Trial Outcomes & Findings for Cognitive Behavioral Therapy for African Americans With Uncontrolled Type-2 Diabetes (NCT NCT03562767)

NCT ID: NCT03562767

Last Updated: 2023-08-02

Results Overview

Feasibility of the intervention will be measured as the percentage of participants who complete the study. The intervention will be considered feasible if no more than 20% of participants are lost to follow up.

Recruitment status

TERMINATED

Study phase

NA

Target enrollment

20 participants

Primary outcome timeframe

3 months post randomization

Results posted on

2023-08-02

Participant Flow

A control group was intended to be added to the study, but the study team decided not to complete this additional research due to the pandemic. Additional funds were not available to enroll a new control group and thus, the study was terminated.

Participant milestones

Participant milestones
Measure
Group-based Cognitive Behavioral Intervention
Subjects receiving the group-based CT-CB intervention Group-based Cognitive Behavioral Intervention: This intervention will include six 1-hour group sessions held biweekly for twelve weeks. Each sixty-minute session will consist of 15 minutes of diabetes education regarding exercise and food planning and approximately 45 minutes of CT-CB presentations/engagement activities. Participants will be encouraged to bring along their family members or friends for support.
Web-based Cognitive Behavioral Intervention
Subjects receiving the web based CT-CB intervention Web-based Cognitive Behavioral Intervention: This intervention will include six 1-hour web-based sessions held biweekly for twelve weeks. Subjects in the web-based CT-CB will be asked to reserve a 1 hour period for a web call from the Behavioral Interventionist team. Text reminders will be sent to the participants prior the sessions. During this period, approximately 15 minutes will be reserved for diabetes exercise and food planning education and approximately 45 minutes of CT-CB engagement activities.
Usual Care
Subjects receiving usual care from their primary care providers Usual Care: Usual care group participants will continue to receive care and follow up from their primary care providers as per the American Diabetes Association guidelines with log books, education regarding self-management strategies and appropriate referrals as needed.
Overall Study
STARTED
10
10
0
Overall Study
COMPLETED
7
7
0
Overall Study
NOT COMPLETED
3
3
0

Reasons for withdrawal

Reasons for withdrawal
Measure
Group-based Cognitive Behavioral Intervention
Subjects receiving the group-based CT-CB intervention Group-based Cognitive Behavioral Intervention: This intervention will include six 1-hour group sessions held biweekly for twelve weeks. Each sixty-minute session will consist of 15 minutes of diabetes education regarding exercise and food planning and approximately 45 minutes of CT-CB presentations/engagement activities. Participants will be encouraged to bring along their family members or friends for support.
Web-based Cognitive Behavioral Intervention
Subjects receiving the web based CT-CB intervention Web-based Cognitive Behavioral Intervention: This intervention will include six 1-hour web-based sessions held biweekly for twelve weeks. Subjects in the web-based CT-CB will be asked to reserve a 1 hour period for a web call from the Behavioral Interventionist team. Text reminders will be sent to the participants prior the sessions. During this period, approximately 15 minutes will be reserved for diabetes exercise and food planning education and approximately 45 minutes of CT-CB engagement activities.
Usual Care
Subjects receiving usual care from their primary care providers Usual Care: Usual care group participants will continue to receive care and follow up from their primary care providers as per the American Diabetes Association guidelines with log books, education regarding self-management strategies and appropriate referrals as needed.
Overall Study
Physician Decision
2
0
0
Overall Study
Logistic Reason
1
3
0

Baseline Characteristics

Cognitive Behavioral Therapy for African Americans With Uncontrolled Type-2 Diabetes

