Food Delivery, Remote Monitoring, and Coaching-Enhanced Education for Optimized Diabetes Management (FREEDOM)

NCT ID: NCT05288452

Last Updated: 2025-05-30

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

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

304 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-01-01

Study Completion Date

2026-06-30

Brief Summary

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Brief Summary:

The FREEDOM study aims to develop a scalable intervention to improve type 2 diabetes mellitus control in low-income Black adults in the Deep South. The intervention targets social determinants of health (SDoH) such as reduced healthcare access, poverty, transportation barriers, and food insecurity.

Detailed Description

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Detailed Description:

1. FREEDOM Study (Type 2 Diabetes Mellitus):

The FREEDOM study is a 12-month clinical trial enrolling 304 Black adults with Type 2 Diabetes Mellitus across three healthcare systems in Alabama and Mississippi. Participants are randomly assigned to one of eight combinations of three intervention components:
* Digital Health Coaching: Participants receive one-on-one phone-based coaching for optimized diabetes management.
* Food Box Delivery: Food boxes are delivered every two weeks to participants' homes,
* Remote Patient Monitoring (RPM): Participants receive essential supplies, including glucometers, for remote blood glucose measurement. Data is monitored remotely for timely interventions.

The study involves three in-person visits at baseline, month 6, and month 12, as well as two telephone study check-ins at month 3 and 9. Survey packets are administered at each time point.
2. FREEDOM-HIV Study (Type 2 Diabetes Mellitus and HIV Cohort):

Additionally, a cohort within the study, known as the FREEDOM-HIV study, will enroll additional 80 adults who have both Type 2 Diabetes Mellitus and HIV. This cohort will be observed over a 6-month period and will also consist of the same three intervention components.

Conditions

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Diabetes Mellitus, Type 2

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

We used the multiphase optimization strategy (MOST) as the ideal approach for the proposed study as, with the three proposed intervention components, identifying an optimal intervention through a single randomized controlled trial (RCT) with multiple arms or through multiple RCTs would be methodologically inefficient and resource-intensive. Given this, we rely on the eloquent and rigorous MOST-based optimization design, which leverages factorial experimentation to identify an optimal set of intervention component(s). In a factorial experiment, the goal is not to compare individual experimental conditions (in this case, eight conditions), but to use combinations of conditions to estimate the main and interaction effects of the intervention components. Thus, numerous intervention components can be evaluated simultaneously while utilizing the entire randomized sample.
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

SINGLE

Investigators

Study Groups

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Arm 1

Digital coaching+ Food delivery+ RPM

Group Type EXPERIMENTAL

Digital Health Coaching

Intervention Type BEHAVIORAL

The digital health coaching intervention program involves an evidence-based curriculum and one-on-one support to promote positive health behaviors and patient self-management of diabetes.

Food Box Delivery

Intervention Type DIETARY_SUPPLEMENT

The food box intervention component will consist of biweekly food boxes delivered directly to participants over the course of 6 months. The food boxes will contain shelf-stable groceries that adhere to ADA nutritional guidelines for individuals with T2DM.

Remote Patient Monitoring (RPM)

Intervention Type BEHAVIORAL

The RPM team will instruct the participants to monitor blood glucose levels 3 times daily. Glucose levels will be monitored 8 a.m. to 5 p.m.Monday to Friday. Data summaries will be reviewed bi-monthly with RNs and pharmacists. Participants will be provided with a glucometer, test strips, and mobile divide to record their blood glucose levels.

Diabetes Education Class

Intervention Type BEHAVIORAL

The diabetes education class will be administered by a certified diabetes educator.

Arm 2

Digital coaching

Group Type ACTIVE_COMPARATOR

Digital Health Coaching

Intervention Type BEHAVIORAL

The digital health coaching intervention program involves an evidence-based curriculum and one-on-one support to promote positive health behaviors and patient self-management of diabetes.

Diabetes Education Class

Intervention Type BEHAVIORAL

The diabetes education class will be administered by a certified diabetes educator.

Arm 3

Digital coaching+ Food delivery

Group Type ACTIVE_COMPARATOR

Digital Health Coaching

Intervention Type BEHAVIORAL

The digital health coaching intervention program involves an evidence-based curriculum and one-on-one support to promote positive health behaviors and patient self-management of diabetes.

Food Box Delivery

Intervention Type DIETARY_SUPPLEMENT

The food box intervention component will consist of biweekly food boxes delivered directly to participants over the course of 6 months. The food boxes will contain shelf-stable groceries that adhere to ADA nutritional guidelines for individuals with T2DM.

Diabetes Education Class

Intervention Type BEHAVIORAL

The diabetes education class will be administered by a certified diabetes educator.

Arm 4

Digital coaching+ RPM

Group Type ACTIVE_COMPARATOR

Digital Health Coaching

Intervention Type BEHAVIORAL

The digital health coaching intervention program involves an evidence-based curriculum and one-on-one support to promote positive health behaviors and patient self-management of diabetes.

Remote Patient Monitoring (RPM)

Intervention Type BEHAVIORAL

The RPM team will instruct the participants to monitor blood glucose levels 3 times daily. Glucose levels will be monitored 8 a.m. to 5 p.m.Monday to Friday. Data summaries will be reviewed bi-monthly with RNs and pharmacists. Participants will be provided with a glucometer, test strips, and mobile divide to record their blood glucose levels.

