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Northern Manhattan Diabetes Community Outreach Project (NOCHOP)

This study has been completed.
Sponsor:
Collaborator:
National Institutes of Health (NIH)
Information provided by (Responsible Party):
Walter Palmas, MD, MS, FAHA, Columbia University
ClinicalTrials.gov Identifier:
NCT00787475
First received: November 6, 2008
Last updated: February 2, 2015
Last verified: February 2015
  Purpose

The objective of this study is to examine the effectiveness of a community health worker intervention at helping to control diabetes among Latinos with poorly controlled Type 2 diabetes.

Hypothesis: Compared to those in Enhanced usual care group, patients randomized to the intervention will, at 12 months, have greater reductions in: (1) HgA1C; (2) low density lipoprotein (LDL); and (3) systolic and diastolic BP.


Condition Intervention
Diabetes Other: Community Health worker

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single Blind (Investigator)
Primary Purpose: Prevention
Official Title: Northern Manhattan Diabetes Community Outreach Project

Further study details as provided by Walter Palmas, MD, MS, FAHA, Columbia University:

Primary Outcome Measures:
  • HgA1C level [ Time Frame: Up to 12 months ]

Secondary Outcome Measures:
  • Measurement of LDL [ Time Frame: Up to 12 months ]
  • Measurement of systolic blood pressure [ Time Frame: Up to 12 months ]

Enrollment: 360
Study Start Date: September 2008
Study Completion Date: February 2014
Primary Completion Date: February 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: 1
CHW intervention
Other: Community Health worker
Community Health workers with at least 4 home visits, 8 phone calls, and 10 group visits.
No Intervention: 2
Enhanced usual care (brochure mailings)

Detailed Description:
The objective of this project is to examine the effectiveness of a community health worker (CHW) intervention at addressing glycemic control among Latinos with poorly controlled Type 2 diabetes. Our group has worked with a promising model of intervention that utilizes CHW's based at one of our major community partners. Pilot data from this program has shown clinically significant prepost test improvements in HgA1C. Using the Chronic Care Model as an overarching framework, the study design of NOCHOP is a randomized controlled trial of 360 Latinos, mostly of Caribbean descent, aged 35-70 years with HgA1C >=8.0. At a minimum, subjects in the intervention group will receive four home visits, ten group level visits and monthly phone calls by CHWs based at Alianza. The control groups will receive three separate mailings of bilingual diabetes health education materials. The primary outcome is glycemic control at 12month follow up, as measured by HgA1c. The secondary outcomes are changes in cholesterol and blood pressure (BP). We will also collect exploratory data on potential mechanisms through which our intervention resulted in hypothesized improvements including medication adherence, medication Intensification, diet and exercise. If successful, our project will make an important contribution to ongoing national and local debates about the sustainability of CHW programs. In particular, data from this study would be extremely useful for local Medicaid managed care plans who have expressed strong interests in data from rigorously designed clinical trials addressing the role of CHWs in delivering culturally appropriate and effective diabetes care.
  Eligibility

Ages Eligible for Study:   35 Years to 70 Years   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Adult patients age 35-70 years*
  • Receiving care at our clinic (2 visits with a primary care provider in the previous year)
  • Living in Northern Manhattan or Western Bronx (based on zip codes)
  • Had a hemoglobin A1C-done within the past year, with the latest value being > or = 8.0

Exclusion Criteria:

  • Patients whose primary care physician (PCP) believes are not appropriate candidates for participation
  • Type 1 diabetics (identified by PCP), as their care is quite distinct from that of Type II patients, and there are very few such patients in our clinic
  • Patients with diabetes diagnosed when under age 25 ("new-onset" Type I diabetes) as such patients are extremely rare in our primary care clinics
  • Patients who do not self-identify as Hispanic (Hispanics can be of any race e.g. white, black, mixed)
  • Any life-threatening or extreme medical co-morbidity, such as an active cancer diagnosis, paraplegia, or end stage cardio-pulmonary disease
  • Having a diabetes diagnosis for < 1 year, to ensure the stability of hemoglobin A1C values above 8.0
  • Planning to move out of the neighborhood during the next year
  • Planning to travel out of the neighborhood for more than three consecutive months
  • Enrollment in any other cardiovascular disease (CVD) or diabetes intervention study
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00787475

Locations
United States, New York
Columbia University Medical Center
New York, New York, United States, 10032
Sponsors and Collaborators
Columbia University
National Institutes of Health (NIH)
Investigators
Principal Investigator: Walter Palmas, MD Columbia University Medical Director
  More Information

Publications:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Walter Palmas, MD, MS, FAHA, Associate Professor of Clinical Medicine, Columbia University
ClinicalTrials.gov Identifier: NCT00787475     History of Changes
Other Study ID Numbers: AAAD1689
MD00206P60 ( Other Grant/Funding Number: NIH )
Study First Received: November 6, 2008
Last Updated: February 2, 2015

Keywords provided by Walter Palmas, MD, MS, FAHA, Columbia University:
Diabetes
Community health worker
Community outreach

Additional relevant MeSH terms:
Diabetes Mellitus
Glucose Metabolism Disorders
Metabolic Diseases
Endocrine System Diseases

ClinicalTrials.gov processed this record on July 26, 2017