This project will test different ways of helping primary care practices to do a better job of self-management support (SMS) for their patients with diabetes.
The specific aims of the proposed study are: * Primary Specific Aims 1. To conduct a cluster randomized trial to examine the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) of Connection to Health (CTH) for patients with type 2 diabetes in primary care practice settings. Primary effectiveness outcomes will include hemoglobin A1c, Body Mass Index (BMI), blood pressure and Low Desity Lipprotein (LDL) cholesterol. 2. To determine the incremental benefit, using the RE-AIM framework, of brief targeted practice coaching on the implementation of CTH in diverse primary care practices. * Secondary Specific Aims 1. To identify key practice characteristics (e.g., practice size, organization, setting, and level of experience with practice redesign efforts) that impact CTH RE-AIM. These results will inform dissemination of the CTH intervention. 2. To determine the relative costs associated with implementing CTH and practice coaching to further inform dissemination efforts.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
901
Same as Arm Description
Same as Arm Description
Same as Arm Description
University of Colorado at Denver and Health Sciences Center
Aurora, Colorado, United States
Change in HbA1c from baseline to 18 months
Glycosylated hemoglobin (HbA1c) will be measured at baseline and 18 months from baseline.
Time frame: 18 months from baseline
Change in LDL from baseline to 18 months
Low-density lipoprotein (LDL) cholesterol will be measured at baseline and 18 months from baseline (in mg/dL; e.g., 160 mg/dL).
Time frame: 18 months from baseline
Change in systolic and diastolic blood pressure from baseline to 18 months
Systolic and diastolic blood pressure will be measured at baseline and 18 months from baseline (in mmHg; e.g., 140/90 mmHg)
Time frame: 18 months from baseline
Change in body mass index (BMI) from baseline to 18 months
Body mass index (BMI) will be measured at baseline and 18 months from baseline (weight (kg) / \[height (m)\]2; e.g., 24.96)
Time frame: 18 months from baseline
Evidence of documented self-management support for patients through medical record review
The following elements will be assessed in medical record review: presence of a personal care plan with regular updating, evidence of collaborative goal setting, evidence of action planning around prioritized patient goals, evidence of collaborative problem-solving regarding the action planning process, use of community resources to assist in goal attainment, and evidence of ongoing monitoring of progress on identified goals. A total score will be the sum of positive elements.
Time frame: 18 months from baseline
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