Interprofessional Community-Based Diabetes Intervention for Older Adults

Study Overview
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Brief Summary
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This study will examine the feasibility and acceptability of a 6-month interprofessional community-based health promotion program, and explore its effects on older adults' self-management of Type 2 Diabetes (T2DM). Recently enrolled clients of Diabetes Care Guelph (DCG), who are age 65+ and have at least two other chronic conditions, will be eligible to participate. Participants must be English speaking, community-dwelling, independent in activities of daily living, and mentally competent to give informed consent. The 6-month intervention will consist of: in-home visits by a Registered Nurse and Registered Dietitian from DCG; participation in a monthly Diabetes Wellness Day group program offered through the Guelph Wellington Seniors Association (GWSA) together with DCG; peer support from trained volunteers at the Diabetes Wellness Day group program; care coordination by the DCG Registered Nurse to help participants access necessary supports and services; and monthly team conferences between care providers at DCG and the GWSA to develop a client-centred plan of care. To evaluate the program, participants will complete interviewer-administered questionnaires before and after the intervention, and care providers and peer volunteers will take part in group interviews.

Official Title
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Feasibility, Acceptability and Effects of an Interprofessional Community-Based Health Promotion Intervention on Self-Management in Older Adults With Type 2 Diabetes and Comorbid Chronic Conditions: A Pilot Study

Conditions
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Diabetes Mellitus, Type 2

Intervention / Treatment
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* Other: Home visits and group program


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 65+ Referred to Diabetes Care Guelph within the past 12 months At least two chronic conditions in addition to Type 2 Diabetes Mellitus English speaking Community-dwelling, in the city of Guelph Independent in activities of daily living Mentally competent to provide informed consent

Ages Eligible for Study
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Minimum Age: 65 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
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Home visits and group program<br> | Other: Home visits and group program<br>* Participants will receive up to three home visits by a Registered Nurse and two home visits by a Registered Dietitian over the 6-month intervention period. Participants will also be invited to attend a monthly Diabetes Wellness Day group program which will include diabetes education, interaction with peer volunteers, group exercise, and a meal. The Registered Nurse will coordinate care to help participants access necessary community supports and services and lead monthly interprofessional case conferences to develop a client-centred plan of care for each study participant.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes from baseline in the Summary of Diabetes Self-Care Activities questionnaire | This questionnaire measures self-care activities including diet, exercise, blood glucose testing, foot care, and smoking. | baseline and 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes from baseline in health-related quality of life (SF-12v2 health survey) |  | Baseline and 6 months | 
| Changes from baseline in depressive symptoms (Centre for Epidemiological Studies Depression Scale) |  | Baseline and 6 months | 
| Changes from baseline in symptoms of anxiety (Generalized Anxiety Disorder Screener-7 Scale) |  | Baseline and 6 months | 
| Changes from baseline in costs of use of health services (Health and Social Services Utilization Inventory) |  | Baseline and 6 months | 
| Changes from baseline in fasting blood glucose (mmol/L) |  | Baseline and 6 months | 
| Changes from baseline in HbA1C (%) |  | Baseline and 6 months | 
| Changes from baseline in number of hypoglycemic events per week (blood glucose <4.0 mmol/L) |  | Baseline and 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Diabetes Mellitus, Type 2, Comorbidity, Aged, Health Services