Effectiveness of the Diabetes Homeless Medication Support (D-HOMES) Program on Diabetes Management

NCT ID: NCT07091487

Last Updated: 2025-07-29

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

RECRUITING

Clinical Phase

NA

Total Enrollment

256 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-06-25

Study Completion Date

2029-09-30

Brief Summary

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The goal of this clinical trial is to learn if the Diabetes Homelessness Medication Support (D-HOMES) wellness coaching model is effective for adults who speak English or Spanish, have Type 2 diabetes with an HbA1c at or above 7.5, and have recently experienced homelessness. Researchers will compare a one-time education session about diabetes to 10 wellness coaching sessions to see if there are differences between the groups' health outcomes. The main questions it aims to answer are:

* Do D-HOMES participants have greater reductions in HbA1c at 3 months than participants who received education?
* Do D-HOMES participants have greater reductions in HbA1c at 6 and 12 months compared to those who received education?
* Do D-HOMES participants have improvements in blood pressure control, quality of life, self-reported psychological wellness, diabetes distress, and diabetes medication adherence and self-management at 3, 6, and 12 months?
* What factors must be considered to make D-HOMES scalable?

Participants will:

* complete 5 assessments including two baseline assessments and follow-ups at months 3,6, and 12
* participate in a one-time education session or 10 weeks of wellness coaching.

Detailed Description

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Conditions

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Type 2 Diabetes

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Enhanced Usual Care/Education Session

Brief one-on-one diabetes education session provided by a diabetes wellness coach.

Group Type ACTIVE_COMPARATOR

Enhanced Usual Care/ Education

Intervention Type BEHAVIORAL

Trained diabetes wellness coaches will provide approximately 15 minutes of instruction about the basic concepts of diabetes. They will use handouts aligned with American Diabetes Association guidelines. They will use the ask-offer-ask method to review these with participants and answer basic questions. Handouts will cover (1) general diabetes knowledge, (2) healthy eating with diabetes, (3) physical activity with diabetes. The coach will also provide a general tool to support medication adherence (e.g. pillbox).

Diabetes Homeless Medication Support (D-HOMES)

10 one-on-one behavioral treatments by a diabetes wellness coach.

Group Type EXPERIMENTAL

Diabetes Homeless Medication Support

Intervention Type BEHAVIORAL

There will be 10 one-on-one sessions offered within 12 weeks to participants. Sessions will last approximately 30 minutes. During sessions a diabetes wellness coach will use behavioral activation and motivational interviewing to get to know participants and set goals to improve diabetes care. The coach will encourage a focus on medication adherence behaviors and psychologiccal wellness to the extent that participants are willing. The coach will also help with resource and care coordination. The coach will also provide a tailored tool matched to the patient's needs/goals and tailored diabetes education as needed.

Interventions

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Diabetes Homeless Medication Support

There will be 10 one-on-one sessions offered within 12 weeks to participants. Sessions will last approximately 30 minutes. During sessions a diabetes wellness coach will use behavioral activation and motivational interviewing to get to know participants and set goals to improve diabetes care. The coach will encourage a focus on medication adherence behaviors and psychologiccal wellness to the extent that participants are willing. The coach will also help with resource and care coordination. The coach will also provide a tailored tool matched to the patient's needs/goals and tailored diabetes education as needed.

Intervention Type BEHAVIORAL

Enhanced Usual Care/ Education

Trained diabetes wellness coaches will provide approximately 15 minutes of instruction about the basic concepts of diabetes. They will use handouts aligned with American Diabetes Association guidelines. They will use the ask-offer-ask method to review these with participants and answer basic questions. Handouts will cover (1) general diabetes knowledge, (2) healthy eating with diabetes, (3) physical activity with diabetes. The coach will also provide a general tool to support medication adherence (e.g. pillbox).

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

1. Age 18 yrs. or older
2. English or Spanish-speaking
3. Recent homelessness by HUD and HHS definitions

1. Any housing instability in the last 12 mo. (includes supported housing or worry about paying rent)
2. Significant housing instability in the last 24 mos. (includes any stay in shelter, outside, or places not meant for human habitation)
4. Self-reported diagnosis of type 2 diabetes with A1c \>7.5%, later verified in medical record and study lab. test
5. Plan to stay in local area or be reachable by phone for the next 12 months
6. Willingness to work on medication adherence and diabetes self-care

Exclusion Criteria

1. Inability to provide informed consent (e.g., presence of a legal guardian, prisoners)
2. Active psychosis or intoxication precluding ability to give informed consent
3. Pregnant or lactating people at initial enrollment, determined by specific screening questions.
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

Katherine Vickery

OTHER

Sponsor Role lead

Responsible Party

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Katherine Vickery

Primary Investigator

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Katherine D Vickery, MD, MSc

Role: PRINCIPAL_INVESTIGATOR

Hennepin Healthcare Research Institute

Locations

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Hennepin Healthcare Research Institute

Minneapolis, Minnesota, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Katherine D Vickery, MD, MSc

Role: CONTACT

6128736852

Facility Contacts

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Katherine D Vickery, MD, MSc

Role: primary

612-873-6852

Other Identifiers

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R01DK139152

Identifier Type: NIH

Identifier Source: secondary_id

View Link

IRB-FY2024-849

Identifier Type: -

Identifier Source: org_study_id

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