Care Navigator Support for Younger Latinx Adults With Type 2 Diabetes

NCT ID: NCT05754008

Last Updated: 2024-05-03

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

RECRUITING

Clinical Phase

NA

Total Enrollment

204 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-03-31

Study Completion Date

2025-12-31

Brief Summary

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

The study proposes to rigorously evaluate a proactive, culturally responsive care navigator intervention targeting younger-onset Latinx individuals with a new T2D diagnosis (AURORA \[Active Outreach to Younger Latinx\]) within Kaiser Permanente Northern California (KPNC).

Detailed Description

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

The study has three primary objectives: 1) learn what is required to create and sustain a care navigator workforce and document our experience hiring a care navigator for the study, 2) implement and evaluate the AURORA strategy within KPNC, and 3) refine and adapt the AURORA strategy for future Kaiser Permanente (KP) wide dissemination. The AURORA strategy centers on a care navigator who will proactively conduct three telemedicine visits tailored to Latinx adults with early onset type 2 diabetes (T2D, defined as age \<45 years). The AURORA strategy will conducted with the following five goals: 1) assessment of familiarity and use of T2D care within KP, 2) assessment of individual's self-management support needs, 3) motivational interviewing to support behavior change, 4) pragmatic skills training, including use of crucial technologies to support self-management, and 5) matching member's needs with existing KPNC T2D resources.

Conditions

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

Diabetes Mellitus, Type 2

Study Design

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

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

The study team will conduct a patient-level randomized, parallel-group pragmatic trial of usual care vs. the AURORA care strategy among Latinx members (ages 18-44), recently diagnosed with T2D with a diagnosis HbA1c ≥8% (n=102/study arm). Outcomes assessed at 6 months post-enrollment will include HbA1c changes, medication initiation and adherence, and changes in patient-reported measures (e.g., self-efficacy).
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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

AURORA Care Strategy

Participants will receive the AURORA Care Strategy in addition to their usual diabetes care.

Group Type EXPERIMENTAL

AURORA Care Strategy

Intervention Type BEHAVIORAL

Participants will be invited to partake in three telemedicine visits with the care navigator during the months following diagnosis. The visits center around proactive and tailored T2D self-management support.

Usual Care

No intervention will be employed. This arm will continue to receive their usual diabetes care.

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.

AURORA Care Strategy

Participants will be invited to partake in three telemedicine visits with the care navigator during the months following diagnosis. The visits center around proactive and tailored T2D self-management support.

Intervention Type BEHAVIORAL

Eligibility Criteria

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

Inclusion Criteria

* KPNC member, age \>20 and age \<45 with
* New clinical diagnosis of T2D within the prior 1-8 months
* HbA1c≥8%. If the study team are having trouble recruiting an adequate sample, the study team may lower the HbA1c threshold to ≥7.5%
* Proficient (written and spoken) in English or Spanish

Exclusion Criteria

* Pregnant women
* Type 1 Diabetes
Minimum Eligible Age

21 Years

Maximum Eligible Age

44 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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

Kaiser Permanente

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.

Anjali Gopalan, MD, MS

Role: PRINCIPAL_INVESTIGATOR

Kaiser Permanente

Locations

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

Kaiser Permanente Northern California

Oakland, California, United States

Site Status RECRUITING

Countries

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

United States

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Amy Valdati

Role: CONTACT

510-410-6659

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Amy Valdati

Role: primary

References

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

Wilmot E, Idris I. Early onset type 2 diabetes: risk factors, clinical impact and management. Ther Adv Chronic Dis. 2014 Nov;5(6):234-44. doi: 10.1177/2040622314548679.

Reference Type BACKGROUND
PMID: 25364491 (View on PubMed)

Gopalan A, Mishra P, Alexeeff SE, Blatchins MA, Kim E, Man A, Karter AJ, Grant RW. Initial Glycemic Control and Care Among Younger Adults Diagnosed With Type 2 Diabetes. Diabetes Care. 2020 May;43(5):975-981. doi: 10.2337/dc19-1380. Epub 2020 Mar 4.

Reference Type BACKGROUND
PMID: 32132007 (View on PubMed)

Laiteerapong N, Ham SA, Gao Y, Moffet HH, Liu JY, Huang ES, Karter AJ. The Legacy Effect in Type 2 Diabetes: Impact of Early Glycemic Control on Future Complications (The Diabetes & Aging Study). Diabetes Care. 2019 Mar;42(3):416-426. doi: 10.2337/dc17-1144. Epub 2018 Aug 13.

Reference Type BACKGROUND
PMID: 30104301 (View on PubMed)

Holman RR, Paul SK, Bethel MA, Matthews DR, Neil HA. 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med. 2008 Oct 9;359(15):1577-89. doi: 10.1056/NEJMoa0806470. Epub 2008 Sep 10.

Reference Type BACKGROUND
PMID: 18784090 (View on PubMed)

American Diabetes Association. 1. Improving Care and Promoting Health in Populations: Standards of Medical Care in Diabetes-2021. Diabetes Care. 2021 Jan;44(Suppl 1):S7-S14. doi: 10.2337/dc21-S001.

