AzTrials
AzTrials

Type 1 Diabetes MellitusNCT03324438

Home Telemedicine to Optimize Health Outcomes in High-Risk Youth With Type 1 Diabetes

A study testing Home Telehealth T1D C2oYoT1-HR, Personalized Behavioral Health and Personalized Adherence Feedback in people with Type 1 Diabetes Mellitus, run by University of Colorado, Denver at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

This study addresses the critical need for improving Type 1 Diabetes (T1D) health outcomes in high-risk youth (A1C=9-12%; ages 10-17 yrs) (AIC: glycated hemoglobin) where suboptimal glycemic control has severe acute and long-term complications with potentially life threatening consequences. Read more about this study

Who is it for?
Ages 10 to 17 years
Conditions the study is for
Type 1 Diabetes Mellitus
What is being tested?
Home Telehealth T1D C2oYoT1-HR, Personalized Behavioral Health and Personalized Adherence Feedback
Could I receive a placebo?
No, everyone receives an active treatment
How many people
108 participants
Where
1 siteUnited States
Study dates
1 Nov 2017to 30 Sep 2021
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 10 to 17 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • youth age 10-17 years
  • A1C=9-12%
  • parent(s) of child with confirmed diagnosis of T1D
  • T1D duration >1 year
  • parent and child agree to participate in home telehealth sessions
  • ability to use telehealth equipment (i.e., computer, tablet, smartphone with internet connectivity)

Who cannot join

  • developmental disability or reading disorder that prevents understanding of the intervention materials
  • non-English speaking adolescents
  • those with severe psychological disorders
  • prescribed and taking medications that increase blood glucoses
  • not seen in T1D clinic within the past year; pregnant if female; situational concerns (e.g., active custody battle)
  • type 2 diabetes

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Barbara Davis Center for Childhood Diabetes

    Aurora, Colorado, 80045

Other trials in United States

About this study

This study addresses the critical need for improving Type 1 Diabetes (T1D) health outcomes in high-risk youth (A1C=9-12%; ages 10-17 yrs) (AIC: glycated hemoglobin) where suboptimal glycemic control has severe acute and long-term complications with potentially life threatening consequences. Lack of regular contact with T1D care providers, continued T1D nonadherence, and suboptimal behavioral and mental health functioning compromises the physical health of youth with T1D and the ability of T1D teams to provide effective treatment. If the aims of this study are achieved, this study will change T1D care practices by providing high-risk youth with T1D, and their parents, medical and behavioral health support via home telehealth intervention. This has the potential to significantly change access to T1D care, decrease time spent in hyperglycemia, reduce the frequency of hospital admissions, and improve glycemic control. In addition, this study's use of Multiphase Optimization Strategy (MOST), a highly efficient experimental strategy to determine effective intervention components, should be generalizable to all individuals with T1D, leading to cost-effective, home telehealth intervention programs. Innovative aspects include: 1) assessment of physical and behavioral health characteristics associated with high-risk status; 2) delivery of home telehealth that incorporates: 2a) medical and behavioral health care delivered with the endocrinologist and behavioral health specialist working together with high-risk youth; 2b) personalized intervention to improve T1D adherence and T1D clinical health outcomes; 2c) personalized intervention to improve mental health comorbidities and T1D clinical health outcomes; and 3) an underused methodological approach for optimizing intervention components to be delivered at point of care.

Read the detailed description

AIM 1: PHASE 1: Use Multiphasic Optimization Strategy (i.e., MOST), a highly efficient experimental strategy, to determine specific components for inclusion in an intervention to 1a) improve primary clinical outcomes of A1C and percentage of time spent in hyperglycemia and 1b) address secondary clinical outcomes by improving adherence and biological markers of complications in high-risk pediatric patients with T1D (A1C=9-12%) as part of 12-month personalized behavioral intervention delivered via in-person T1D clinic visits and home telemedicine.

