Bamberg Diabetes Transitional Care Pilot Study

Summary

Bamberg County residents who has been diagnosed with or is at high risk for diabetes, may be eligible for a clinical research study to improve diabetes self-management and decrease hospital re-admissions.

The purpose of this study is to compare the effectiveness of three hospital discharge follow-up methods:

1. standard of care,
2. a nurse telephone intervention (care coordination and education), and
3. an in-home community health worker intervention (care coordination and education).

Conditions

• Diabetes

Interventions

BEHAVIORAL

Surveys

The following information will be collected: demographics, literacy screener, depression screener, medication adherence, self-efficacy, tobacco use, patient activation, health questionnaire, eating patterns, diabetes self-management assessment, stages of change questionnaire, vitals, and self-care behaviors.

BEHAVIORAL

Telephonic Nurse Intervention

A nurse will contact patients by phone at least weekly for month 1 and at least every other week for months 2 and 3 and will collect the following information: medication adherence, discharge plan adherence, problem solving, diet and physical activity issues and to assess self-management, dietary, and physical activity improvements. In addition the nurse will link participants with resources.

BEHAVIORAL

In-person Community Health Worker

An in-person Community Health Worker will contact patients in-person at least weekly for month 1 and at least every other week for months 2 and 3 and will collect the following information: medication adherence, discharge plan adherence, problem solving, diet and physical activity issues and to assess self-management, dietary, and physical activity improvements. In addition the nurse will link participants with resources.

Sponsors & Collaborators

• Medical University of South Carolina

  lead OTHER

• University of North Carolina, Chapel Hill

  collaborator OTHER

• South Carolina Department of Health and Human Services

  collaborator UNKNOWN

• North Carolina Translational and Clinical Sciences Institute

  collaborator OTHER

• The Regional Medical Center of Orangeburg and Calhoun Counties

  collaborator UNKNOWN

Principal Investigators

• Carolyn Jenkins, DrPh, MSN · Medical University of South Carolina

• Samuel Cykert, MD · University of North Carolina, Chapel Hill

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

75 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2015-06-01

Primary Completion

2017-10-01

Completion

2017-10-01

Countries

• United States

Study Locations