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| ID | Type | Description | Link |
|---|---|---|---|
| R21DK123632 | U.S. NIH Grant/Contract | View source |
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| Name | Class |
|---|---|
| Project Open Hand | OTHER |
| Contra Costa Health Services | OTHER_GOV |
| National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) | NIH |
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This is a pragmatic, pilot randomized controlled trial (RCT) of the Nutrition-Supported Diabetes Education Program (NU-DSMP). This study will test the feasibility and preliminary impact of providing diabetes-tailored food support and individualized case-management on glycemic control and other intermediate outcomes including food security, diet, mental health, and health care behaviors, among Medicaid-enrolled patients with type 2 diabetes in a safety-net county health system.
Together with Contra Costa Health Services, a safety-net county health system, and Project Open Hand, a non-profit organization with extensive experience providing nutrition services to low-income, chronically ill individuals in the San Francisco Bay Area, the investigators will conduct the Nutrition-Supported Diabetes Education Program (NU-DSMP) Pilot Study. The goal for this pragmatic, pilot randomized trial is to test the feasibility, acceptability and preliminary impact of providing 12 weeks of diabetes-healthy food support (i.e. medically tailored meals and groceries) supported by individualized case-management to low-income individuals with type 2 diabetes mellitus (T2DM) participating in the evidence-based Diabetes Self- Management Program (DSMP), compared to DSMP participation alone.
The study will randomize 72 individuals 1:1 to intervention and control arms, following them at 0, 12 and 24 weeks with surveys and medical record review (with an interim brief 6 week assessment with the survey only), to understand the impact on diabetes health. Data from this pilot study will inform the planning of a full-size randomized trial to test the efficacy of the NU-DSMP model, with a long-term goal to inform policy debates about the value of implementing medically tailored food interventions as part of healthcare.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Standard of care including diabetes self-management education | No Intervention | Control participants will receive standard of care as offered by clinical partners to all T2DM patients, including referral to nutritional counseling, T2DM support groups, and participation in local diabetes self-management programs. Control participants are also often provided referral information for locally available food support services in the region that provide diabetes-appropriate foods. Control participants will participate in the Diabetes Self-Management Program, an evidence-based program that takes place over 6 weeks that meets the standard of care for diabetes education. At the end of follow up, the control arm will receive three months diabetes-tailored food support consisting of diabetes-tailored grocery boxes and nutrition case-management. | |
| Diabetes-tailored food support plus diabetes self-management education | Experimental | The intervention has two components: 1) diabetes-tailored food support that consists of weekly, home-delivered medically tailored meals, and monthly home-delivered healthy groceries, from baseline to 24 weeks, and 2) three case-management sessions with client services staff from the partnering nutrition agency over the 12 weeks of intervention. The intervention will be delivered in addition to a base condition consisting of remote participation in the Diabetes Self-Management Program, an evidence-based diabetes education program that takes place over 6 weeks also received by the control group as part of the standard of care. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Food support | Other | Diabetes-tailored food support. Project Open Hand (POH) will provide intervention participants twelve weeks of supplemental food support. Food support will consist of a mix of meals tailored for T2DM, and T2DM-healthy groceries, consistent with American Diabetes Association (ADA) guidelines for diabetes healthy diets under the responsibility of a registered dietitian. All food support will be home delivered. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Hemoglobin A1c (HbA1c) From Baseline to Twelve Weeks by Study Arm | Change HbA1c levels (%) from baseline to twelve weeks by study arms | Baseline and twelve weeks |
| Change in Food Security Severity From Baseline to Twelve Weeks by Study Arm | The US household food security survey module (adult version) from the US Department of Agriculture (USDA) will be used to assess the change in the food security scores from baseline to twelve weeks. The score ranges from 0 to 10. Higher score indicates higher severity of food insecurity. | Baseline and twelve weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Change in the Percentage of Participants With Glucose Control From Baseline to Twelve Weeks by Study Arm | Glucose control will be defined as HbA1c lower than 9%. The change from baseline to twelve weeks, in the percentage of participants with glucose control will be reported. | Baseline and twelve weeks |
| Change in the Percentage of Participants With Low and Very Low Food Security From Baseline to Twelve Weeks by Study Arm |
| Measure | Description | Time Frame |
|---|---|---|
| Change in HbA1c Values From Twelve Weeks to Twenty-four Weeks by Study Arm | To evaluate durability of changes, if any, in HbA1c after the intervention ended, the change in HbA1c levels (%) from 12 weeks to 24 weeks by study arm will be reported. | Twelve weeks and twenty-four weeks |
