A Self-Management Intervention for African Americans With Comorbid Diabetes and Hypertension: A Pilot Randomized Controlled Trial

Lynch, Elizabeth B.; Liebman, Rebecca; Ventrelle, Jennifer; Avery, Elizabeth; Richardson, DeJuran

doi:10.5888/pcd11.130349

Cited by 65 publications

(102 citation statements)

References 29 publications

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“…In fact, several recent weight loss trials highlight the potential efficacy of peer-delivered weight loss programs in a variety of community-based settings. 21–22, 31 There are several key features of peer-delivered programs, including the provision of informational and emotional support, that make this approach appealing and potentially effective for the management of obesity. 19 In addition, peer coaches may be more accessible to patients and more familiar with their personal experiences than healthcare providers.…”

Section: Discussionmentioning

confidence: 99%

Pilot Study Evaluating the Feasibility and Initial Outcomes of a Primary Care Weight Loss Intervention With Peer Coaches

et al. 2015

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Purpose The purpose of this single-group pilot study was to evaluate the feasibility, acceptability, and initial outcomes of a novel approach to delivering weight loss treatment in primary care using peer coaches and targeting predominantly African American patients with diabetes or pre-diabetes. Methods Participants (N=33) were recruited from a family medicine practice for a 6-month lifestyle intervention. Eligible patients were obese adults (body mass index; BMI ≥30 kg/m2) with ≥1 additional cardio-metabolic risk factor(s), including 1) elevated hemoglobin A1C or diagnosed diabetes, 2) elevated blood pressure, 3) elevated triglycerides, and/or 4) low HDL. The intervention included a combination of 12 group-based office visits with health professionals plus 12 individual phone contacts with peer coaches. Outcomes included weight loss, program adherence, and program satisfaction. Results Participants (mean age = 56±10 years; BMI=42.9±11.0 kg/m2) were predominantly female (88%) and African American (85%). Treatment resulted in a significant mean weight loss of −4.5±7.2 kg, and approximately 27% of participants lost ≥5% of their initial body weight. Participants completed approximately 50% of the group visits and 40% of the telephone calls with peer coaches. Participants rated both components of the intervention favorably. Conclusions Results of this pilot study indicated that a primary care weight management program including group-based visits and peer-delivered telephone contacts achieved significant weight loss among predominantly African-American patients with weight-related comorbidities, including diabetes and pre-diabetes. Additional research is needed to examine the long-term outcomes of this novel approach and to identify program components supporting patients’ success.

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Section: Discussionmentioning

confidence: 99%

Pilot Study Evaluating the Feasibility and Initial Outcomes of a Primary Care Weight Loss Intervention With Peer Coaches

et al. 2015

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“…Three diet and physical activity interventions showed short-term improvements in glycemic control but none showed improvements at six months following intervention. [62-64] The recent failure of the Look AHEAD intensive lifestyle intervention to show long-term reduction in cardiovascular outcomes,[65] highlights the need for novel approaches to diabetes self-management that will result in long-term reductions in diabetes complications. The LIFE intervention can also be used to inform development of an adaptive intervention by identifying tailoring variables that may distinguish between early, late and non-responders.…”

Section: Discussionmentioning

confidence: 99%

“…The LIFE curriculum described here was informed by a pilot study conducted using an earlier version of the curriculum. [51]…”

Section: Methodsmentioning

confidence: 99%

“…This hypothesis is supported by data obtained from the LIFE pilot study. [51] We further assume that the standard deviation of this change in A1C is approximately 1.6, as was observed in both the LIFE pilot study and the MATCH study, a two-year community-based study of Mexican-Americans with diabetes. [60, 61] A two-sample, two-sided, t-test will be used for the primary analysis.…”

Section: Methodsmentioning

confidence: 99%

“… * from Lynch, E. B., et al (2014). “A self-management intervention for African Americans with comorbid diabetes and hypertension: a pilot randomized controlled trial.” Prev Chronic Dis 11: E90.…”

Section: Figurementioning

confidence: 99%

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Design of the Lifestyle Improvement through Food and Exercise (LIFE) study: A randomized controlled trial of self-management of type 2 diabetes among African American patients from safety net health centers

Lynch

Liebman

Ventrelle

et al. 2014

Contemporary Clinical Trials

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The Lifestyle Improvement through Food and Exercise (LIFE) study is a community-based randomized-controlled trial to measure the effectiveness of a lifestyle intervention to improve glycemic control among African Americans with type 2 diabetes attending safety net clinics. The study enrolled African American adults with a diagnosis of type 2 diabetes and HbA1c ≥ 7.0 who had attended specific safety net community clinics in the prior year. 210 patients will be enrolled and randomized to either the LIFE intervention or a standard of care control group, which consists of two dietitian-led diabetes self-management classes. The LIFE intervention was delivered in 30 group sessions over 12-months and focused on improving diet through dietitian-led culturally-tailored nutrition education, increasing physical activity through self-monitoring using an accelerometer, increasing ability to manage blood sugar through modifications to lifestyle, and providing social support for behavior change. In addition to the group sessions, peer supporters made regular telephone calls to participants to monitor progress towards behavioral goals and provide social support. The 12-month intervention phase was followed by a six-month maintenance phase consisting of two group sessions. The primary outcome of the study is change in A1C from baseline to 12-months, and an additional follow-up will occur at 18-months. The hypothesis of the study is that the participants in the LIFE intervention will show a greater improvement in glycemic control over 12-months than participants in the control group.

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Interventions for improving outcomes in patients with multimorbidity in primary care and community settings

Smith

Wallace

O’Dowd

et al. 2016

Cochrane Database of Systematic Reviews

551

428

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This review identifies the emerging evidence to support policy for the management of people with multimorbidity and common comorbidities in primary care and community settings. There are remaining uncertainties about the effectiveness of interventions for people with multimorbidity in general due to the relatively small number of RCTs conducted in this area to date, with mixed findings overall. It is possible that the findings may change with the inclusion of large ongoing well-organised trials in future updates. The results suggest an improvement in health outcomes if interventions can be targeted at risk factors such as depression, or specific functional difficulties in people with multimorbidity.

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A Self-Management Intervention for African Americans With Comorbid Diabetes and Hypertension: A Pilot Randomized Controlled Trial

Cited by 65 publications

References 29 publications

Pilot Study Evaluating the Feasibility and Initial Outcomes of a Primary Care Weight Loss Intervention With Peer Coaches

Pilot Study Evaluating the Feasibility and Initial Outcomes of a Primary Care Weight Loss Intervention With Peer Coaches

Design of the Lifestyle Improvement through Food and Exercise (LIFE) study: A randomized controlled trial of self-management of type 2 diabetes among African American patients from safety net health centers

Interventions for improving outcomes in patients with multimorbidity in primary care and community settings

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