Building a Healthy Temple: a Diabetes Self-management Support Program in Hispanic Faith Community Settings
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|ClinicalTrials.gov Identifier: NCT03934593|
Recruitment Status : Recruiting
First Posted : May 2, 2019
Last Update Posted : May 2, 2019
|Condition or disease||Intervention/treatment||Phase|
|Type2 Diabetes Mellitus||Behavioral: Faith-Based (FB, BHT DSMS) Other: Faith-Placed (FP, Stanford DSMP)||Not Applicable|
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||360 participants|
|Intervention Model:||Parallel Assignment|
|Intervention Model Description:||We will conduct a cluster randomized trial with repeated measures to compare the effectiveness of BHT DSMS intervention strategies among 360 adult diabetic congregants from 18 predominantly Hispanic churches in San Antonio, Texas (20 participants/church).|
|Masking Description:||Using cluster randomized trial design; nine churches will be randomly assigned to the FB intervention (BHT DSMS), and nine to the FP intervention (Stanford DSMP).|
|Primary Purpose:||Supportive Care|
|Official Title:||Building a Healthy Temple: a Diabetes Self-management Support Program in Hispanic Faith Community Settings|
|Actual Study Start Date :||January 1, 2017|
|Estimated Primary Completion Date :||June 30, 2020|
|Estimated Study Completion Date :||June 30, 2020|
Experimental: Faith-Based (FB, BHT DSMS)
The BHT DSMD intervention strategies adapted Stanford DSMP in a spiritual context is used in this group. Participants in the FB group will participate in BHT DSMS, which includes a Health Sermon, a 6-session Health Bible Study with cooking demonstrations, the Stanford DSMP and a Diabetes Resource Seminar delivered by two trained church lay leaders.
Behavioral: Faith-Based (FB, BHT DSMS)
BHT DSMS Intervention components include Health Sermon and a 6-session Health Bible Study with cooking demonstrations, followed by the Stanford DSMP and a Diabetes Resource Seminar. All intervention activities are implemented by trained church lay leaders.
Active Comparator: Faith-Placed (FP, Stanford DSMP)
The traditional Stanford DSMP is conducted in this control group. Participants in the FP group will first attend a 7-session community health and safety curriculum as a partial attention control intervention, followed by the Stanford DSMP and Diabetes Resource Seminar facilitated by the local public health department.
Other: Faith-Placed (FP, Stanford DSMP)
Standard Stanford DSMP delivered by health professional
- The change in HbA1c [ Time Frame: Data is collected at baseline, 6, 9, and 12-months during the study period. ]A finger-prick blood sample will be collected for HbA1c testing using Metrika A1cNowTM (Bayer Health Care).
- Waist circumference [ Time Frame: Data is collected at baseline, 6, 9, and 12-months during the study period. ]waist circumference (WC) will measured in the horizontal plane midway between the lowest rib and the iliac crest.
- Body Mass Index [ Time Frame: Data is collected at baseline, 6, 9, and 12-months during the study period. ]Participants' body weight and height will be measured. BMI will be calculated height and weight (kg/M2)
- Quality of Life (QoL) [ Time Frame: Data is collected at baseline, 6, 9, and 12-months during the study period. ]Quality of life in present study will be measured using the Problem Areas in Diabetes (PAID) scale (Polonsky and Anderson, 1995). The PAID measure of diabetes related emotional distress correlates with measures of related concepts such as depression, social support, health beliefs, and coping style, as well as predicts future blood glucose control of the patient. Questionnaire scale scoring: Each question has 5 possible answers with a value from 0 to 4, with 0 representing "no problem" and 4 "a serious problem". The scores are added up and multiplied by 1.25, generating a total score between 0 - 100. Patients scoring 40 or higher may be at the level of "emotional burnout" and warrant special attention. PAID scores in these patients may drop 10-15 points in response to
- Diabetes Self-care practices [ Time Frame: Data is collected at baseline, 6, 9, and 12-months during the study period. ]The Revised Summary of Diabetes Self-Care Activities (SDSCA) (Toobert, Hampson, and Glasgow, 2000). It is a 25-item self-report measure of the frequency of performing diabetes self-care tasks over the preceding 7 days. The response is based on a seven-point Likert scale to answer the question phrased as "On how many of the last 7 days did you…?". Higher overall scores reflect good diabetes self-care practice.
- The barriers to diabetes care. [ Time Frame: Data is collected at baseline, 6, 9, and 12-months during the study period. ]The barriers to diabetes care are investigated using selected questions from the National Survey of People with Diabetes (Harris, McGee, and Andrews, 2007).