| Change in the Proportion of Participants With Glycemic Control From Twelve Weeks to Twenty-four by Study Arm |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Kartika Palar, PhD | University of California, San Francisco | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Contra Costa Health Services | Martinez | California | 94553 | United States |
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| ID | Title | Description |
|---|---|---|
| FG000 | Standard of Care and Diabetes Self-management Education | Control participants will receive standard of care as offered by clinical partners to all type 2 diabetes mellitus (T2DM) patients, including referral to nutritional counseling, T2DM support groups, and participation in local diabetes self-management programs. Control participants are also often provided referral information for locally available food support services in the region that provide diabetes-appropriate foods. Control participants will participate in the Diabetes Self-Management Program, an evidence-based program that takes place over 6 weeks that meets the standard of care for diabetes education. At the end of follow up, the control arm will receive three months diabetes-tailored food support consisting of diabetes-tailored grocery boxes and nutrition case-management. |
| FG001 | Diabetes-tailored Food Support Plus Diabetes Self-management Education | The intervention has two components: 1) diabetes-tailored food support that consists of weekly, home-delivered medically tailored meals, and monthly home-delivered healthy groceries, from baseline to 24 weeks, and 2) three case-management sessions with client services staff from the partnering nutrition agency over the 12 weeks of intervention. The intervention will be delivered in addition to a base condition consisting of remote participation in the Diabetes Self-Management Program, an evidence-based diabetes education program that takes place over 6 weeks (same as control group). Food support: Diabetes-tailored food support. Project Open Hand (POH) will provide intervention participants twelve weeks of supplemental food support. Food support will consist of a mix of meals tailored for T2DM, and T2DM-healthy groceries, consistent with American Diabetes Association (ADA) guidelines for diabetes healthy diets under the responsibility of a registered dietitian. All food support will be home delivered. Case-management: Project Open Hand client services staff will conduct three case management sessions with the participant. The first session will initiate food services and ensure orientation to the intervention and set up delivery; the second session will support the participant with any issues related to the intervention; the third session will provide transition from the intervention and connect the participant with local food resources. |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Standard of Care and Diabetes Self-management Education | Control participants will receive standard of care as offered by clinical partners to all T2DM patients, including referral to nutritional counseling, T2DM support groups, and participation in local diabetes self-management programs. Control participants are also often provided referral information for locally available food support services in the region that provide diabetes-appropriate foods. Control participants will participate in the Diabetes Self-Management Program, an evidence-based program that takes place over 6 weeks that meets the standard of care for diabetes education. At the end of follow up, the control arm will receive three months diabetes-tailored food support consisting of diabetes-tailored grocery boxes and nutrition case-management. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Change in Hemoglobin A1c (HbA1c) From Baseline to Twelve Weeks by Study Arm | Change HbA1c levels (%) from baseline to twelve weeks by study arms | Posted | Mean | Standard Deviation | Percentage of glycated hemoglobin | Baseline and twelve weeks |
|
Baseline to 24 months
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Standard of Care and Diabetes Self-management Education | Control participants will receive standard of care as offered by clinical partners to all T2DM patients, including referral to nutritional counseling, T2DM support groups, and participation in local diabetes self-management programs. Control participants are also often provided referral information for locally available food support services in the region that provide diabetes-appropriate foods. Control participants will participate in the Diabetes Self-Management Program, an evidence-based program that takes place over 6 weeks that meets the standard of care for diabetes education. At the end of follow up, the control arm will receive three months diabetes-tailored food support consisting of diabetes-tailored grocery boxes and nutrition case-management. |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Kartika Palar | University of California San Francisco | 415-502-8492 | kartika.palar@ucsf.edu |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Apr 17, 2025 | Apr 18, 2025 | Prot_SAP_001.pdf |
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| ID | Term |
|---|---|
| D003924 | Diabetes Mellitus, Type 2 |
| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
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| ID | Term |
|---|---|
| D019090 | Case Management |
| ID | Term |
|---|---|
| D010347 | Patient Care Planning |
| D003191 | Comprehensive Health Care |
| D010346 | Patient Care Management |
| D006298 | Health Services Administration |
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Participants (n=72) will be randomized to the intervention (n=36) or control (n=36) arms. The intervention consists of providing diabetes-tailored food support and individualized case management over 12 weeks to patients with type 2 diabetes.