Reference Type BACKGROUND
PMID: 33298412 (View on PubMed)

Hildebrand JA, Billimek J, Lee JA, Sorkin DH, Olshansky EF, Clancy SL, Evangelista LS. Effect of diabetes self-management education on glycemic control in Latino adults with type 2 diabetes: A systematic review and meta-analysis. Patient Educ Couns. 2020 Feb;103(2):266-275. doi: 10.1016/j.pec.2019.09.009. Epub 2019 Sep 9.

Reference Type BACKGROUND
PMID: 31542186 (View on PubMed)

Flores-Luevano S, Pacheco M, Shokar GS, Dwivedi AK, Shokar NK. Impact of a Culturally Tailored Diabetes Education and Empowerment Program in a Mexican American Population Along the US/Mexico Border: A Pragmatic Study. J Clin Med Res. 2020 Aug;12(8):517-529. doi: 10.14740/jocmr4273. Epub 2020 Jul 22.

Reference Type BACKGROUND
PMID: 32849940 (View on PubMed)

Rosal MC, Ockene IS, Restrepo A, White MJ, Borg A, Olendzki B, Scavron J, Candib L, Welch G, Reed G. Randomized trial of a literacy-sensitive, culturally tailored diabetes self-management intervention for low-income latinos: latinos en control. Diabetes Care. 2011 Apr;34(4):838-44. doi: 10.2337/dc10-1981. Epub 2011 Mar 4.

Reference Type BACKGROUND
PMID: 21378213 (View on PubMed)

Islam NS, Wyatt LC, Taher MD, Riley L, Tandon SD, Tanner M, Mukherji BR, Trinh-Shevrin C. A Culturally Tailored Community Health Worker Intervention Leads to Improvement in Patient-Centered Outcomes for Immigrant Patients With Type 2 Diabetes. Clin Diabetes. 2018 Apr;36(2):100-111. doi: 10.2337/cd17-0068.

Reference Type BACKGROUND
PMID: 29686448 (View on PubMed)

Spencer MS, Gunter KE, Palmisano G. Community health workers and their value to social work. Soc Work. 2010 Apr;55(2):169-80. doi: 10.1093/sw/55.2.169.

Reference Type BACKGROUND
PMID: 20408358 (View on PubMed)

Hartzler AL, Tuzzio L, Hsu C, Wagner EH. Roles and Functions of Community Health Workers in Primary Care. Ann Fam Med. 2018 May;16(3):240-245. doi: 10.1370/afm.2208.

Reference Type BACKGROUND
PMID: 29760028 (View on PubMed)

Adair R, Wholey DR, Christianson J, White KM, Britt H, Lee S. Improving chronic disease care by adding laypersons to the primary care team: a parallel randomized trial. Ann Intern Med. 2013 Aug 6;159(3):176-84. doi: 10.7326/0003-4819-159-3-201308060-00007.

Reference Type BACKGROUND
PMID: 23922063 (View on PubMed)

Palmas W, March D, Darakjy S, Findley SE, Teresi J, Carrasquillo O, Luchsinger JA. Community Health Worker Interventions to Improve Glycemic Control in People with Diabetes: A Systematic Review and Meta-Analysis. J Gen Intern Med. 2015 Jul;30(7):1004-12. doi: 10.1007/s11606-015-3247-0. Epub 2015 Mar 4.

Reference Type BACKGROUND
PMID: 25735938 (View on PubMed)

Kvedar J, Coye MJ, Everett W. Connected health: a review of technologies and strategies to improve patient care with telemedicine and telehealth. Health Aff (Millwood). 2014 Feb;33(2):194-9. doi: 10.1377/hlthaff.2013.0992.

Reference Type BACKGROUND
PMID: 24493760 (View on PubMed)

Ray KN, Chari AV, Engberg J, Bertolet M, Mehrotra A. Disparities in Time Spent Seeking Medical Care in the United States. JAMA Intern Med. 2015 Dec;175(12):1983-6. doi: 10.1001/jamainternmed.2015.4468. No abstract available.

Reference Type BACKGROUND
PMID: 26437386 (View on PubMed)

Reed ME, Huang J, Parikh R, Millman A, Ballard DW, Barr I, Wargon C. Patient-Provider Video Telemedicine Integrated With Clinical Care: Patient Experiences. Ann Intern Med. 2019 Aug 6;171(3):222-224. doi: 10.7326/M18-3081. Epub 2019 Apr 30. No abstract available.

Reference Type BACKGROUND
PMID: 31035294 (View on PubMed)

Wagner EH. Chronic disease management: what will it take to improve care for chronic illness? Eff Clin Pract. 1998 Aug-Sep;1(1):2-4. No abstract available.

Reference Type BACKGROUND
PMID: 10345255 (View on PubMed)

Wan EYF, Fung CSC, Jiao FF, Yu EYT, Chin WY, Fong DYT, Wong CKH, Chan AKC, Chan KHY, Kwok RLP, Lam CLK. Five-Year Effectiveness of the Multidisciplinary Risk Assessment and Management Programme-Diabetes Mellitus (RAMP-DM) on Diabetes-Related Complications and Health Service Uses-A Population-Based and Propensity-Matched Cohort Study. Diabetes Care. 2018 Jan;41(1):49-59. doi: 10.2337/dc17-0426. Epub 2017 Nov 14.

