intervention effects of social networks in improving lifestyle risk factors on a small sample of Phase 1 controls in a repeated measures design. Observational controls with 7 repeated measures in Phase 1 (pre-intervention) will receive the 9-month diabetes, weight, and cardiovascular disease education and management program with microclinic social support model condensed in a 4-6 months program. The controls in this cycle will also receive 17 medical screenings during the intervention, and 6-month follow-up (post-intervention).

Aim 1- (Phase 1 and 2, Cycles 1 & 2)

To evaluate the efficacy of the microclinic intervention group versus observational control in improving lifestyle factors and metabolic outcome.

Aim 2- (Phase 2, Cycle 3)

To examine the effect of the microclinic intervention by comparing pre- and post measures among those who were first controls in Phase 1 and then participated in the microclinic intervention Phase 2, Cycle 3.

AIM 3- (Phases 1 & 2, cycles 1, 2, and 3)

To differentiate the modalities of social network effects: direct causal induction versus homophilly, and to determine the extent of long-term temporal cross-propagating effects between-persons in a microclinic group.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 919 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Prevention
Official Title: Micro-Clinic Obesity and Metabolic Risk Prevention Program: A Randomized-Control Trial of a Social-Network Based Intervention
Study Start Date : June 2011
Actual Primary Completion Date : December 2014
Actual Study Completion Date : December 2014

Arm Intervention/treatment
Experimental: Microclinics Group A
Subjects will be receiving a 10/9-month Microclinic Diabetes Education Program (Team Up 4 Health) and 6 months of follow up. In the intervention these subjects will engage in the Microclinic Program support groups. The intervention program consists of 25 event sessions. Sessions are offered weekly the first month, and biweekly thereafter.
Behavioral: Microclinic Diabetes Education Program

The microclinic intervention leverages different levels of social networks to positively influence behaviors relating to diabetes and other metabolic conditions through small treatment units called, 'microclinic groups (MC),' consisting of 2-6 friends and family members of the same social network, which lead to a larger network of 'classes' and cohorts.

The program provides MC subjects with shared access to health education and group support to promote glycemic and metabolic control through diet, exercise, and treatment adherence. MC members play a role in the collective effort to combat diabetes and solidifying self-management behavioral skills through peer-monitoring and encouragement of lifestyle behaviors.

Placebo Comparator: Group C Controls
Individuals will receive screening by clinical staff. Control group subjects will receive clinic screenings only; they will not participate in program activities.
Behavioral: Control

Primary Outcome Measures :
  1. Weight [ Time Frame: Seven collected time points from baseline until final session at 10/9 months ]
    Change in weight overtime

Secondary Outcome Measures :
  1. Waist circumference [ Time Frame: Seven collected time points from baseline until final session at 10/9 months ]
    Change in waist measurement overtime

  2. Blood pressure [ Time Frame: Seven collected time points from baseline until final session at 10/9 months ]
    Change in systolic/diastolic blood pressure overtime

  3. HDL [ Time Frame: Seven collected time points from baseline until final session at 10/9 months ]
    Change in HDL overtime

  4. Hemoglobin A1c (%, HbA1c) [ Time Frame: Seven collected time points from baseline until final session at 10/9 months ]
    Change in HbA1c overtime

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Must be enrolled in our community health program.
  • Over the age of 18
  • BMI of 30 or higher, or
  • BMI of 25 or higher AND must be diagnosed with at least one additional risk factor 1) type 2 diabetes, 2) high blood pressure, and/or 3) high cholesterol
  • For those who will be participating in the cross-over sub-sample, they must have previously participated in Phase 1 as subject of the control group, or

Exclusion Criteria:

  • Patients who are not enrolled in the our community health education program (applies to Phase 1 only)
  • Are not able to provide informed consent for themselves
  • Under the age of 18
  • Has undergone weight loss surgery
  • Pregnant women*

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01651065

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United States, Kentucky
Bell County Health Department
Pineville, Kentucky, United States, 40977
Sponsors and Collaborators
Microclinic International
Bell County Department of Health, Kentucky
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Principal Investigator: Daniel E Zoughbie, D.Phil. Microclinic International
Principal Investigator: Eric L Ding, Sc.D. Harvard School of Public Health
Additional Information:
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Responsible Party: Microclinic International Identifier: NCT01651065    
Other Study ID Numbers: 20110766
First Posted: July 26, 2012    Key Record Dates
Last Update Posted: March 17, 2016
Last Verified: March 2016
Additional relevant MeSH terms:
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Heart Diseases
Diabetes Mellitus, Type 2
Cardiovascular Diseases
Nutrition Disorders
Body Weight
Lipid Metabolism Disorders
Metabolic Diseases
Diabetes Mellitus
Glucose Metabolism Disorders
Endocrine System Diseases