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DiabetesNCT05203575

Building a Behavioural Intervention Programme to Improve Self-Management of Diabetes

A study testing Fast-forwarding in Cycle 1, Goal-Setting plus Weekly Nudge in Cycle 1 and Fast-forwarding in Cycle 2 in people with Diabetes, run by National University of Singapore at 1 site in Singapore.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Effective control of diabetes requires patients to change their daily behaviour. The investigators propose an intervention programme for behavioural change with two components, targeting motivation and implementation. Read more about this study

Who is it for?
Ages 21 to 70 years
Conditions the study is for
Diabetes
What is being tested?
Fast-forwarding in Cycle 1, Goal-Setting plus Weekly Nudge in Cycle 1 and Fast-forwarding in Cycle 2
Could I receive a placebo?
No, everyone receives an active treatment
How many people
225 participants
Where
1 siteSingapore
Study dates
28 Mar 2022to 31 Aug 2023
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 21 to 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age between 21-70
  • Has type 2 diabetes
  • Comfortable communicating English
  • Uses smartphone app WhatsApp

Who cannot join

  • Participants with diagnoses of mental health illnesses
  • Participants who are unable to provide informed consent

Trial locations and contacts

1 site in 1 country.

Singapore1 site
  • National University of Singapore

    Singapore

Other trials in Singapore

About this study

Effective control of diabetes requires patients to change their daily behaviour. The investigators propose an intervention programme for behavioural change with two components, targeting motivation and implementation. The motivation component raises the salience of probable patient-specific detrimental future outcomes by 'fast-forwarding' awareness of these outcomes to the present. The implementation component helps patients to set goals and to act based on weekly tips. A factorial design will be used to establish the necessity and sufficiency of the two components on changing mind and guiding behaviour to improve blood glucose level. Individual-level measures of psychological, physical and medical conditions will be shown to drive the heterogenous responses to the two components. Intervention is expanded into two cycles with crossover design to demonstrate how the individual-level measures drive the wear-off, built-up and persistence of the two components. The results of this two-component programme will serve as a basis for systematic synthesis of component-level effectiveness in behavioural intervention research.

Read the detailed description

This behavioural-change-intervention programme will be an online 'single-centre' outpatient randomized controlled trial (RCT) with ten study arms. It will be a two-component intervention consisting of a motivation component of fast-forwarding and an implementation component of goal-setting and weekly nudges. The field intervention will be structured into a two-cycle four-treatment crossover design with four treatment conditions in the first cycle and crossing-over into eight treatment conditions (including one control condition) in the second cycle. In addition to the control group in the study, a group of patients from the Singapore Health Services (SingHealth) Diabetes Registry dataset will be identified using propensity scoring to serve as a 'match-pair' for each study participant. The electronic medical record of this match-pair will provide an additional benchmark of biological measure in addition to that provided by the control group.

The field study will run for 34 weeks, in two cycles of 14 weeks each, with a 2-week transition period between the two cycles. There will also be a 2-week baseline period in which baseline measurements will be taken before the first cycle begins and a 2-week debriefing period where the final measurement will be taken after the end of the second cycle. Measurements will be taken three times: once before Cycle 1 (as the baseline), once between Cycles 1 and 2, and once at the end of Cycle 2. Participants who are assigned to the motivation component of fast-forwarding will receive fast-forwarding immediately after the measurement session and before the cycle. The participants who are randomly assigned to treatment conditions, including the implementation component, will receive a weekly nudge programme with each 14-week cycle. All participants will have access to the resources used to generate the 14-week cycles.

The investigators will measure the following: (i) physiological and medical information related to the progression of diabetes; (ii) diet quality and exercise level; (iii) psychological reactions towards diabetes management; (iv) behavioural change readiness and commitment; and (v) lifestyle (smoking, alcohol consumption, and sleep quality).

Conditions
Diabetes
Being tested
Fast-forwarding in Cycle 1, Goal-Setting plus Weekly Nudge in Cycle 1, Fast-forwarding in Cycle 2, Goal-Setting plus Weekly Nudge in Cycle 2
Medical subject headings
Diabetes Mellitus

What participants receive

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

  • Fast-forwarding in Cycle 1Behavioural

    The fast-forwarding intervention will consist of a projection of future risk of co-morbidities. A visual projection model will be built using archival data available through the Singapore Diabetes Registry. The projection model will use the current profile of the participant to calculate a risk profile for the participant's potential complications and co-morbidities, which will be presented as a pie chart. The tool will also present alternative scenarios to the participant and visualize how the likelihood of complications or co-morbidities would decrease or increases if his/her habits changed. This will provide the motivational aspect of the intervention.

    This intervention takes place during Cycle 1 (first 14 weeks).

  • Goal-Setting plus Weekly Nudge in Cycle 1Behavioural

    The procedure for goal-setting will start with the participant receiving a list of possible goals. The moderator will go through the list with the participant to identify which goals the participant is comfortable with and could reasonably achieve, and to tick off those goals that the participant has already achieved. The participants will choose their own goals. In each subsequent week, the moderator will check-in with the participant and tick off the goal(s) that have been achieved.

