Feasibility and Efficacy of Brief Behavior Change Counseling on Lifestyle in Hypertensive and Diabetics Participants

NCT ID: NCT04625452

Last Updated: 2020-11-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-08-13

Study Completion Date

2021-03-30

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The purpose of this study will be to assess the feasibility and the preliminary efficacy of brief behavior change counseling on lifestyle among diabetic and hypertensive patients

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

1. BACKGROUND Noncommunicables diseases (NCDs) are on the rise globally as well as in Malawi, alongside their behavioral modifiable risk factors. Behavioral intervention such as brief behavior change counseling using 5A's and a guiding style (BBCC + 5As +GS) has shown an effect on reducing these lifestyles risk factors. Their effectiveness varies between the behavioral technique used. But So far, available evidences of this effect are from western countries. Even implementation of these techniques has been done in some countries, but so far there is no information about their implementation in noncommunicable diseases field in Mangochi, even Malawi. Therefore, a really need to conduct this study in Mangochi, Southern Malawi.
2. OBJECTIVES

1. Overall objective: The primary objective of the study is to test the feasibility of the brief behavior change counseling using 5 A's and a guiding style from motivational interviewing which will be used for NCDs 'patients and assess its efficacy in improving lifestyle risk factors in NCDs' patients.
2. Specific objectives for this study are

1\. to evaluate the feasibility of participating in a future quasi-experimental study of BBCC + 5A's + GS ; 2. to estimate the efficacy of BBCC + 5A's + GS from MI on lifestyle risk factors, theory constructs, quality of life domains; 3. to provide data on which to estimate the sample size required to detect a statistically significant difference between experimental and control groups; 4. and to explore experience of participants and care providers during the brief behaviour change counseling sessions to NCDs' patients in Mangochi

4\. Methodology:

1. Design: mixed methods (pilot quasi-experimental and qualitative study)
2. Settings: The study will take place at two sites: Mangochi District Hospital and Monkey Bay Community Hospital; Malawi.
3. sample size: Purposeful sampling and successive eligible patients. Sample size: Efficacy study will be conducted on 50 patients.
4. Intervention: brief behaviour change using 5A's and a Guiding style from motivational interviewing will be administered to participants in the intervention group by trained counsellors (nurses).

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Hypertension Diabetes Life Style

Keywords

Explore important study keywords that can help with search, categorization, and topic discovery.

lifestyle diabetics hypertensives brief behavior change counseling motivational interviewing 5 A's

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Intervention group will be administered at 3, 12 and 24 weeks. The intervention consists in addition to normal care and distribution of printed education pamphlets, of an individual counseling based on lifestyle risk factors of diabetic or hypertensive participants themed around 5 points (ask, advice or alert, assess , assist and arrange). It will use a guiding style from motivational interviewing consisting of asking opened questions, summarizing patients, reflecting him his statements, and capture change words, and requesting for permission to introduce any new point.

Normal care Participants allocated to normal care (control group) will receive standard care for diabetes or hypertension as per Malawi- government's NCD's guidelines: drugs, inconsistent unstructured advises regarding lifestyle behavior, opportunistic biological tests as per clinician's judgement.
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

DOUBLE

Investigators Outcome Assessors
The data will be collected under investigator's supervision, documented by nurses ( counselors), clinical officers ( doing routine consultations), lab technicians ( analyzing blood) and the clerk doing the measurements. Data sent to the investigators and statisticians for entry and analysis will be blinded beforehand by removing the identifiers' information. After completing the analysis, results will be again allocated to their respective arms.

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

BBCC+5A's+GS

Brief behavior change counseling using 5A's + Guiding style (from motivational interviewing) + Printed education materials ( at baseline, 12 weeks, 24 weeks)

Group Type EXPERIMENTAL

BBCC+5A's+GS

Intervention Type BEHAVIORAL

It is a 5-steps intervention delivered in a motivational interviewing spirit. Clearly the five steps are asking about the behaviour risk factors, assessing the level of risk factors; providing information about the pros and cons of the behaviour in a neutral way; assessing the change by probing about the importance in and the confidence of changing the risk factor; assisting the patient to come-up with a road map about changing the risk factor, connecting the patient to support networks or drugs which can increase the likelihood to change; and arranging for the next visit.

All this given by asking opened question to participant, active listening, summarizing what he is saying, evoking change through concepts or statements, empathy and asking permission to provide further information.

Normal care

They will receive the normal care: simple advice on changing lifestyle risk factors + medications for diabetes or hypertension ( at baseline, 12 weeks, 24 weeks)

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

BBCC+5A's+GS

It is a 5-steps intervention delivered in a motivational interviewing spirit. Clearly the five steps are asking about the behaviour risk factors, assessing the level of risk factors; providing information about the pros and cons of the behaviour in a neutral way; assessing the change by probing about the importance in and the confidence of changing the risk factor; assisting the patient to come-up with a road map about changing the risk factor, connecting the patient to support networks or drugs which can increase the likelihood to change; and arranging for the next visit.

All this given by asking opened question to participant, active listening, summarizing what he is saying, evoking change through concepts or statements, empathy and asking permission to provide further information.