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The analyst(s) and investigator(s) conducting and reviewing the analyses of the data will be masked to whether participants were in the intervention or control arm.
|
| Case-management | Other | Project Open Hand client services staff will conduct three case management sessions with the participant. The first session will initiate food services and ensure orientation to the intervention and set up delivery; the second session will support the participant with any issues related to the intervention (logistical or nutrition-related, with referral to the POH registered dietitian as needed); the third session will provide transition from the intervention, connect the participant with local food resources, and ensure a "warm hand-off" to nutrition |
|
Low and very low food security will be defined as 3 or more items answered affirmatively in the USDA's US household food security survey module. Change in the percentage of participants with low or very low food security, from baseline to twelve weeks by intervention arms will be reported. |
| Baseline and twelve weeks |
| Change in Health-related Quality of Life (Healthy Days) From Baseline to Twelve Weeks by Study Arm | Health-related quality of life will be measured using the Summary Index of Unhealthy Days collected via the Centers for Disease Control (CDC) Healthy Days scale. This scale asks the number of days in the past 30 days the person felt physically or mentally unwell. The summary index then estimates the number of recent days when a person's physical and mental health was good (or better) and is calculated by subtracting the number of unhealthy days from 30 days. The change in healthy days from baseline to twelve weeks by study arm will be reported. | Baseline and twelve weeks |
| Change in Consumption of Fruits and Vegetables From Baseline to Twelve Weeks by Study Arm | Dietary information using the Dietary Screener Questionnaire (DSQ) will be collected. The DSQ obtains information on the frequency of consumption of fruits and vegetables. These responses are then converted to cup equivalents per day using a scoring algorithm based on the NHANES 24-hour recall. Fruit and vegetable consumption from baseline to twelve weeks by study arm will be reported. | Baseline and twelve weeks |
| Change in Consumption of Added Sugars From Baseline to Twelve Weeks by Study Arm | Dietary information using the Dietary Screener Questionnaire (DSQ) will be collected. The DSQ obtains information on the frequency of consumption of added sugars. These responses are then converted to teaspoon equivalents per day using a scoring algorithm based on the NHANES 24-hour recall. Added sugars consumption (teaspoon equivalents per day) from baseline to twelve weeks by study arm will be reported. | Baseline and twelve weeks |
| Change in Depressive Symptoms From Baseline to Twelve Weeks by Study Arm | The 8-item Patient Health Questionnaire (PHQ-8) will be used to evaluate depressive symptoms. The PHQ-8 score ranges from 0 to 24, with higher scores indicating higher levels of depression. The change in PHQ-8 scores from baseline to twelve weeks by study arm will be reported. | Baseline and twelve weeks |
| Change in Diabetes Self-efficacy From Baseline to Twelve Weeks by Study Arm | The 8-item Diabetes Self-Efficacy scale will be used to assess confidence in one's ability to manage numerous self-care behaviors. The scores ranges from 8 to 40, with higher scores indicating more confidence in self-managing their diabetes. The changes in the scores from baseline to twelve weeks by study arm will be reported. | Baseline and twelve weeks |
To evaluate durability of changes, if any, in glycemic control after the intervention ended, the change in the percent of participants with HbA1c levels less than 9% from 12 weeks to 24 weeks by study arm will be reported. |
| Twelve weeks and twenty-four weeks |
| Change in Health-related Quality of Life (Healthy Days) From Twelve Weeks to Twenty-four Weeks by Study Arm | Health-related quality of life will be measured using the Summary Index of Unhealthy Days collected via the CDC Healthy Days scale. This scale asks the number of days in the past 30 days the person felt physically or mentally unwell. The summary index then estimates the number of recent days when a person's physical and mental health was good (or better) and is calculated by subtracting the number of unhealthy days from 30 days. To evaluate the durability of changes, if any, in health-related quality of life, the change in healthy days from 12 weeks to 24 weeks by study arm will be reported. | Twelve weeks and twenty-four weeks |