    Chat groups of 10-15 people will be formed to administer the weekly nudge. The participants will be encouraged to introduce themselves and to interact with each other during each the chat session. Every week for the following 14 weeks, the moderator will post diabetes-related content on the WhatsApp chat group and introduce topics of interest according to a planned schedule.

    This intervention takes place during Cycle 1 (first 14 weeks).

  • Fast-forwarding in Cycle 2Behavioural

    The fast-forwarding intervention will consist of a projection of future risk of co-morbidities. A visual projection model will be built using archival data available through the Singapore Diabetes Registry. The projection model will use the current profile of the participant to calculate a risk profile for the participant's potential complications and co-morbidities, which will be presented as a pie chart. The tool will also present alternative scenarios to the participant and visualize how the likelihood of complications or co-morbidities would decrease or increases if his/her habits changed. This will provide the motivational aspect of the intervention.

    This intervention takes place during Cycle 2 (second 14 weeks).

  • Goal-Setting plus Weekly Nudge in Cycle 2Behavioural

    The procedure for goal-setting will start with the participant receiving a list of possible goals. The moderator will go through the list with the participant to identify which goals the participant is comfortable with and could reasonably achieve, and to tick off those goals that the participant has already achieved. The participants will choose their own goals. In each subsequent week, the moderator will check-in with the participant and tick off the goal(s) that have been achieved.

    Chat groups of 10-15 people will be formed to administer the weekly nudge. The participants will be encouraged to introduce themselves and to interact with each other during each the chat session. Every week for the following 14 weeks, the moderator will post diabetes-related content on the WhatsApp chat group and introduce topics of interest according to a planned schedule.

    This intervention takes place during Cycle 2 (second 14 weeks).

Study groups in NCT05203575
Study groupRoleWhat they receive
ControlNo interventionControl condition
Weekly nudge in Cycle 2ExperimentalWeekly nudge intervention in Cycle 2
Receives: Behavioral: Goal-Setting plus Weekly Nudge in Cycle 2
Fast-forwardingExperimentalFast-forwarding interventions in both Cycles
Receives: Behavioral: Fast-forwarding in Cycle 1; Behavioral: Fast-forwarding in Cycle 2
Fast-forwarding with weekly nudge in Cycle 2ExperimentalFast-forwarding interventions in both Cycles, plus weekly nudge intervention in Cycle 2
Receives: Behavioral: Fast-forwarding in Cycle 1; Behavioral: Fast-forwarding in Cycle 2; Behavioral: Goal-Setting plus Weekly Nudge in Cycle 2
Weekly nudge in Cycle 1ExperimentalWeekly nudge intervention in Cycle 1
Receives: Behavioral: Goal-Setting plus Weekly Nudge in Cycle 1
Weekly nudgeExperimentalWeekly nudge interventions in both Cycles
Receives: Behavioral: Goal-Setting plus Weekly Nudge in Cycle 1; Behavioral: Goal-Setting plus Weekly Nudge in Cycle 2
Fast-forwarding with weekly nudge in Cycle 1ExperimentalFast-forwarding interventions in both Cycles, plus weekly nudge intervention in Cycle 1
Receives: Behavioral: Fast-forwarding in Cycle 1; Behavioral: Goal-Setting plus Weekly Nudge in Cycle 1; Behavioral: Fast-forwarding in Cycle 2
Full interventionExperimentalAll interventions applied in all Cycles
Receives: Behavioral: Fast-forwarding in Cycle 1; Behavioral: Goal-Setting plus Weekly Nudge in Cycle 1; Behavioral: Fast-forwarding in Cycle 2; Behavioral: Goal-Setting plus Weekly Nudge in Cycle 2
Fast-forwarding in Cycle 1ExperimentalFast-forwarding intervention in Cycle 1
Receives: Behavioral: Fast-forwarding in Cycle 1
Full in Cycle 1ExperimentalFast-forwarding and weekly nudge interventions in Cycle 1
Receives: Behavioral: Fast-forwarding in Cycle 1; Behavioral: Goal-Setting plus Weekly Nudge in Cycle 1

What is being measured

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

  1. HbA1c after Cycle 1

    Results from HbA1c test

    Measured: Measured between Weeks 17-18

  2. HbA1c after Cycle 2

    Results from HbA1c test

    Measured: Measured between Weeks 33-34

Secondary outcomes (14)
  1. Diet quality after Cycle 1

    Diet quality will be measured using the well-validated Food Frequency Questionnaire

    Measured: Measured between Weeks 17-18

  2. Diet quality after Cycle 2

    Diet quality will be measured using the well-validated Food Frequency Questionnaire

    Measured: Measured between Weeks 33-34

  3. Exercise levels after Cycle 1

    Exercise level will be assessed based on the Global Physical Activity Questionnaire (GPAQ) developed by the World Health Organization in 2002 for chronic disease risk-factor surveillance

