Health literacy intervention on type 2 diabetes in China

ISRCTN ISRCTN76130594
DOI https://doi.org/10.1186/ISRCTN76130594
Secondary identifying numbers Grant 13-159
Submission date
27/08/2014
Registration date
22/09/2014
Last edited
02/01/2020
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Nutritional, Metabolic, Endocrine
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Background and study aims
Type 2 diabetes is a chronic condition that causes the amount of sugar in a person’s blood to be too high. It happens when the body doesn’t produce enough insulin or doesn’t respond to insulin very well (insulin resistance). It can cause a number of long-term health problems such as kidney failure and limb amputation, and can lead to partial or complete blindness. It is therefore very important for patients to make changes to their lifestyle and learn how to manage their diabetes. In this study, we are looking at how a modified Chinese version of a set of materials developed to help patients understand and self-manage their condition (Diabetes Education Toolkit) can help them to keep the glucose in the blood at a healthy level (glycemic control). The study’s findings should help to show the importance of people understanding their condition in terms of them better being able to manage their disease and improve their health.

Who can participate?
Adults aged at least 18 with type 2 diabetes, hemoglobin A1c ≥ 7.5%, from eight communities of Shanghai, China.

What does the study involve?
The participants are randomly allocated into one of two groups (an intervention and a control group). Their hemoglobin A1c levels are measured and they take part in a survey that assesses their health and diabetes literacy. The control group then are treated as usual and the intervention group tale part in a comprehensive health literacy course for 12 months. Follow up surveys and measurements are carried out for all patients at 3, 6, 12 and 24 months after the start of the study where we compare the HbA1c level between the two groups.

What are the possible benefits and risks of participating?
The participants in the intervention group will obtain additional education on diabetes self-management. There will be no immediate direct benefit for those in the control group. But there should be benefits to all diabetes patients in the future, particularly for those with low literacy levels, because the results of the study are likely to influence how the government provides healthcare services in the future. There are no risks to taking part.

Where is the study run from?
Fudan University in collaboration with Vanderbilt University and Shanghai CDC (China)

When is the study starting and how long is it expected to run for?
January 2015 to December 2016

Who is funding the study?
China Medical Board (CMB) (USA)

Who is the main contact?
Professor Wanghong Xu
wanghong.xu@fudan.edu.cn

Contact information

Prof Wanghong Xu
Scientific

138 Yi Xue Yuan Road
Shanghai
200032
China

Study information

Study designA cluster randomized controlled trial (RCT)
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Other
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleA randomized trial on using a comprehensive health literacy strategy to improve self-management skills and glycemic control in chinese patients with type 2 diabetes
Study hypothesisParticipants randomized to the intervention arm will have significant improvements in HbA1C, blood pressure, lipids, self-management behavior, self-efficacy, and other patient outcomes important to improving diabetes care when compared to the control group participants.
Ethics approval(s)IRB of School of Public Health, Fudan University (IRB00002408 & FWA00002399), 28/06/2013, ref. IRB#2013-06-0451
ConditionType 2 diabetes
InterventionThe intervention will include two main components:
1. Modified Chinese version of Diabetes Education Toolkit, a set of plain-language tools to aid provider-patient communication about diabetes management
2. A modified Chinese version of Clear Health Communication Curriculum (CHCC), a structured training program for healthcare providers to improve diabetes-related counseling communication skills, with specific attention to issues of literacy and numeracy
Control group:
Will receive usual care which refers to education according to the Chinese Guideline for Diabetes Care and Education, which is widely used in China.
Intervention typeOther
Primary outcome measureThe primary outcome will be changes in HbA1c at baseline and at 3, 6, 12, and 24 months of intervention. HbA1c level will be measured by a blood test.
Secondary outcome measuresOther measures include self-care behaviors, blood pressure, cholesterol, and utilization of clinical services. Incremental costs per behavioral, biologic and QALY change will also be determined. This will be measured at baseline and at 3, 6, 12, and 24 months of intervention.
Overall study start date01/01/2015
Overall study end date31/12/2016

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
Upper age limit85 Years
SexBoth
Target number of participants800
Total final enrolment799
Participant inclusion criteria1. Patient has a clinical diagnosis of type 2 diabetes
2. Age 18-85 years
3. Most recent HbA1c >=7.5%
4. Patient agrees to participate in the study for the full two years duration
Participant exclusion criteria1. Poor visual acuity (vision worse than 20/50 using Rosenbaum Pocket Screener)
2. Significant dementia, or psychosis (by health provider report or chart review)
3. Terminal illness with anticipated life expectancy < 2 years
Recruitment start date01/01/2015
Recruitment end date31/12/2016

Locations

Countries of recruitment

  • China

Study participating centre

138 Yi Xue Yuan Road
Shanghai
200032
China

Sponsor information

China Medical Board (CMB) (USA)
Government

2 Arrow Street
Cambriage
MA 02138
United States of America

Website http://www.chinamedicalboard.org

Funders

Funder type

Government

China Medical Board (CMB-OC) (USA)
Private sector organisation / Trusts, charities, foundations (both public and private)
Alternative name(s)
CMB
Location
United States of America

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Protocol article protocol 20/12/2014 Yes No
Results article results 19/11/2019 02/01/2020 Yes No

Editorial Notes

02/01/2020: The following changes have been made:
1. Publication reference added.
2. The total final enrolment number has been added from the reference.