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Group-based Cognitive Behavioral Intervention
n=7 Participants
Subjects receiving the group-based CT-CB intervention Group-based Cognitive Behavioral Intervention: This intervention will include six 1-hour group sessions held biweekly for twelve weeks. Each sixty-minute session will consist of 15 minutes of diabetes education regarding exercise and food planning and approximately 45 minutes of CT-CB presentations/engagement activities. Participants will be encouraged to bring along their family members or friends for support.
Web-based Cognitive Behavioral Intervention
n=7 Participants
Subjects receiving the web based CT-CB intervention Web-based Cognitive Behavioral Intervention: This intervention will include six 1-hour web-based sessions held biweekly for twelve weeks. Subjects in the web-based CT-CB will be asked to reserve a 1 hour period for a web call from the Behavioral Interventionist team. Text reminders will be sent to the participants prior the sessions. During this period, approximately 15 minutes will be reserved for diabetes exercise and food planning education and approximately 45 minutes of CT-CB engagement activities.
Usual Care
Subjects receiving usual care from their primary care providers Usual Care: Usual care group participants will continue to receive care and follow up from their primary care providers as per the American Diabetes Association guidelines with log books, education regarding self-management strategies and appropriate referrals as needed.
Total
n=14 Participants
Total of all reporting groups
Age, Customized
<55 Years Old
4 Participants
n=5 Participants
1 Participants
n=7 Participants
0 Participants
n=5 Participants
5 Participants
n=4 Participants
Age, Customized
≥55 Years Old
3 Participants
n=5 Participants
6 Participants
n=7 Participants
0 Participants
n=5 Participants
9 Participants
n=4 Participants
Sex: Female, Male
Female
5 Participants
n=5 Participants
6 Participants
n=7 Participants
11 Participants
n=4 Participants
Sex: Female, Male
Male
2 Participants
n=5 Participants
1 Participants
n=7 Participants
3 Participants
n=4 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Black or African American
7 Participants
n=5 Participants
7 Participants
n=7 Participants
0 Participants
n=5 Participants
14 Participants
n=4 Participants
Race (NIH/OMB)
White
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Region of Enrollment
United States
7 participants
n=5 Participants
7 participants
n=7 Participants
14 participants
n=4 Participants
BMI
Normal (BMI 18.5-24.9 kg/m^2)
1 Participants
n=5 Participants
1 Participants
n=7 Participants
0 Participants
n=5 Participants
2 Participants
n=4 Participants
BMI
Overweight (BMI 25.0-29.9 kg/m^2)
1 Participants
n=5 Participants
2 Participants
n=7 Participants
0 Participants
n=5 Participants
3 Participants
n=4 Participants
BMI
Obese (BMI >= 30.0 kg/m^2)
5 Participants
n=5 Participants
4 Participants
n=7 Participants
0 Participants
n=5 Participants
9 Participants
n=4 Participants

PRIMARY outcome

Timeframe: 3 months post randomization

Population: A control group was intended to be added to the study, but the study team decided not to complete this additional research due to the pandemic. Additional funds were not available to enroll a new control group and thus, the study was terminated.

Feasibility of the intervention will be measured as the percentage of participants who complete the study. The intervention will be considered feasible if no more than 20% of participants are lost to follow up.

Outcome measures

Outcome measures
Measure
Group-based Cognitive Behavioral Intervention
n=7 Participants
Subjects receiving the group-based CT-CB intervention Group-based Cognitive Behavioral Intervention: This intervention will include six 1-hour group sessions held biweekly for twelve weeks. Each sixty-minute session will consist of 15 minutes of diabetes education regarding exercise and food planning and approximately 45 minutes of CT-CB presentations/engagement activities. Participants will be encouraged to bring along their family members or friends for support.
Web-based Cognitive Behavioral Intervention
n=7 Participants
Subjects receiving the web based CT-CB intervention Web-based Cognitive Behavioral Intervention: This intervention will include six 1-hour web-based sessions held biweekly for twelve weeks. Subjects in the web-based CT-CB will be asked to reserve a 1 hour period for a web call from the Behavioral Interventionist team. Text reminders will be sent to the participants prior the sessions. During this period, approximately 15 minutes will be reserved for diabetes exercise and food planning education and approximately 45 minutes of CT-CB engagement activities.
Usual Care
Subjects receiving usual care from their primary care providers Usual Care: Usual care group participants will continue to receive care and follow up from their primary care providers as per the American Diabetes Association guidelines with log books, education regarding self-management strategies and appropriate referrals as needed.
Percentage of Participants That Complete the Study Compared to Enrolled
7 Participants
7 Participants
0 Participants

PRIMARY outcome

Timeframe: 3 months post randomization

Population: A control group was intended to be added to the study, but the study team decided not to complete this additional research due to the pandemic. Additional funds were not available to enroll a new control group and thus, the study was terminated

Acceptability of the intervention will be operationalized as study session attendance and will be considered adequate if at least 70% of the sessions are attended.