| BG001 | Diabetes-tailored Food Support Plus Diabetes Self-management Education | The intervention has two components: 1) diabetes-tailored food support that consists of weekly, home-delivered medically tailored meals, and monthly home-delivered healthy groceries, from baseline to 24 weeks, and 2) three case-management sessions with client services staff from the partnering nutrition agency over the 12 weeks of intervention. The intervention will be delivered in addition to a base condition consisting of remote participation in the Diabetes Self-Management Program, an evidence-based diabetes education program that takes place over 6 weeks (same as control group). Food support: Diabetes-tailored food support. Project Open Hand will provide intervention participants twelve weeks of supplemental food support. Food support will consist of a mix of meals tailored for T2DM, and T2DM-healthy groceries, consistent with American Diabetes Association (ADA) guidelines for diabetes healthy diets under the responsibility of a registered dietitian. All food support will be home delivered. Case-management: Project Open Hand client services staff will conduct three case management sessions with the participant. The first session will initiate food services and ensure orientation to the intervention and set up delivery; the second session will support the participant with any issues related to the intervention; the third session will provide transition from the intervention and connect the participant with local food resources. |
| BG002 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race/Ethnicity, Customized | Count of Participants | Participants |
|
| Education | Count of Participants | Participants |
|
| Annual household income | Count of Participants | Participants |
|
| Has child dependents | Count of Participants | Participants |
|
| HbA1c (%) | Error in laboratory result; one baseline value implausibly high (30.5). The value was removed (intervention group). | Mean | Standard Deviation | Percentage of glycated hemoglobin |
|
| HbA1c < 9% | Measure Analysis Population Description: Error in laboratory result; one baseline value implausibly high (30.5). The value was removed (intervention group). | Count of Participants | Participants |
|
| Food security score | USDA Household Food Security Survey Module - 10 item (adult items). The score ranges from 0 to 10. A higher score indicates a higher severity of food insecurity. | Mean | Standard Deviation | units on a scale |
|
| Low or very low food security | USDA Household Food Security Survey Module - 10 item (adult items) | Count of Participants | Participants |
|
| Healthy days (last 30 days) | Mean | Standard Deviation | days |
|
| Fruit and vegetable consumption | Mean | Standard Deviation | Cup equivalents per day |
|
| Added sugar consumption | Mean | Standard Deviation | teaspoon equivalents per day |
|
| Depressive symptom severity score (PHQ-8) | The PHQ-8 score ranges from 0 to 24, with higher scores indicating higher severity of depressive symptoms. | Mean | Standard Deviation | units on a scale |
|
| Diabetes self-efficacy score | The 8-item Diabetes Self-Efficacy scale was used to assess confidence in one's ability to manage numerous self-care behaviors. Scores range from 8 to 40, with higher scores indicating more confidence in self-managing their diabetes. | Mean | Standard Deviation | units on a scale |
|
