Evaluation of a Long-Term Self-Management Support System

长期自我管理支持系统的评估

• 批准号: 7100450
• 负责人: Robert Michael Anderson
• 金额: $ 75.43万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-06-01 至 2011-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7100450
• 关键词: African American; behavior prediction; behavioral /social science research tag; clinical research; clinical trials; community health services; health behavior; health care cost /financing; health care service availability; health care service evaluation; health service demonstration project; health services research tag; human subject; longitudinal human study; mathematical model; noninsulin dependent diabetes mellitus; patient oriented research; quality of life; self care; urban area

DESCRIPTION (provided by applicant): Although diabetes is a lifelong, chronic disease, the majority of intervention studies to enhance and support diabetes self-management have focused on short-term interventions. Short-term diabetes self-management interventions without follow-up have only short-term (generally less than six months) positive effects on self- management behavior and glycemic control. This study will compare the effectiveness of access to a weekly community-based group (CBG) intervention, and an enhanced usual-care (EUC) control group in helping urban African-American adults with type 2 diabetes achieve and sustain effective self-management, quality of life, and diabetes-related health gains over the long term (three years duration). Specific Aim 1: To conduct a longitudinal randomized controlled trial to evaluate the relative effectiveness of access to a weekly community-based group (CBG) intervention, and an enhanced usual care (EUC) control group. Specific Aim 2: To determine predictors (attendance patterns, demographic, behavioral, health-related) of patients who benefit the most from access to a weekly CBG intervention and EUC control group. Specific Aim 3: To assess the cost, health effects, and cost-effectiveness of access to the CBG intervention versus EUC control group in the short term. Specific Aim 4: To estimate the expected effect that access to the CBG intervention and EUC control group have on end-stage patient outcomes (both microvascular and macrovascular complications) and long-term costs through the use of Monte Carlo simulation models. Hypotheses 1: Access to the CBG intervention will prove more effective than the EUC control group in helping patients achieve and/or sustain improvement in A1C and diabetes-related quality of life. Hypotheses 2: Access to the CBG intervention will be more cost-effective than the EUC control group. The cost of diabetes in the United States has reached $132 billion per year accounting for 10% of total health care expenditures. These costs are expected to increase steadily over the next 20 years. African Americans are two times more likely to have diabetes than Caucasian Americans. The purpose of this study is to develop and evaluate a community-based program to help African Americans with diabetes prevent complications, thus reducing the financial and human cost of this illness.

描述（由申请人提供）： 尽管糖尿病是一种终身，慢性疾病，但大多数以增强和支持糖尿病自我管理的干预研究集中在短期干预措施上。没有随访的短期糖尿病自我管理干预措施仅对自我管理行为和血糖控制的短期（通常少于六个月）的积极影响。这项研究将比较获得每周基于社区的小组（CBG）干预措施的有效性，以及增强的常规护理（EUC）对照组在帮助有2型糖尿病的城市非裔美国人成年人实现并维持有效的自我管理，生活质量以及长期（持续三年）的有效自我管理，生活质量以及与糖尿病相关的健康良好。具体目的1：进行纵向随机对照试验，以评估获得基于社区的每周组（CBG）干预措施的相对有效性，以及增强的常规护理（EUC）对照组。具体目标2：确定从获得每周CBG干预和EUC对照组的最大受益的患者的预测因素（出勤模式，人口统计学，行为，与健康相关的）。具体目标3：评估短期内与CBG干预措施与EUC对照组的访问的成本，健康效果和成本效益。具体目标4：估计获得CBG干预和EUC对照组的预期影响对终阶段患者结局（微血管和大血管并发症）和长期成本通过使用Monte Carlo Simulation模型。假设1：获得CBG干预措施将比EUC对照组更有效地帮助患者获得和/或维持与A1C和糖尿病相关的生活质量的改善。假设2：对CBG干预的访问将比EUC对照组更具成本效益。美国糖尿病的成本每年达到1320亿美元，占医疗保健总支出的10％。预计这些成本将在未来20年内稳步增长。非裔美国人患糖尿病的可能性是白种人的两倍。这项研究的目的是制定和评估一项基于社区的计划，以帮助糖尿病的非洲裔美国人预防并发症，从而降低这种疾病的财务和人为成本。