Outcome measures

Outcome measures
Measure
Group-based Cognitive Behavioral Intervention
n=7 Participants
Subjects receiving the group-based CT-CB intervention Group-based Cognitive Behavioral Intervention: This intervention will include six 1-hour group sessions held biweekly for twelve weeks. Each sixty-minute session will consist of 15 minutes of diabetes education regarding exercise and food planning and approximately 45 minutes of CT-CB presentations/engagement activities. Participants will be encouraged to bring along their family members or friends for support.
Web-based Cognitive Behavioral Intervention
n=7 Participants
Subjects receiving the web based CT-CB intervention Web-based Cognitive Behavioral Intervention: This intervention will include six 1-hour web-based sessions held biweekly for twelve weeks. Subjects in the web-based CT-CB will be asked to reserve a 1 hour period for a web call from the Behavioral Interventionist team. Text reminders will be sent to the participants prior the sessions. During this period, approximately 15 minutes will be reserved for diabetes exercise and food planning education and approximately 45 minutes of CT-CB engagement activities.
Usual Care
Subjects receiving usual care from their primary care providers Usual Care: Usual care group participants will continue to receive care and follow up from their primary care providers as per the American Diabetes Association guidelines with log books, education regarding self-management strategies and appropriate referrals as needed.
Percentage of Participants That Are Enrolled and Attend the Study the Study Sessions Compared to Enrolled
7 Participants
7 Participants
0 Participants

SECONDARY outcome

Timeframe: Baseline and 3 months post randomization

Population: The A1C results may be affected by variations in point of care vs regular blood testing and the timing of follow up for participants. Data is included for participants who completed more than 65% of the intervention sessions.

Hemoglobin A1c (HbA1C) in % will be measured via blood draw and processing. Normal values HbA1C are less than 5.7%, values between 5.7% and 6.4% indicate pre-diabetes, and persons with levels of 6.5% or higher are considered to have diabetes.

Outcome measures

Outcome measures
Measure
Group-based Cognitive Behavioral Intervention
n=7 Participants
Subjects receiving the group-based CT-CB intervention Group-based Cognitive Behavioral Intervention: This intervention will include six 1-hour group sessions held biweekly for twelve weeks. Each sixty-minute session will consist of 15 minutes of diabetes education regarding exercise and food planning and approximately 45 minutes of CT-CB presentations/engagement activities. Participants will be encouraged to bring along their family members or friends for support.
Web-based Cognitive Behavioral Intervention
n=7 Participants
Subjects receiving the web based CT-CB intervention Web-based Cognitive Behavioral Intervention: This intervention will include six 1-hour web-based sessions held biweekly for twelve weeks. Subjects in the web-based CT-CB will be asked to reserve a 1 hour period for a web call from the Behavioral Interventionist team. Text reminders will be sent to the participants prior the sessions. During this period, approximately 15 minutes will be reserved for diabetes exercise and food planning education and approximately 45 minutes of CT-CB engagement activities.
Usual Care
Subjects receiving usual care from their primary care providers Usual Care: Usual care group participants will continue to receive care and follow up from their primary care providers as per the American Diabetes Association guidelines with log books, education regarding self-management strategies and appropriate referrals as needed.
Change in Hemoglobin A1c (HbA1C) Level
Baseline
10.35 percentage of HbA1C
Standard Deviation 1.01
9.67 percentage of HbA1C
Standard Deviation 1.39
Change in Hemoglobin A1c (HbA1C) Level
Month 3
9.21 percentage of HbA1C
Standard Deviation 0.91
8.74 percentage of HbA1C
Standard Deviation 2.06

SECONDARY outcome

Timeframe: Baseline and 3 months post randomization

Population: A control group was intended to be added to the study, but the study team decided not to complete this additional research due to the pandemic. Additional funds were not available to enroll a new control group and thus, the study was terminated

Depressive symptoms are assessed by the Patient Health Questionnaire (PHQ-9). The PHQ-9 is a 9-item scale where respondents indicate how much they are bothered by certain problems on a 4-point scale where 0 = not at all and 3 = nearly every day. Total scores range from 0 to 27 with degree of depression considered minimal for scores between 0-4, mild for scores of 5-9, moderate for scores of 10-14, moderate to severe for scores 15-19, and severe for scores of 20-27.

