GODART Pilot and Feasibility

NCT ID: NCT05344859

Last Updated: 2025-12-17

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

COMPLETED

Clinical Phase

NA

Total Enrollment

88 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-05-15

Study Completion Date

2025-10-31

Brief Summary

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The purpose of this study is to pilot and assess the feasibility of implementing an artificial intelligence-assisted individualized lifestyle modification intervention for glycemic control in rural populations, which can be delivered even with regular landline phone service. This study will provide us with the knowledge to plan a well-powered optimization trial in the future to develop an optimal (low-cost) intervention package that can be delivered in a sustainable manner to the rural portions of America.

Detailed Description

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Evidence-based guidelines for type 2 diabetes mellitus (T2DM) management aimed at glycemic control (reduced hemoglobin A1c) include a combination of diet, physical activity (PA), glucose monitoring, and medication adherences. However, the majority of individuals with T2DM are unable to follow these guidelines due to a lack of consistent health behavior counseling offered in the primary care setting. This problem is amplified in remote rural communities within the U.S. In response, this project aims to create an optimized telehealth-based intervention - Gamified Optimized Diabetes management with Artificial Intelligence-powered Rural Telehealth (GODART). GODART is grounded in the social cognitive theory and will serve as an automated behavior-monitoring and telecoaching platform. At the core, GODART is an automated conversational-style behavior-monitoring system using natural language-understanding technologies. In this project, we propose to pilot and feasibility test the various components of GODART by leveraging a multiphase optimization strategy (MOST). MOST is an efficient and rigorous resource-management and continuous- improvement framework for developing optimized interventions. Our proposal focuses on the MOST preparatory phase and will use full factorial experimentation. We will pilot and assess the feasibility of and evaluate two different intervention components, with two levels in each of the groups, yielding four experimental conditions. These groups will test the effect of (i) a fixed vs. adaptive (gamified) rewards program and (ii) automated vs. human-delivered weekly health coaching. We will end the project with exit interviews conducted with a subset of participants. Study findings will help us learn the feasibility of delivering such an intervention and its preliminary effectiveness in reducing HbA1c, leading to adequately powered confirmatory effectiveness studies.

Participants will be enrolled in the study in 2 phases:

Phase 1-The Feasibility Phase: Up to 16 participants will be enrolled in this phase of the study. Participants will be in the study for a duration of 14 days. This phase of the study is conducted to access the feasibility, usability, and accessibility of the GODART platform, before the actual intervention phase.

Phase 2- Intervention Phase: 88 participants will be enrolled in this phase of the study for a duration of 6 months.

Conditions

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Diabetes Mellitus, Type 2

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

We propose to use the multiphase optimization strategy (MOST) design, as an ideal approach for the study, that is based on the principle of resource management and continuous improvement. Our study aim aligns with the preparatory and optimization phases of MOST, and is structured to serve as the preparatory phase for a future large-scale MOST optimization phase.
Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

DOUBLE

Investigators Outcome Assessors
Statistician and the assessor will be blinded/masked to participant assignment. The health coach will not be blinded. It will not be possible to blind the participants.

Study Groups

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Arm 1

Adaptive Rewards + Weekly automated coaching

Group Type EXPERIMENTAL

Weekly Automated Health Coaching

Intervention Type BEHAVIORAL

This intervention will involve health coaching delivered by Artificial intelligence (AI). The automated health coaching mechanism will be coupled with AI-based responses, and recent advancements have made the voices generated through the AI, almost human-like voices. Every week participants enrolled in automated health coaching intervention will receive a health coaching and goal-setting call that will help guide the participants in managing their Type 2 Diabetes Mellitus. This technology-driven study group will inform us whether trained human coaches are required or if the automated technologies are sufficient to create clinically meaningful HbA1c improvements.

Adapted Reward Level

Intervention Type BEHAVIORAL

In the adapted reward (gamified) variation, participants will receive 25 cents per day for the first week of daily-monitoring calls, 50 cents per day in the second week, 75 cents per day in the third week, and a dollar per day from the fourth week until the end of the study (Aim 2). In the adaptive variation, missing one day of monitoring (in the past seven days), drops the reward value by one level (example: 75 cents becomes 50 cents), two days of missed calls drop the reward level by two levels, and similarly for three days. In the adaptive variation, participants have to continue to daily monitor their behavior to again build up their reward levels.

Arm 2

Adaptive Rewards + Weekly human coaching

Group Type EXPERIMENTAL

Weekly Human Health Coaching

Intervention Type BEHAVIORAL

Every week participants enrolled in human health coaching intervention will receive a health coaching call and goal-setting call from their respective health coaches to guide them in managing their Type 2 Diabetes Mellitus.

Adapted Reward Level

Intervention Type BEHAVIORAL

In the adapted reward (gamified) variation, participants will receive 25 cents per day for the first week of daily-monitoring calls, 50 cents per day in the second week, 75 cents per day in the third week, and a dollar per day from the fourth week until the end of the study (Aim 2). In the adaptive variation, missing one day of monitoring (in the past seven days), drops the reward value by one level (example: 75 cents becomes 50 cents), two days of missed calls drop the reward level by two levels, and similarly for three days. In the adaptive variation, participants have to continue to daily monitor their behavior to again build up their reward levels.