Intervention Type BEHAVIORAL

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

Brief behavior change using 5A's and a guiding style from motivational interviewing

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* aged between 18-65 years old,
* registered in the clinic at least for 6 months,
* been screened for at least 1 lifestyle risk factor,
* express willingness to participate in the study,
* being permanent resident in Mangochi District for at least 12 months from recruitment, and
* Fluent in Chichewa and/or Yao

Exclusion Criteria

* \- present with any concomitant severe disease,
* being pregnant
* patient with an active Psychiatrics' comorbidity
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

National Heart, Lung, and Blood Institute (NHLBI)

NIH

Sponsor Role collaborator

Kamuzu University of Health Sciences

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Adamson S Muula, PhD

Role: STUDY_DIRECTOR

Kamuzu University of Health Sciences

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Mangochi District Hospital

Mangochi, Eastern-Region, Malawi

Site Status

Countries

Review the countries where the study has at least one active or historical site.

Malawi

References

Explore related publications, articles, or registry entries linked to this study.

Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000;894:i-xii, 1-253.

Reference Type BACKGROUND
PMID: 11234459 (View on PubMed)

De Vet E, de Nooijer J, de Vries NK, Brug J. The Transtheoretical model for fruit, vegetable and fish consumption: associations between intakes, stages of change and stage transition determinants. Int J Behav Nutr Phys Act. 2006 Jun 19;3:13. doi: 10.1186/1479-5868-3-13.

Reference Type BACKGROUND
PMID: 16784520 (View on PubMed)

Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA. The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test. Arch Intern Med. 1998 Sep 14;158(16):1789-95. doi: 10.1001/archinte.158.16.1789.

Reference Type BACKGROUND
PMID: 9738608 (View on PubMed)

de Granda-Orive JI, Pascual-Lledo JF, Asensio-Sanchez S, Solano-Reina S, Garcia-Rueda M, Martinez-Muniz MA, Lazaro-Asegurado L, Bujulbasich D, Pendino R, Luhning S, Cienfuegos-Agustin I, Jimenez-Ruiz CA. Fagerstrom Test and Heaviness Smoking Index. Are they Interchangeable as a Dependence Test for Nicotine? Subst Use Misuse. 2020;55(2):200-208. doi: 10.1080/10826084.2019.1660680. Epub 2019 Sep 13.

Reference Type BACKGROUND
PMID: 31519135 (View on PubMed)

Cleland C, Ferguson S, Ellis G, Hunter RF. Validity of the International Physical Activity Questionnaire (IPAQ) for assessing moderate-to-vigorous physical activity and sedentary behaviour of older adults in the United Kingdom. BMC Med Res Methodol. 2018 Dec 22;18(1):176. doi: 10.1186/s12874-018-0642-3.

Reference Type BACKGROUND
PMID: 30577770 (View on PubMed)

Malan Z, Mash B, Everett-Murphy K. Evaluation of a training programme for primary care providers to offer brief behaviour change counselling on risk factors for non-communicable diseases in South Africa. Patient Educ Couns. 2016 Jan;99(1):125-31. doi: 10.1016/j.pec.2015.08.008. Epub 2015 Aug 14.

Reference Type BACKGROUND
PMID: 26324109 (View on PubMed)

Amberbir A, Lin SH, Berman J, Muula A, Jacoby D, Wroe E, Maliwichi-Nyirenda C, Mwapasa V, Crampin A, Makwero M, Singogo E, Phiri S, Gordon S, Tobe SW, Masiye J, Newsome B, Hosseinipour M, Nyirenda MJ, van Oosterhout JJ. Systematic Review of Hypertension and Diabetes Burden, Risk Factors, and Interventions for Prevention and Control in Malawi: The NCD BRITE Consortium. Glob Heart. 2019 Jun;14(2):109-118. doi: 10.1016/j.gheart.2019.05.001.

Reference Type BACKGROUND
PMID: 31324364 (View on PubMed)

Colbourn T, Masache G, Skordis-Worrall J. Development, reliability and validity of the Chichewa WHOQOL-BREF in adults in Lilongwe, Malawi. BMC Res Notes. 2012 Jul 3;5:346. doi: 10.1186/1756-0500-5-346.

Reference Type BACKGROUND
PMID: 22759784 (View on PubMed)

Sim J, Lewis M. The size of a pilot study for a clinical trial should be calculated in relation to considerations of precision and efficiency. J Clin Epidemiol. 2012 Mar;65(3):301-8. doi: 10.1016/j.jclinepi.2011.07.011. Epub 2011 Dec 9.

Reference Type BACKGROUND
PMID: 22169081 (View on PubMed)

Related Links

Access external resources that provide additional context or updates about the study.

https://www.ichange4health.co.za/wp-content/uploads/2016/01/HELPING-PEOPLE-CHANGE.pdf

book website used for training of health workers in brief behavior change counseling in South Africa . Which we adopted for our study.

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

5U24HL136791-01

Identifier Type: NIH

Identifier Source: secondary_id

View Link

P.08/18/2454

Identifier Type: -

Identifier Source: org_study_id