Using Peer Support to Aid in Prevention and Treatment in Prediabetes

Completed · Not applicable

Conditions studied: PreDiabetes

In brief

An estimated 86 million adults in the United States have prediabetes, and low-income Latino and African American adults have disproportionately high rates compared to non-Hispanic adults. Structured lifestyle interventions can prevent or delay type 2 diabetes in these at-risk populations and now are widely offered at community organizations and health systems. Yet, uptake of and engagement in available formal programs is very low. Low-income adults in particular face multiple barriers to navigating, engaging in, and sustaining involvement in available programs and lifestyle behaviors found to decrease progression to diabetes. It is critically important to develop and evaluate innovative approaches to increase uptake, engagement, and maintenance of gains in diabetes prevention activities. Peer support has been shown in the investigators' and others' effectiveness trials to be a sustainable, effective approach for positive behavior change and improved outcomes in adults with diabetes and other chronic conditions. The study team's pilot work suggests such approaches are feasible and acceptable among low-income Latino and African American patients with prediabetes to prevent chronic disease and better navigate their health care systems to obtain healthy lifestyle counseling and support. However, such peer support models among Latino, African American, and other low-income adults with prediabetes have not yet been rigorously evaluated. Accordingly, the study will conduct a parallel, two-arm randomized controlled trial in primary care centers in two different health systems that serve multi-ethnic communities with a high concentration of Latinos and African Americans and diverse socio-economic backgrounds. The study will compare enhanced usual care (providing referrals to diabetes prevention programs and resources) with a model of a structured behavioral change intervention supplementing enhanced referral to programs and resources with peer support to help link adults with prediabetes to existing health system and community diabetes prevention programs, to support their engagement in formal programs, maintain achieved gains, and support participants to initiate and sustain healthy behaviors to prevent diabetes.

Key facts

Study ID

NCT03689530

Run by

University of Michigan

People needed

450

Starts

2018-10-02

Expected to finish

2022-04-15

Last updated by the study team

2023-03-03

Who can join

Age: 18 and older, up to 99. Sex: any. Healthy volunteers: accepted.

You may qualify if…

• Peer supporter:
• prior A1c 5.7 - 6.4 in last 3 years, with most recent being either lass than 5.7 or 0.4 points less than prior; AND/OR
• prior BMI >=25 or >=23 if Asian American in last three years with most recent 2% lower body weight;AND/OR
• prior completion of a wellness or diabetes prevention program; AND/OR
• completion of initial 6 months of UPSTART intervention as participant.
• Patient participant:
• no prior dx of DM or current use of anti-hyperglycemic medication;
• BMI >=25 m2/kg or >=23 if Asian; and
• A1c 5.7 - 6.4.

You may not qualify if…

• serious psychiatric disorder in past 24 months
• pregnant or planning pregnancy
• substance abuse in past 12 months
• diagnosis of dementia, bipolar, schizophrenia, personality disorder
• other serious concerns rendering possible development of diabetes unimportant to potential participant.

Where it is running

• Kaiser Permanente Northern California — Oakland, California, United States
• University of Michigan — Ann Arbor, Michigan, United States

Full record on ClinicalTrials.gov

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