MOST methodology uses factorial designs and the hypotheses in Aim 1 will be tested through a 2x2 factorial experiment, a highly efficient experimental design despite several common misconceptions about sample size requirements and power. A 2x2 factorial experiment is NOT a 4-arm trial in which each condition is compared in turn to a control condition. In fact, factorial designs do not require a larger number of participants than other designs (e.g., Randomized Controlled Trials (RCT)) and when used to address suitable research questions, they require fewer participants than other designs. Adding factors does not require a dramatic increase in sample size to maintain power.

H1: There will be a main effect of Personalized Adherence Intervention on percentage of A1C, time spent in hyperglycemia, adherence behaviors, and biological markers of complications.

H2: There will be a main effect of Personalized Behavioral Health Intervention on percentage of A1C, time spent in hyperglycemia, adherence behaviors, and biological markers of complications.

AIM 2: PHASE 2: Determine effectiveness of the intervention components on maintenance of A1C, percentage of time spent in hyperglycemia, adherence, and biological markers improvements throughout 6-month follow-up.

H1: Participants who are randomized to T1D medical appointments every 6 weeks will show better improvements in gains in A1C, percentage of time spent in hyperglycemia, adherence, and biological markers compared to those participants who revert to medical appointments occurring every 3 months.

Being tested
Home Telehealth T1D C2oYoT1-HR, Personalized Behavioral Health, Personalized Adherence Feedback
Keywords
pediatrics
Medical subject headings
Diabetes Mellitus, Type 1

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Home Telehealth T1D C2oYoT1-HRBehavioural

    Also called C2oYoT1-HR

    1. assessment of physical and behavioral health characteristics associated with high-risk status; 2) delivery of home telehealth that incorporates: 2a) medical and behavioral health care delivered with the endocrinologist and behavioral health specialist working together with high-risk youth; 2b) personalized intervention to improve T1D adherence and T1D clinical health outcomes; 2c) personalized intervention to improve mental health comorbidities and T1D clinical health outcomes; and 3) an underused methodological approach for optimizing intervention components to be delivered at point of care.
  • Personalized Behavioral HealthBehavioural

    Also called C2oYoT1-HR + Behavioral Health

    1. assessment of physical and behavioral health characteristics associated with high-risk status; 2) delivery of home telehealth that incorporates: 2a) medical and behavioral health care delivered with the endocrinologist and behavioral health specialist working together with high-risk youth; 2b) personalized intervention to improve T1D adherence and T1D clinical health outcomes; 2c) personalized intervention to improve mental health comorbidities and T1D clinical health outcomes; and 3) an underused methodological approach for optimizing intervention components to be delivered at point of care.
  • Personalized Adherence FeedbackBehavioural

    Also called C2oYoT1-HR + Personalized Adherence Intervention

    1. assessment of physical and behavioral health characteristics associated with high-risk status; 2) delivery of home telehealth that incorporates: 2a) medical and behavioral health care delivered with the endocrinologist and behavioral health specialist working together with high-risk youth; 2b) personalized intervention to improve T1D adherence and T1D clinical health outcomes; 2c) personalized intervention to improve mental health comorbidities and T1D clinical health outcomes; and 3) an underused methodological approach for optimizing intervention components to be delivered at point of care.
Study groups in NCT03324438
Study groupRoleWhat they receive
Home Telehealth T1D (CoYoT1-HR)Active comparatorHome Telehealth T1D (C2oYoT1-HR), standard of care delivered via Telehealth for high-risk youth
Receives: Behavioral: Home Telehealth T1D C2oYoT1-HR
Personalized Adherence FeedbackExperimentalC2oYoT1-HR+Personalized Adherence Intervention
Receives: Behavioral: Personalized Adherence Feedback
Personalized Behavioral HealthExperimentalC2oYoT1-HR+Personalized Behavioral Health
Receives: Behavioral: Personalized Behavioral Health
C2oYoT1-HR + Adherence + BehavioralExperimentalC2oYoT1-HR + both Personalized Adherence Feedback + Personalized Behavioral Health (C2oYoT1-HR + Adherence + Behavioral)
Receives: Behavioral: Home Telehealth T1D C2oYoT1-HR; Behavioral: Personalized Behavioral Health; Behavioral: Personalized Adherence Feedback