| OG001 | Diabetes-tailored Food Support Plus Diabetes Self-management Education | The intervention has two components: 1) diabetes-tailored food support that consists of weekly, home-delivered medically tailored meals, and monthly home-delivered healthy groceries, from baseline to 24 weeks, and 2) three case-management sessions with client services staff from the partnering nutrition agency over the 12 weeks of intervention. The intervention will be delivered in addition to a base condition consisting of remote participation in the Diabetes Self-Management Program, an evidence-based diabetes education program that takes place over 6 weeks (same as control group). Food support: Diabetes-tailored food support. Project Open Hand will provide intervention participants twelve weeks of supplemental food support. Food support will consist of a mix of meals tailored for T2DM, and T2DM-healthy groceries, consistent with American Diabetes Association (ADA) guidelines for diabetes healthy diets under the responsibility of a registered dietitian. All food support will be home delivered. Case-management: Project Open Hand client services staff will conduct three case management sessions with the participant. The first session will initiate food services and ensure orientation to the intervention and set up delivery; the second session will support the participant with any issues related to the intervention; the third session will provide transition from the intervention and connect the participant with local food resources. |
|
|
|
| Primary | Change in Food Security Severity From Baseline to Twelve Weeks by Study Arm | The US household food security survey module (adult version) from the US Department of Agriculture (USDA) will be used to assess the change in the food security scores from baseline to twelve weeks. The score ranges from 0 to 10. Higher score indicates higher severity of food insecurity. | Posted | Mean | Standard Deviation | score on a scale | Baseline and twelve weeks |
|
|
|
|
| Secondary | Change in the Percentage of Participants With Glucose Control From Baseline to Twelve Weeks by Study Arm | Glucose control will be defined as HbA1c lower than 9%. The change from baseline to twelve weeks, in the percentage of participants with glucose control will be reported. | Posted | Number | Percentage of participants | Baseline and twelve weeks |
|
|
|
|
| Secondary | Change in the Percentage of Participants With Low and Very Low Food Security From Baseline to Twelve Weeks by Study Arm | Low and very low food security will be defined as 3 or more items answered affirmatively in the USDA's US household food security survey module. Change in the percentage of participants with low or very low food security, from baseline to twelve weeks by intervention arms will be reported. | Posted | Number | Percentage of participants | Baseline and twelve weeks |
|
|
|
|
| Secondary | Change in Health-related Quality of Life (Healthy Days) From Baseline to Twelve Weeks by Study Arm | Health-related quality of life will be measured using the Summary Index of Unhealthy Days collected via the Centers for Disease Control (CDC) Healthy Days scale. This scale asks the number of days in the past 30 days the person felt physically or mentally unwell. The summary index then estimates the number of recent days when a person's physical and mental health was good (or better) and is calculated by subtracting the number of unhealthy days from 30 days. The change in healthy days from baseline to twelve weeks by study arm will be reported. | Posted | Mean | Standard Deviation | days | Baseline and twelve weeks |
|
|
|
|
| Secondary | Change in Consumption of Fruits and Vegetables From Baseline to Twelve Weeks by Study Arm | Dietary information using the Dietary Screener Questionnaire (DSQ) will be collected. The DSQ obtains information on the frequency of consumption of fruits and vegetables. These responses are then converted to cup equivalents per day using a scoring algorithm based on the NHANES 24-hour recall. Fruit and vegetable consumption from baseline to twelve weeks by study arm will be reported. | Posted | Mean | Standard Deviation | cup equivalents | Baseline and twelve weeks |
|
|
|
|
| Secondary | Change in Consumption of Added Sugars From Baseline to Twelve Weeks by Study Arm | Dietary information using the Dietary Screener Questionnaire (DSQ) will be collected. The DSQ obtains information on the frequency of consumption of added sugars. These responses are then converted to teaspoon equivalents per day using a scoring algorithm based on the NHANES 24-hour recall. Added sugars consumption (teaspoon equivalents per day) from baseline to twelve weeks by study arm will be reported. | Posted | Mean | Standard Deviation | teaspoon equivalents | Baseline and twelve weeks |
|
|
|
|