Outcome measures

Outcome measures
Measure
Group-based Cognitive Behavioral Intervention
n=7 Participants
Subjects receiving the group-based CT-CB intervention Group-based Cognitive Behavioral Intervention: This intervention will include six 1-hour group sessions held biweekly for twelve weeks. Each sixty-minute session will consist of 15 minutes of diabetes education regarding exercise and food planning and approximately 45 minutes of CT-CB presentations/engagement activities. Participants will be encouraged to bring along their family members or friends for support.
Web-based Cognitive Behavioral Intervention
n=7 Participants
Subjects receiving the web based CT-CB intervention Web-based Cognitive Behavioral Intervention: This intervention will include six 1-hour web-based sessions held biweekly for twelve weeks. Subjects in the web-based CT-CB will be asked to reserve a 1 hour period for a web call from the Behavioral Interventionist team. Text reminders will be sent to the participants prior the sessions. During this period, approximately 15 minutes will be reserved for diabetes exercise and food planning education and approximately 45 minutes of CT-CB engagement activities.
Usual Care
Subjects receiving usual care from their primary care providers Usual Care: Usual care group participants will continue to receive care and follow up from their primary care providers as per the American Diabetes Association guidelines with log books, education regarding self-management strategies and appropriate referrals as needed.
Change in Patient Health Questionnaire (PHQ-9) Score
Baseline
7.29 Score on a scale
Standard Deviation 5.47
6.00 Score on a scale
Standard Deviation 4.90
Change in Patient Health Questionnaire (PHQ-9) Score
3 months post randomization
7.71 Score on a scale
Standard Deviation 6.92
5.00 Score on a scale
Standard Deviation 3.87

SECONDARY outcome

Timeframe: Baseline and 3 months post randomization

Population: A control group was intended to be added to the study, but the study team decided not to complete this additional research due to the pandemic. Additional funds were not available to enroll a new control group and thus, the study was terminated.

The Diabetes Distress Scale (DDS17) is a 17-item questionnaire assessing the severity of problems of living with diabetes. Participants indicate the degree to which each item impacts their life on a 6-point scale where 1 = not a problem and 6 = a very serious problem. The scores are summed and divided by 17 to generate an average score that can range from 1 to 6. Scores of 3 or more are considered high distress.

Outcome measures

Outcome measures
Measure
Group-based Cognitive Behavioral Intervention
n=7 Participants
Subjects receiving the group-based CT-CB intervention Group-based Cognitive Behavioral Intervention: This intervention will include six 1-hour group sessions held biweekly for twelve weeks. Each sixty-minute session will consist of 15 minutes of diabetes education regarding exercise and food planning and approximately 45 minutes of CT-CB presentations/engagement activities. Participants will be encouraged to bring along their family members or friends for support.
Web-based Cognitive Behavioral Intervention
n=7 Participants
Subjects receiving the web based CT-CB intervention Web-based Cognitive Behavioral Intervention: This intervention will include six 1-hour web-based sessions held biweekly for twelve weeks. Subjects in the web-based CT-CB will be asked to reserve a 1 hour period for a web call from the Behavioral Interventionist team. Text reminders will be sent to the participants prior the sessions. During this period, approximately 15 minutes will be reserved for diabetes exercise and food planning education and approximately 45 minutes of CT-CB engagement activities.
Usual Care
Subjects receiving usual care from their primary care providers Usual Care: Usual care group participants will continue to receive care and follow up from their primary care providers as per the American Diabetes Association guidelines with log books, education regarding self-management strategies and appropriate referrals as needed.
Change in Diabetes Distress Scale (DDS17) Score
Baseline
2.35 score on a scale
Standard Deviation 0.82
2.57 score on a scale
Standard Deviation 0.90
Change in Diabetes Distress Scale (DDS17) Score
3 months post randomization
1.74 score on a scale
Standard Deviation 0.64
2.15 score on a scale
Standard Deviation 0.99

SECONDARY outcome

Timeframe: Baseline and 3 months post randomization

Population: There was an error in data collection forms provided to participants, which made these questionnaires unusable for data analysis.

Quality of life will be assessed with the 12-Item Short Form Health Survey (SF-12). The Short Form-12 Health Survey Questionnaire (SF-12) is a measure of general physical and mental health. The SF-12 consists of 12 items with a Likert-type response format that measures quality of life with a Physical Component Summary (PCS) and Mental Component Summary (MCS). Subscales associated with the PCS include physical functioning, role limitations due to physical problems, bodily pain, and general health perceptions. Subscales associated with the MCS include vitality (energy and fatigue), social functioning, role limitations due to emotional problems, and mental health. A scoring algorithm is used to generate a total score for each component ranging from 0 to 100. Low values represent a poor health state while high values represent a good health state.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Baseline and 3 months post randomization

Population: A control group was intended to be added to the study, but the study team decided not to complete this additional research due to the pandemic. Additional funds were not available to enroll a new control group and thus, the study was terminated.

Anxiety will be assessed using the Generalized Anxiety Disorder 7-item (GAD-7) Scale. Participants use a 4-point scale in response to statements about anxiety (such as "trouble relaxing") to indicate how bothered they have felt by item over the last two weeks. Degree of anxiety is rated as 0 = "not at all" to 3 = "nearly every day". Total scores range from 0 to 21. Scores of 5-9 indicate mild anxiety, 10-15 indicates moderate anxiety and scores 15 and greater indicate severe anxiety.

