Comparison of Outreach Methods to Encourage Enrollment in Diabetes Prevention and Weight Management Programs

Study Overview
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Brief Summary
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Individuals with prediabetes are at increased risk for developing diabetes. Higher hemoglobin A1c's (6.1-6.4%) are associated with a high risk of developing diabetes. It is known that programs such weight management classes and one-on-one counseling with registered dieticians can lead to weight loss and decrease the risk of diabetes. However, engagement of Kaiser Permanente Colorado members in these activities is low. The purpose of this study is to determine which of three outreach methods is most effective in increasing engagement in these activities.

Official Title
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Comparison of Outreach Methods to Encourage Enrollment in Diabetes Prevention and Weight Management Programs

Conditions
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PreDiabetes, Obesity

Intervention / Treatment
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* Other: EHR gaps
* Other: Bulk outreach
* Other: Dietician call


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Kaiser Permanente Member Age 18-75 Prediabetes BMI >= 25 A1c 6.1-6.4% No dietitian visit within the past 3 years Exclusion Criteria: - Pregnancy

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Individuals with a body mass index between 25 and 30 are randomized 1:1 to the Usual Care or EHR Gap arms. Individuals with a body mass index >=30 are randomized to all 4 arms, with n=1000 for the Personalized Outreach arm and 1:1:1 for the other three arms.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Usual care<br>Usual care | |
| Active Comparator: Electronic health record gaps<br>Gaps will appear in the electronic health record and patient portal in order to prompt referral by provider or patient | Other: EHR gaps<br>* Gaps will appear in the electronic health record and patient portal in order to prompt referral by provider or patient<br>|
| Active Comparator: Bulk outreach<br>Gaps will appear in the electronic health record and patient portal in order to prompt referral by provider or patient; in addition a bulk letter or email will be sent | Other: EHR gaps<br>* Gaps will appear in the electronic health record and patient portal in order to prompt referral by provider or patient<br>Other: Bulk outreach<br>* A bulk letter or email will be sent<br>|
| Active Comparator: Personalized outreach<br>Gaps will appear in the electronic health record and patient portal in order to prompt referral by provider or patient; in addition a bulk letter or email will be sent and patients will receive a personalized call by a registered dietitian | Other: EHR gaps<br>* Gaps will appear in the electronic health record and patient portal in order to prompt referral by provider or patient<br>Other: Bulk outreach<br>* A bulk letter or email will be sent<br>Other: Dietician call<br>* Patients will receive a personalized call by a registered dietitian<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Enrollment in Diabetes Prevention or Weight Management Class (Online) | Percent of individuals who have enrolled in online diabetes prevention or weight management classes (online) over a 4.5 month period | 4.5 months (6/26/2017-11/10/2017) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Enrollment in Diabetes Prevention or Weight Management Class (in Person) | Percent of individuals who have enrolled in diabetes prevention or weight management class (in person) over a 4.5 month follow-up period | 4.5 months (6/26/2017-11/10/2017) |