| Secondary | Change in Depressive Symptoms From Baseline to Twelve Weeks by Study Arm | The 8-item Patient Health Questionnaire (PHQ-8) will be used to evaluate depressive symptoms. The PHQ-8 score ranges from 0 to 24, with higher scores indicating higher levels of depression. The change in PHQ-8 scores from baseline to twelve weeks by study arm will be reported. | Posted | Mean | Standard Deviation | score on a scale | Baseline and twelve weeks |
|
|
|
|
| Secondary | Change in Diabetes Self-efficacy From Baseline to Twelve Weeks by Study Arm | The 8-item Diabetes Self-Efficacy scale will be used to assess confidence in one's ability to manage numerous self-care behaviors. The scores ranges from 8 to 40, with higher scores indicating more confidence in self-managing their diabetes. The changes in the scores from baseline to twelve weeks by study arm will be reported. | Posted | Mean | Standard Deviation | score on a scale | Baseline and twelve weeks |
|
|
|
|
| Other Pre-specified | Change in HbA1c Values From Twelve Weeks to Twenty-four Weeks by Study Arm | To evaluate durability of changes, if any, in HbA1c after the intervention ended, the change in HbA1c levels (%) from 12 weeks to 24 weeks by study arm will be reported. | Not Posted | Twelve weeks and twenty-four weeks | Participants |
| Other Pre-specified | Change in the Proportion of Participants With Glycemic Control From Twelve Weeks to Twenty-four by Study Arm | To evaluate durability of changes, if any, in glycemic control after the intervention ended, the change in the percent of participants with HbA1c levels less than 9% from 12 weeks to 24 weeks by study arm will be reported. | Not Posted | Twelve weeks and twenty-four weeks | Participants |
| Other Pre-specified | Change in Health-related Quality of Life (Healthy Days) From Twelve Weeks to Twenty-four Weeks by Study Arm | Health-related quality of life will be measured using the Summary Index of Unhealthy Days collected via the CDC Healthy Days scale. This scale asks the number of days in the past 30 days the person felt physically or mentally unwell. The summary index then estimates the number of recent days when a person's physical and mental health was good (or better) and is calculated by subtracting the number of unhealthy days from 30 days. To evaluate the durability of changes, if any, in health-related quality of life, the change in healthy days from 12 weeks to 24 weeks by study arm will be reported. | Posted | Mean | Standard Deviation | days | Twelve weeks and twenty-four weeks |
|
|
|
|
| 0 |
| 15 |
| 0 |
| 15 |
| 0 |
| 15 |
| EG001 | Diabetes-tailored Food Support Plus Diabetes Self-management Education | The intervention has two components: 1) diabetes-tailored food support that consists of weekly, home-delivered medically tailored meals, and monthly home-delivered healthy groceries, from baseline to 24 weeks, and 2) three case-management sessions with client services staff from the partnering nutrition agency over the 12 weeks of intervention. The intervention will be delivered in addition to a base condition consisting of remote participation in the Diabetes Self-Management Program, an evidence-based diabetes education program that takes place over 6 weeks (same as control group). Food support: Diabetes-tailored food support. Project Open Hand will provide intervention participants twelve weeks of supplemental food support. Food support will consist of a mix of meals tailored for T2DM, and T2DM-healthy groceries, consistent with American Diabetes Association (ADA) guidelines for diabetes healthy diets under the responsibility of a registered dietitian. All food support will be home delivered. Case-management: Project Open Hand client services staff will conduct three case management sessions with the participant. The first session will initiate food services and ensure orientation to the intervention and set up delivery; the second session will support the participant with any issues related to the intervention; the third session will provide transition from the intervention and connect the participant with local food resources. | 0 | 21 | 0 | 21 | 0 | 21 |
Not provided
Not provided
| D004700 | Endocrine System Diseases |
| Hispanic, Latino |
|
| Asian, Pacific Islander |
|
| American Indian, Native American |
|
| Other race/ethnicity |
|
| More than one race/ethnicity |
|
| More than high school |
|
| $20,000 to $30,000 |
|
| $30,000 to $40,000 |
|
| Over $40,000 |
|
| Refused to answer |
|