Diabetes Education Class

Intervention Type BEHAVIORAL

The diabetes education class will be administered by a certified diabetes educator.

Arm 5

Food delivery+ RPM

Group Type ACTIVE_COMPARATOR

Food Box Delivery

Intervention Type DIETARY_SUPPLEMENT

The food box intervention component will consist of biweekly food boxes delivered directly to participants over the course of 6 months. The food boxes will contain shelf-stable groceries that adhere to ADA nutritional guidelines for individuals with T2DM.

Remote Patient Monitoring (RPM)

Intervention Type BEHAVIORAL

The RPM team will instruct the participants to monitor blood glucose levels 3 times daily. Glucose levels will be monitored 8 a.m. to 5 p.m.Monday to Friday. Data summaries will be reviewed bi-monthly with RNs and pharmacists. Participants will be provided with a glucometer, test strips, and mobile divide to record their blood glucose levels.

Diabetes Education Class

Intervention Type BEHAVIORAL

The diabetes education class will be administered by a certified diabetes educator.

Arm 6

The participant's will not receive any Intervention

Group Type ACTIVE_COMPARATOR

Diabetes Education Class

Intervention Type BEHAVIORAL

The diabetes education class will be administered by a certified diabetes educator.

Arm 7

Food delivery

Group Type ACTIVE_COMPARATOR

Food Box Delivery

Intervention Type DIETARY_SUPPLEMENT

The food box intervention component will consist of biweekly food boxes delivered directly to participants over the course of 6 months. The food boxes will contain shelf-stable groceries that adhere to ADA nutritional guidelines for individuals with T2DM.

Diabetes Education Class

Intervention Type BEHAVIORAL

The diabetes education class will be administered by a certified diabetes educator.

Arm 8

RPM

Group Type ACTIVE_COMPARATOR

Remote Patient Monitoring (RPM)

Intervention Type BEHAVIORAL

The RPM team will instruct the participants to monitor blood glucose levels 3 times daily. Glucose levels will be monitored 8 a.m. to 5 p.m.Monday to Friday. Data summaries will be reviewed bi-monthly with RNs and pharmacists. Participants will be provided with a glucometer, test strips, and mobile divide to record their blood glucose levels.

Diabetes Education Class

Intervention Type BEHAVIORAL

The diabetes education class will be administered by a certified diabetes educator.

Interventions

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Digital Health Coaching

The digital health coaching intervention program involves an evidence-based curriculum and one-on-one support to promote positive health behaviors and patient self-management of diabetes.

Intervention Type BEHAVIORAL

Food Box Delivery

The food box intervention component will consist of biweekly food boxes delivered directly to participants over the course of 6 months. The food boxes will contain shelf-stable groceries that adhere to ADA nutritional guidelines for individuals with T2DM.

Intervention Type DIETARY_SUPPLEMENT

Remote Patient Monitoring (RPM)

The RPM team will instruct the participants to monitor blood glucose levels 3 times daily. Glucose levels will be monitored 8 a.m. to 5 p.m.Monday to Friday. Data summaries will be reviewed bi-monthly with RNs and pharmacists. Participants will be provided with a glucometer, test strips, and mobile divide to record their blood glucose levels.

Intervention Type BEHAVIORAL

Diabetes Education Class

The diabetes education class will be administered by a certified diabetes educator.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

1. Self-identified as Black/African American
2. ICD diagnosis of T2DM
3. ≥18 years of age
4. Ongoing insulin treatment
5. HbA1c ≥8% within 6 weeks of study screening
6. has the ability to converse in and read English
7. must provide written informed consent prior to enrollment


1. ≥ 18 years of age
2. ICD diagnosis of T2DM
3. HbA1c ≥ 7%
4. Confirmed HIV+ diagnosis
5. Prescribed HIV ART therapy as part of care

Exclusion Criteria

1. Current enrollment in any diabetes-related interventional study
2. Cognitive impairment
3. End-stage kidney disease (CKD-5)
4. Pregnant or plans to become pregnant within 12 months
5. Currently enrolled in a structured lifestyle change program
6. Enrolled in remote patient monitoring or health coaching within 60 days of the study or intervention

HIV Cohort Criteria


1. Current enrollment in any diabetes-related interventional study or structured lifestyle change program
2. Enrolled in RPM or health coaching (except for coaching on smoking cessation) within 60 days of the intervention
3. Cognitive impairment
4. End-stage kidney disease (CKD-5)
5. Pregnant or plans to become pregnant within 12 months
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Mississippi Medical Center

OTHER

Sponsor Role collaborator

Cooper Green Mercy Health Services

UNKNOWN

Sponsor Role collaborator

Pack Health

INDUSTRY

Sponsor Role collaborator

National Institute on Minority Health and Health Disparities (NIMHD)

NIH

Sponsor Role collaborator

University of Alabama at Birmingham

OTHER

Sponsor Role lead

Responsible Party

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Tapan Shirish Mehta

Professor, Director of Research

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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UAB Hospital and UMMC Cardiology Clinics

Birmingham, Alabama, United States

Site Status

Countries

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United States

Other Identifiers

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5P50MD017338-03

Identifier Type: NIH

Identifier Source: secondary_id

View Link

IRB-300008387

Identifier Type: -

Identifier Source: org_study_id

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