The purpose of this study is to test a measurement tool and a new training intervention for problem solving in self-management of high cardiovascular disease (CVD) risk in African Americans with type 2 diabetes.
BACKGROUND: African Americans with type 2 diabetes carry a high burden of CVD risk and adverse vascular events such as stroke and peripheral vascular disease. CVD risk factors of suboptimal blood pressure, lipids, and glycemic control are controllable through medical management and lifestyle behavior modification. The traditional primary care medical management model for these chronic CVD risks is inadequate, and models are shifting toward increased disease-related decision-making and self-management on the part of the patient. Yet, precise methods for: 1) identifying patients with ineffective disease-related problem-solving skills, and 2) providing patients with disease-related education that incorporates problem-solving and decision-making skills, have yet to be determined DESIGN NARRATIVE: The study will test a measurement tool and a novel training intervention for problem solving as applied to self-management of high CVD risk in African Americans with type 2 diabetes. The specific aims are to: 1) assess the validity and reliability of an empirically derived assessment tool of effective versus ineffective CVD risk-related problem-solving ability (the Health Problem Solving Scale, HPSS), 2) develop a novel intervention to teach CVD risk-related problem-solving skills to ineffective problem solvers, and 3) conduct a pilot study with a sample of African Americans with type 2 diabetes who have a high CVD risk profile (suboptimal blood pressure, lipids, and/or HbA1c) AND ineffective CVD risk-related problem-solving skills, as measured by the HPSS. The principal investigator is the recipient of a Research Scientist Development Award. Her career goal is to become an independent researcher in self-management of CVD risk in high-risk African American populations, and to be a leader in the development and translation into practice of novel, theory-driven and empirically based interventions to improve patient self-management of CVD risks.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
139
Intensive Intervention: CVD Risk Self-Management Education (1 session) + Intensive Health Problem-Solving Training (8 sessions)
Brief Intervention: CVD Risk Self-Management Education (1 session) + Brief Problem-Solving Training (1 session)
Johns Hopkins School of Medicine/General Clinical Research Center
Baltimore, Maryland, United States
A1C
Time frame: Baseline, 3-month post-intervention follow-up
Barriers to Self-Management
Time frame: Baseline, 1-week post-intervention follow-up, 3-month post-intervention follow-up
Dietary risk assessment
Time frame: Baseline, 3-month post-intervention follow-up
Summary of Diabetes Self-Care Activities Scale
Time frame: Baseline, 3-month post-intervention follow-up
Health Problem-Solving Scale
Time frame: baseline, 1-week post-intervention follow-up, 3-month post-intervention follow-up
Diabetes and CVD Knowledge Test
Time frame: Baseline, 1-week post-intervention follow-up, 3-month post-intervention follow-up
Blood pressure
Time frame: Baseline, 3-month post-intervention follow-up
Lipid panel
Time frame: Baseline, 3-month post-intervention follow-up
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