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Glycemic control (A1C): Change from baseline and every 12 weeks up to 72 weeks (18 mo)

    A1C will be measured in the central lab located within the Barbara Davis Center at Study Visits 1 (week 1), 5 (week 24) and 9 (week 48), and Follow-Up Visit 2 (week 72) or 4 (week 72) which correspond to in-person T1D visits. In addition, participants will be asked to complete A1C measurements at an outside, independent Certified Laboratory Improvement Amendments (CLIA) lab prior to home telehealth T1D Study Visits 3 (week 12) and 7 (week 36). The rationale for measurement at these study visits is that they occur every 3 months, which is the interval in which A1C is measured as standard of care. Change in A1c will be looked at from baseline every 3 months throughout the study.

    Measured: weeks 1, 12, 24, 36, 48, 72

  2. Hyperglycemia - Change from baseline and every 12 weeks up to 72 weeks (18 mo)

    Time spent in hyperglycemia - change will be looked at from baseline every 12 weeks throughout the study.

    Measured: weeks 1, 12, 24, 36, 48, 72

  3. Pediatric Diabetes Quality of Life Scale - Change from baseline and every 12 weeks up to 72 weeks (18 mo)

    The PDQ is a 20-question self-administered scale that evaluates and quantifies the quality of life as related to diabetes - change will be looked at from baseline every 3 months throughout the study.

    Measured: weeks 1, 12, 24, 36, 48, 72

Secondary outcomes (3)
  1. Adherence - Change from baseline and every 12 weeks up to 72 weeks (18 mo)

    Objectively Measured Adherence, Self-Reported Adherence, Number of T1D Appointments Attended. - change will be looked at from baseline every 3 months throughout the study.

    Measured: weeks 1, 12, 24, 36, 48, 72

  2. Psychosocial Measures - Change from baseline and every 24 weeks up to 72 weeks (18 mo)

    Diabetes Family Conflict Scale (DFCS), Diabetes Family Responsibility Questionnaire (DFRQ), Hypoglycemia Fear Scale (HFS), Patient Health Questionnaire - 9 (PHQ-9), Problem Area in Diabetes Version (PAID), Puberty - change will be looked at from baseline every 3 months throughout the study.

    Measured: weeks 1, 24, 48, 72

  3. Biological Markers of T1D Complications - Change from baseline and every 24 weeks up to 72 weeks (18 mo)

    Urinary microalbumin, endothelial function - change will be looked at from baseline every 3 months throughout the study.

    Measured: weeks 1, 24, 48, 72

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted27 Oct 2017
  2. Study start1 Nov 2017
  3. Primary completion30 Sep 2021
  4. Study completion30 Sep 2021

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Factorial
Model description
MOST methodology uses factorial designs and the hypotheses in Aim 1 will be tested through a 2x2 factorial experiment, a highly efficient experimental design despite several common misconceptions about sample size requirements and power. A 2x2 factorial experiment is NOT a 4-arm trial in which each condition is compared in turn to a control condition. In fact, factorial designs do not require a larger number of participants than other designs (e.g., RCT) and when used to address suitable research questions, they require fewer participants than other designs. Adding factors does not require a dramatic increase in sample size to maintain power. The number of arms is listed below as 4 as # of arms is required by the clinicaltrails.gov site; please refer above for a more accurate description of the study design.
Masking
None (open label)
Enrolment
108 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03324438
Sponsor's protocol ID
17-0004
Other IDs
DP3DK113363
Status last verified
Jul 2022
First submitted
21 Aug 2017
Last updated
21 Jul 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: no sharing will occur at this point.

Questions about this trial

What is this clinical trial studying?

A study testing Home Telehealth T1D C2oYoT1-HR, Personalized Behavioral Health and Personalized Adherence Feedback in people with Type 1 Diabetes Mellitus, run by University of Colorado, Denver at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 21 Jul 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Glycemic control (A1C): Change from baseline and every 12 weeks up to 72 weeks (18 mo) (time frame: weeks 1, 12, 24, 36, 48, 72). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Jul 2022.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in