Reference Type BACKGROUND
PMID: 29138274 (View on PubMed)

American Diabetes Association. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2021. Diabetes Care. 2021 Jan;44(Suppl 1):S15-S33. doi: 10.2337/dc21-S002.

Reference Type BACKGROUND
PMID: 33298413 (View on PubMed)

Gopalan A, Blatchins MA, Altschuler A, Mishra P, Fakhouri I, Grant RW. Disclosure of New Type 2 Diabetes Diagnoses to Younger Adults: a Qualitative Study. J Gen Intern Med. 2021 Jun;36(6):1622-1628. doi: 10.1007/s11606-020-06481-y. Epub 2021 Jan 26.

Reference Type BACKGROUND
PMID: 33501523 (View on PubMed)

Klompas M, Eggleston E, McVetta J, Lazarus R, Li L, Platt R. Automated detection and classification of type 1 versus type 2 diabetes using electronic health record data. Diabetes Care. 2013 Apr;36(4):914-21. doi: 10.2337/dc12-0964. Epub 2012 Nov 27.

Reference Type BACKGROUND
PMID: 23193215 (View on PubMed)

Makam AN, Nguyen OK, Moore B, Ma Y, Amarasingham R. Identifying patients with diabetes and the earliest date of diagnosis in real time: an electronic health record case-finding algorithm. BMC Med Inform Decis Mak. 2013 Aug 1;13:81. doi: 10.1186/1472-6947-13-81.

Reference Type BACKGROUND
PMID: 23915139 (View on PubMed)

Pandit AU, Bailey SC, Curtis LM, Seligman HK, Davis TC, Parker RM, Schillinger D, DeWalt D, Fleming D, Mohr DC, Wolf MS. Disease-related distress, self-care and clinical outcomes among low-income patients with diabetes. J Epidemiol Community Health. 2014 Jun;68(6):557-64. doi: 10.1136/jech-2013-203063. Epub 2014 Jan 31.

Reference Type BACKGROUND
PMID: 24489044 (View on PubMed)

Ratanawongsa N, Karter AJ, Parker MM, Lyles CR, Heisler M, Moffet HH, Adler N, Warton EM, Schillinger D. Communication and medication refill adherence: the Diabetes Study of Northern California. JAMA Intern Med. 2013 Feb 11;173(3):210-8. doi: 10.1001/jamainternmed.2013.1216.

Reference Type BACKGROUND
PMID: 23277199 (View on PubMed)

Campbell MK, Piaggio G, Elbourne DR, Altman DG; CONSORT Group. Consort 2010 statement: extension to cluster randomised trials. BMJ. 2012 Sep 4;345:e5661. doi: 10.1136/bmj.e5661. No abstract available.

Reference Type BACKGROUND
PMID: 22951546 (View on PubMed)

Molyneaux LM, Constantino MI, McGill M, Zilkens R, Yue DK. Better glycaemic control and risk reduction of diabetic complications in Type 2 diabetes: comparison with the DCCT. Diabetes Res Clin Pract. 1998 Nov;42(2):77-83. doi: 10.1016/s0168-8227(98)00095-3.

Reference Type BACKGROUND
PMID: 9886743 (View on PubMed)

The relationship of glycemic exposure (HbA1c) to the risk of development and progression of retinopathy in the diabetes control and complications trial. Diabetes. 1995 Aug;44(8):968-83.

Reference Type BACKGROUND
PMID: 7622004 (View on PubMed)

White IR, Royston P, Wood AM. Multiple imputation using chained equations: Issues and guidance for practice. Stat Med. 2011 Feb 20;30(4):377-99. doi: 10.1002/sim.4067. Epub 2010 Nov 30.

Reference Type BACKGROUND
PMID: 21225900 (View on PubMed)

Rubin DB, Schenker N. Multiple imputation in health-care databases: an overview and some applications. Stat Med. 1991 Apr;10(4):585-98. doi: 10.1002/sim.4780100410.

Reference Type BACKGROUND
PMID: 2057657 (View on PubMed)

Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009 Aug 7;4:50. doi: 10.1186/1748-5908-4-50.

Reference Type BACKGROUND
PMID: 19664226 (View on PubMed)

Barbosa CE, Masho SW, Carlyle KE, Mosavel M. Factors Distinguishing Positive Deviance Among Low-Income African American Women: A Qualitative Study on Infant Feeding. J Hum Lact. 2017 May;33(2):368-378. doi: 10.1177/0890334416673048. Epub 2016 Nov 24.

Reference Type BACKGROUND
PMID: 27881731 (View on PubMed)

Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2006;3(2):77-101. DOI: 10.1191/1478088706qp063oa.

Reference Type BACKGROUND

Other Identifiers

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

1833646

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Outreach for Diabetes Cure
NCT01384045 COMPLETED NA
Together Overcoming Diabetes
NCT04734015 ACTIVE_NOT_RECRUITING NA
Family-Centered Diabetes Project
NCT00006159 COMPLETED NA