- Physical Activity (PA) level assessment [ Time Frame: Data is collected at baseline, 6, 9, and 12-months during the study period. ]A 6-item Exercise Behaviors scale (Lorig et al 1996) measures total minutes per week of aerobic and nonaerobic exercise specifically over the past seven days. The first question measures the amount of time that the participant stretched or engaged in any strengthening exercises. The other five questions measures aerobic activity. The options for the questions include none, less than 30 minutes per week, 30-60 minutes per week, 1-3 hours per week, and more than 3 hours per week. The total aerobic and stretching and/or strengthening minutes were calculate by converting the "None" category to 0 minutes; "Less than 30 minutes/week" into 15 minutes; "30-60 minutes/week" into 45 minutes; "1-3 hours/week" into 120 minutes; and "More than 3 hours/week" into 180 minutes.(6) The response to the first question was used to determine the amount of time for stretching/strengthening while questions 2 through 6 were summed together to determine the amount of aerobic time.
- Occupational physical activity [ Time Frame: Data is collected at baseline, 6, 9, and 12-months during the study period. ]Occupational physical activity also is evaluated using a single-item question recommended by Behavioral Risk Factor Surveillance System (BRFSS) which is designed to categorize occupational physical activity into three components: 1) mostly sitting and standing (inactivity and low-intensity activity); 2) mostly waling (moderate-intensity activity); or 3) mostly heavy labor (vigorous-intensity activity) (www.cdc.gov/brfss/; Yore MM, Bowles HR, 2006)
- Diabetes self-efficacy [ Time Frame: Data is collected at baseline, 6, 9, and 12-months during the study period. ]Diabetes self-efficacy scale will assess participants' diabetes self-efficacy (Sarkar, Fisher and Schillinger, 2006). It is an 8-item instrument assessing diabetic individual's self-management efficacy. These items addressed diabetes-specific domains such as confidence in self-monitoring of blood glucose (SMBG), as well as general health domains such as confidence in ability to get medical attention and take care of health using 4-point Likert-scale with responses from "1 = not at all sure" to "4 = very sure." For each item patients rated their confidence in their ability to perform a recommended self-care routine. The overall self-efficacy score are transformed to a 100-point scale with a higher score representing greater self-efficacy.
- Social support in a spiritual context [ Time Frame: Data is collected at baseline, 6, 9, and 12-months during the study period. ]Social support in a religion context will be measured using the instrument by Olphen et al.(2003) that assess the frequency with which participants receive support from other church members by asking "How often do people in your church or place of worship help you out? The answer options include "1= never; 2= hardly ever; 3= not too often; 4= fairly often and 5= very". Higher scores indicate greater levels of level of support.
- Social support for diabetes self-management [ Time Frame: Data is collected at baseline, 6, 9, and 12-months during the study period. ]• Social support for self-management will be assessed using modified Social Support Scale for Self-care in Middle-aged patients with type II diabetes (S4-MAD) (Naderimagham S, Niknami S, 2012) The questions in S4-MAD will be re-classified to evaluate the social support in emotional and information support, tangible support, affectionate support, positive support and additional support (www.rand.org). The social support resources include "Are you attending worship service at this church?", "Who help you the most in caring for your diabetes outside of church?", "Who helps you the most I caring for your diabetes within the church?". The responses will be "1 = Never; 2 = Rarely; 3 = Sometimes; 4 = Often; 5 = Always". The higher score reflects better spiritual coping.
- Spiritual coping [ Time Frame: Data is collected at baseline, 6, 9, and 12-months during the study period. ]Spiritual coping in the DSMP context will be measured by adapting the RCOPE (Pargament, Koenig, and Perez) instrument particularly measuring spiritual coping strategies identified by diabetic individuals. Areas include "I pray to and believe in God", "God keeps me alive", "I turn things over to God", "God changes my unhealthy behaviors", "God supplies my needs", "I read the Bible", and "I ask religious or spiritual individuals help me". The responses will be "1 = Not at all; 2 = Somewhat; 3 = Quite a bit; 4 = A great deal". The higher score reflects better spiritual coping.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03934593
|Contact: Meizi He, PhDfirstname.lastname@example.org|
|Contact: Leah Carrillo, MSemail@example.com|
|United States, Texas|
|Human Nutrition Lab, UTSA||Recruiting|
|San Antonio, Texas, United States, 78249|
|Contact: Christian Umana, B.Sc. 210-458-7408 firstname.lastname@example.org|
|Contact: Meizi He, PhD 210-458-5416 email@example.com|
|Principal Investigator: Meizi He, PhD|
|Principal Investigator:||Meizi He, PhD||The University of Texas at San Antonio|