scholarly journals Protocol of a cluster randomized trial to investigate the impact of a type 2 diabetes risk prediction model on change in physical activity in primary care

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Esther Jacobs ◽  
Miguel Tamayo ◽  
Joachim Rosenbauer ◽  
Matthias B. Schulze ◽  
Oliver Kuss ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Prediction Model ◽  
Randomized Trial ◽  
Risk Prediction ◽  
Cluster Randomized Trial ◽  
Cluster Randomized ◽  
The Impact

scholarly journals Design of a cluster-randomized trial of the effectiveness and cost-effectiveness of metformin on prevention of type 2 diabetes among prediabetic Mexican adults (the PRuDENTE initiative of Mexico City)

2020 ◽  
Vol 95 ◽  
pp. 106067
Author(s):  
Luis A. Rodríguez ◽  
Simón Barquera ◽  
Carlos A. Aguilar-Salinas ◽  
Jaime Sepúlveda-Amor ◽  
Luz María Sánchez-Romero ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cost Effectiveness ◽  
Randomized Trial ◽  
Mexico City ◽  
Cluster Randomized Trial ◽  
Mexican Adults ◽  
Cluster Randomized

scholarly journals Evaluating the effectiveness of an empowerment program for self-care in type 2 diabetes: a cluster randomized trial

2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Daniel Nogueira Cortez ◽  
Maísa Mara Lopes Macedo ◽  
Débora Aparecida Silva Souza ◽  
Jéssica Caroline dos Santos ◽  
Gesana Sousa Afonso ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Randomized Trial ◽  
Self Care ◽  
Cluster Randomized Trial ◽  
Cluster Randomized ◽  
Empowerment Program

scholarly journals Making sense of diabetes medication decisions: a mixed methods cluster randomized trial using a conversation aid intervention

Endocrine ◽  
2021 ◽  
Author(s):  
Marleen Kunneman ◽  
Megan E. Branda ◽  
Jennifer L. Ridgeway ◽  
Kristina Tiedje ◽  
Carl R. May ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Decision Making ◽  
Mixed Methods ◽  
Medication Adherence ◽  
Usual Care ◽  
Cluster Randomized Trial ◽  
Patient Knowledge ◽  
Cluster Randomized

Abstract Purpose To determine the effectiveness of a shared decision-making (SDM) tool versus guideline-informed usual care in translating evidence into primary care, and to explore how use of the tool changed patient perspectives about diabetes medication decision making. Methods In this mixed methods multicenter cluster randomized trial, we included patients with type 2 diabetes mellitus and their primary care clinicians. We compared usual care with or without a within-encounter SDM conversation aid. We assessed participant-reported decisions made and quality of SDM (knowledge, satisfaction, and decisional conflict), clinical outcomes, adherence, and observer-based patient involvement in decision-making (OPTION12-scale). We used semi-structured interviews with patients to understand their perspectives. Results We enrolled 350 patients and 99 clinicians from 20 practices and interviewed 26 patients. Use of the conversation aid increased post-encounter patient knowledge (correct answers, 52% vs. 45%, p = 0.02) and clinician involvement of patients (Mean between-arm difference in OPTION12, 7.3 (95% CI 3, 12); p = 0.003). There were no between-arm differences in treatment choice, patient or clinician satisfaction, encounter length, medication adherence, or glycemic control. Qualitative analyses highlighted differences in how clinicians involved patients in decision making, with intervention patients noting how clinicians guided them through conversations using factors important to them. Conclusions Using an SDM conversation aid improved patient knowledge and involvement in SDM without impacting treatment choice, encounter length, medication adherence or improved diabetes control in patients with type 2 diabetes. Future interventions may need to focus specifically on patients with signs of poor treatment fit. Clinical trial registration ClinicalTrial.gov: NCT01502891.

Cluster Randomized Trial of the Impact of an Obesity Prevention Intervention on Child Care Center Nutrition and Physical Activity Environment Over Two Years

2021 ◽  
pp. 1-25
Author(s):  
Ruby Natale ◽  
Folefac D. Atem ◽  
Cynthia Lebron ◽  
M. Sunil Mathew ◽  
Sitara M. Weerakoon ◽  
...  
Keyword(s):  
Physical Activity ◽  
Child Care ◽  
Randomized Trial ◽  
Obesity Prevention ◽  
Mixed Models ◽  
Care Center ◽  
Cluster Randomized Trial ◽  
Physical Activity Environment ◽  
Cluster Randomized ◽  
The Impact

Abstract Objective: The prevalence of obesity among preschool-aged children in the United States remains unacceptably high. Here we examine the impact of Healthy Caregivers-Healthy Children (HC2) Phase 2, a child care center (CCC)-based obesity prevention intervention on changes in the CCC nutrition and physical activity environment over two school years. Design: This was a cluster randomized trial with 12 CCC receiving the HC2 intervention arm and 12 in the control arm. The primary outcome was change in the Environment and Policy Assessment and Observation (EPAO) tool over two school years (Fall-2015, Spring-2016 and Spring-2017). Changes in EPAO physical activity and nutrition score were analyzed via a (1) random effects mixed models and (2) mixed models to determine the effect of HC2 versus control. Setting: The study was conducted in 24 CCCs serving low-income, ethnically diverse families in Miami-Dade County. Participants: Intervention CCCs received (1) teachers/parents/children curriculum; (2) snack, beverage, physical activity, and screen time policies; and (3) menu modifications. Results: Two-year EPAO nutrition score changes in intervention CCCs were almost twice that of control CCCs. The EPAO physical activity environment scores only slightly improved in intervention CCCs versus control CCCs. Intervention CCCs showed higher combined EPAO physical activity and nutrition scores compared to control CCCs over the 2-year study period (β=0.09, P=0.05). Conclusions: Obesity prevention programs can have a positive impact on the CCC nutrition environment and can promote healthy weight in early childhood. CCCs may need consistent support to improve the physical activity environment to ensure the policies remain intact.

scholarly journals Effects of lifestyle education program for type 2 diabetes patients in clinics: study design of a cluster randomized trial

2010 ◽  
Vol 10 (1) ◽  
Author(s):  
Misa Adachi ◽  
Kazue Yamaoka ◽  
Mariko Watanabe ◽  
Masako Nishikawa ◽  
Eisuke Hida ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Randomized Trial ◽  
Study Design ◽  
Education Program ◽  
Cluster Randomized Trial ◽  
Cluster Randomized ◽  
Lifestyle Education ◽  
Diabetes Patients
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