    Measured: Measured between Weeks 17-18

  4. Exercise levels after Cycle 2

    Exercise level will be assessed based on the Global Physical Activity Questionnaire (GPAQ) developed by the World Health Organization in 2002 for chronic disease risk-factor surveillance

    Measured: Measured between Weeks 33-34

  5. Attitudes towards diabetes management after Cycle 1

    The participants' psychological reactions towards diabetes treatment will be captured using three main groups of questionnaires. Their general attitudes towards diabetes will be measured using the Diabetes Attitude Survey developed and validated by the University of Michigan Diabetes Research and Training Center (MDRC). The investigators will measure how strongly the patients feel empowered to cope with and manage diabetes, which is a crucial outcome of DSME. Empowerment will be captured using the Diabetes Empowerment Scale (DES) developed by the MDRC. To gain insight into the psychological processes through which fast-forwarding and implementation influence health outcomes, the investigators will measure attitudes towards perceived barriers to diet adherence, exercise, and monitoring, using the respective subscales of the Diabetes Care Profile developed by MDTC

    Measured: Measured between Weeks 17-18

  6. Attitudes towards diabetes management after Cycle 2

    The participants' psychological reactions towards diabetes treatment will be captured using three main groups of questionnaires. Their general attitudes towards diabetes will be measured using the Diabetes Attitude Survey developed and validated by the University of Michigan Diabetes Research and Training Center (MDRC). The investigators will measure how strongly the patients feel empowered to cope with and manage diabetes, which is a crucial outcome of DSME. Empowerment will be captured using the Diabetes Empowerment Scale (DES) developed by the MDRC. To gain insight into the psychological processes through which fast-forwarding and implementation influence health outcomes, the investigators will measure attitudes towards perceived barriers to diet adherence, exercise, and monitoring, using the respective subscales of the Diabetes Care Profile developed by MDTC

    Measured: Measured between Weeks 33-34

  7. Readiness for behavioral change after Cycle 1

    To assess readiness for behavioural change, the investigators will ask the participants to indicate their commitment to make changes to their diet and physical activity. Specifically, the investigators will ask them to name a food that they have been told to eat less of, and to indicate how many times they are willing to cut back on the food. Similarly, the investigators will ask the participants to indicate how much time per week they are willing to exercise to avoid future complications arising from their diabetes

    Measured: Measured between Weeks 17-18

  8. Readiness for behavioral change after Cycle 2

    To assess readiness for behavioural change, the investigators will ask the participants to indicate their commitment to make changes to their diet and physical activity. Specifically, the investigators will ask them to name a food that they have been told to eat less of, and to indicate how many times they are willing to cut back on the food. Similarly, the investigators will ask the participants to indicate how much time per week they are willing to exercise to avoid future complications arising from their diabetes

    Measured: Measured between Weeks 33-34

  9. Smoking status after Cycle 1

    Self-reported smoking status

    Measured: Measured between Weeks 17-18

  10. Smoking status after Cycle 2

    Self-reported smoking status

    Measured: Measured between Weeks 33-34

  11. Level of alcohol consumption after Cycle 1

    Self-reported frequency of alcohol consumption

    Measured: Measured between Weeks 17-18

  12. Level of alcohol consumption after Cycle 2

    Self-reported frequency of alcohol consumption

    Measured: Measured between Weeks 33-34

  13. Sleep quality after Cycle 1

    Self-reported quality of sleep

    Measured: Measured between Weeks 17-18

  14. Sleep quality after Cycle 2

    Self-reported quality of sleep

    Measured: Measured between Weeks 33-34

Timeline

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

  1. First posted24 Jan 2022
  2. Study start28 Mar 2022
  3. Primary completion31 Aug 2023 (estimated)
  4. Study completion31 Aug 2023 (estimated)

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
Other
Allocation
Randomised
Intervention model
Factorial
Masking
Double blind
Who is masked
Investigator, Outcomes assessor
Enrolment
225 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05203575
Sponsor's protocol ID
DCOF
Status last verified
Sep 2022
First submitted
2 Dec 2021
Last updated
28 Sep 2022
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Investigators will not be storing or sharing any personal identifiers. All individual level data will be anonymized, and only anonymized data will be shared with other researchers, upon request.

Questions about this trial

What is this clinical trial studying?

A study testing Fast-forwarding in Cycle 1, Goal-Setting plus Weekly Nudge in Cycle 1 and Fast-forwarding in Cycle 2 in people with Diabetes, run by National University of Singapore at 1 site in Singapore.

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 4 inclusion and 2 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: status not confirmed, as of the sponsor's last update on 28 Sep 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 Singapore. 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?

Results are not available in the source record.

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?

HbA1c after Cycle 1 (time frame: Measured between Weeks 17-18). The study lists 2 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 28 Sep 2022.

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Clinical Trial NCT05203575 | AzTrials