Arm 3

Fixed Reward + Weekly automated coaching

Group Type EXPERIMENTAL

Weekly Automated Health Coaching

Intervention Type BEHAVIORAL

This intervention will involve health coaching delivered by Artificial intelligence (AI). The automated health coaching mechanism will be coupled with AI-based responses, and recent advancements have made the voices generated through the AI, almost human-like voices. Every week participants enrolled in automated health coaching intervention will receive a health coaching and goal-setting call that will help guide the participants in managing their Type 2 Diabetes Mellitus. This technology-driven study group will inform us whether trained human coaches are required or if the automated technologies are sufficient to create clinically meaningful HbA1c improvements.

Fixed Gamified Reward Level

Intervention Type BEHAVIORAL

In our fixed-reward arm, participants will be awarded 25 cents per day for answering the daily monitoring call - this serves simply as a reward for answering the daily calls. It is important that the rewards are for answering the calls and not for the actual values of the responses provided.

Arm 4

Fixed Reward + Weekly human coaching

Group Type EXPERIMENTAL

Weekly Human Health Coaching

Intervention Type BEHAVIORAL

Every week participants enrolled in human health coaching intervention will receive a health coaching call and goal-setting call from their respective health coaches to guide them in managing their Type 2 Diabetes Mellitus.

Fixed Gamified Reward Level

Intervention Type BEHAVIORAL

In our fixed-reward arm, participants will be awarded 25 cents per day for answering the daily monitoring call - this serves simply as a reward for answering the daily calls. It is important that the rewards are for answering the calls and not for the actual values of the responses provided.

Interventions

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Weekly Automated Health Coaching

This intervention will involve health coaching delivered by Artificial intelligence (AI). The automated health coaching mechanism will be coupled with AI-based responses, and recent advancements have made the voices generated through the AI, almost human-like voices. Every week participants enrolled in automated health coaching intervention will receive a health coaching and goal-setting call that will help guide the participants in managing their Type 2 Diabetes Mellitus. This technology-driven study group will inform us whether trained human coaches are required or if the automated technologies are sufficient to create clinically meaningful HbA1c improvements.

Intervention Type BEHAVIORAL

Weekly Human Health Coaching

Every week participants enrolled in human health coaching intervention will receive a health coaching call and goal-setting call from their respective health coaches to guide them in managing their Type 2 Diabetes Mellitus.

Intervention Type BEHAVIORAL

Adapted Reward Level

In the adapted reward (gamified) variation, participants will receive 25 cents per day for the first week of daily-monitoring calls, 50 cents per day in the second week, 75 cents per day in the third week, and a dollar per day from the fourth week until the end of the study (Aim 2). In the adaptive variation, missing one day of monitoring (in the past seven days), drops the reward value by one level (example: 75 cents becomes 50 cents), two days of missed calls drop the reward level by two levels, and similarly for three days. In the adaptive variation, participants have to continue to daily monitor their behavior to again build up their reward levels.

Intervention Type BEHAVIORAL

Fixed Gamified Reward Level

In our fixed-reward arm, participants will be awarded 25 cents per day for answering the daily monitoring call - this serves simply as a reward for answering the daily calls. It is important that the rewards are for answering the calls and not for the actual values of the responses provided.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

1. a diagnosis of T2DM
2. HbA1C ≥7% to ≤ 10.5% for phase 1- 14 days and phase 2 of the study- 6 months.
3. ≥18 years of age
4. the ability to converse in and read English.

Exclusion Criteria

1. Present or soon-planned pregnancy
2. Current enrollment in any structured lifestyle intervention study for diabetes or weight management.
3. Patients currently on insulin treatment
4. Major cardiac event in the past 6 months
5. Renal failure in the past 6 months
6. Listening and Speaking Impairment
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

NIH

Sponsor Role collaborator

University of Alabama at Birmingham

OTHER

Sponsor Role lead

Responsible Party

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Tapan Shirish Mehta

Professor, Vice Chair for Research, Department of Family and Community Medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Tapan Mehta, PHD

Role: PRINCIPAL_INVESTIGATOR

University of Alabama at Birmingham

Mohanraj Thirumalai, PHD

Role: PRINCIPAL_INVESTIGATOR

University of Alabama at Birmingham

Locations

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Department of Family and Community Medicine, University of Alabama at Birmingham

Birmingham, Alabama, United States

Site Status

Countries

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United States

References

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Mehta T, John T, El Zein A, Faught V, Nawshin T, Chilke TS, Cohen CW, Cherrington A, Thirumalai M. Gamified Optimized Diabetes Management With Artificial Intelligence-Powered Rural Telehealth Intervention (GODART): Protocol for an Optimization Pilot and Feasibility Trial. JMIR Res Protoc. 2025 Dec 5;14:e70271. doi: 10.2196/70271.

Reference Type DERIVED
PMID: 41348456 (View on PubMed)

Other Identifiers

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IRB-300008752

Identifier Type: -

Identifier Source: org_study_id

5R01DK129378-03

Identifier Type: NIH

Identifier Source: secondary_id

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5R01DK129378-02

Identifier Type: NIH

Identifier Source: secondary_id

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