Outcome measures

Outcome measures
Measure
Group-based Cognitive Behavioral Intervention
n=7 Participants
Subjects receiving the group-based CT-CB intervention Group-based Cognitive Behavioral Intervention: This intervention will include six 1-hour group sessions held biweekly for twelve weeks. Each sixty-minute session will consist of 15 minutes of diabetes education regarding exercise and food planning and approximately 45 minutes of CT-CB presentations/engagement activities. Participants will be encouraged to bring along their family members or friends for support.
Web-based Cognitive Behavioral Intervention
n=7 Participants
Subjects receiving the web based CT-CB intervention Web-based Cognitive Behavioral Intervention: This intervention will include six 1-hour web-based sessions held biweekly for twelve weeks. Subjects in the web-based CT-CB will be asked to reserve a 1 hour period for a web call from the Behavioral Interventionist team. Text reminders will be sent to the participants prior the sessions. During this period, approximately 15 minutes will be reserved for diabetes exercise and food planning education and approximately 45 minutes of CT-CB engagement activities.
Usual Care
Subjects receiving usual care from their primary care providers Usual Care: Usual care group participants will continue to receive care and follow up from their primary care providers as per the American Diabetes Association guidelines with log books, education regarding self-management strategies and appropriate referrals as needed.
Change in Generalized Anxiety Disorder 7-item (GAD-7) Scale Score
Baseline
7.14 score on a scale
Standard Deviation 4.63
5.57 score on a scale
Standard Deviation 7.28
Change in Generalized Anxiety Disorder 7-item (GAD-7) Scale Score
3 months post randomization
6.00 score on a scale
Standard Deviation 5.80
2.43 score on a scale
Standard Deviation 4.47

SECONDARY outcome

Timeframe: Baseline and 3 months post randomization

Change in Self Efficacy is assessed by Self Efficacy for Diabetes Scale that is administered at Baseline and at 3rd month post randomization. The questionnaire is a 8 item scale. Each question ranks from 1(not confident at all) to 10 (totally confident). The scale score will be compared from Baseline to 3 months post randomization. For diabetes, higher diabetes self-efficacy has been shown to relate to better self-care and glycaemic control. Increase in the score of Self-efficacy is found to directly reinforce adherence to self-care.

Outcome measures

Outcome measures
Measure
Group-based Cognitive Behavioral Intervention
n=7 Participants
Subjects receiving the group-based CT-CB intervention Group-based Cognitive Behavioral Intervention: This intervention will include six 1-hour group sessions held biweekly for twelve weeks. Each sixty-minute session will consist of 15 minutes of diabetes education regarding exercise and food planning and approximately 45 minutes of CT-CB presentations/engagement activities. Participants will be encouraged to bring along their family members or friends for support.
Web-based Cognitive Behavioral Intervention
n=7 Participants
Subjects receiving the web based CT-CB intervention Web-based Cognitive Behavioral Intervention: This intervention will include six 1-hour web-based sessions held biweekly for twelve weeks. Subjects in the web-based CT-CB will be asked to reserve a 1 hour period for a web call from the Behavioral Interventionist team. Text reminders will be sent to the participants prior the sessions. During this period, approximately 15 minutes will be reserved for diabetes exercise and food planning education and approximately 45 minutes of CT-CB engagement activities.
Usual Care
Subjects receiving usual care from their primary care providers Usual Care: Usual care group participants will continue to receive care and follow up from their primary care providers as per the American Diabetes Association guidelines with log books, education regarding self-management strategies and appropriate referrals as needed.
Change in Self Efficacy for Diabetes
Baseline
7.34 score on a scale
Standard Deviation 1.43
6.94 score on a scale
Standard Deviation 2.10
Change in Self Efficacy for Diabetes
3 months post randomization
7.43 score on a scale
Standard Deviation 2.20
6.77 score on a scale
Standard Deviation 1.84

SECONDARY outcome

Timeframe: Baseline and 3 months post randomization

Population: This survey was not administered to participants.

Change in Diabetes Health Belief Scale is assessed by 25-item scale that is administered at baseline and at 3 months post randomization.Each question ranks from (1 = Strongly Disagree) to (5 = Strongly Agree).The scale score will be compared from Baseline to 3 months post randomization

Outcome measures

Outcome data not reported

Adverse Events

Group-based Cognitive Behavioral Intervention

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Web-based Cognitive Behavioral Intervention

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Usual Care

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. Ambar Kulshreshtha

Emory University

Phone: (404) 686-2410

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place