Evidence mapPaperPMID 38467918Full record

Trial reportJournal of general internal medicine2024

A Randomized Controlled Trial to Improve Unmet Social Needs and Clinical Outcomes Among Adults with Diabetes.

Minal R Patel, Guanghao Zhang, Michele Heisler, John D Piette, Kenneth Resnicow, Hae-Mi Choe, Xu Shi, Peter Song

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of general internal medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03950973 (Improving Diabetes Outcomes and Health Disparities Through a Patient Activation Intervention Addressing Unmet Resource Needs), which is not on this map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03950973 nacompletednot on this map

Improving Diabetes Outcomes and Health Disparities Through a Patient Activation Intervention Addressing Unmet Resource Needs

TypeinterventionalSponsorUniversity of MichiganRan2019 to 2023Enrolled667ConditionsDiabetesArmsCareAvenue, Guest Assistance Program
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Minal R PatelDepartment of Health Behavior & Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA. minalrp@umich.edu.ORCID 0000-0002-3400-5155
Guanghao ZhangDepartment of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA.
Michele HeislerDepartment of Health Behavior & Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA.
John D PietteDepartment of Health Behavior & Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA.
Kenneth ResnicowDepartment of Health Behavior & Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA.
Hae-Mi ChoeCollege of Pharmacy, University of Michigan, Ann Arbor, MI, USA.
Xu ShiDepartment of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA.
Peter SongDepartment of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA.

Funding

Pilot and Feasibility ProgramP30DK092926 · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2025 to 2025
$779k
NIDDK NIH HHS P30 DK092926NIDDK NIH HHS P30DK092926NIDDK NIH HHS R01 DK116715NIDDK NIH HHS R01 DK116715-01A1
6 · The paper itself

Abstract

backgroundAdults with type 1 or type 2 diabetes often face financial challenges and other unmet social needs to effective diabetes self-management.

objectiveWhether a digital intervention focused on addressing socioeconomic determinants of health improves diabetes clinical outcomes more than usual care.

designRandomized trial from 2019 to 2023.

participantsA total of 600 adults with diabetes, HbA1c ≥ 7.5%, and self-reported unmet social needs or financial burden from a health system and randomized to the intervention or standard care.

interventionCareAvenue is an automated, e-health intervention with eight videos that address unmet social needs contributing to poor outcomes. MEASURES: Primary outcome was HbA1c, measured at baseline, and 6 and 12 months after randomization. Secondary outcomes included systolic blood pressure and reported met social needs, cost-related non-adherence (CRN), and financial burden. We examined main effects and variation in effects across predefined subgroups.

resultsSeventy-eight percent of CareAvenue participants completed one or more modules of the website. At 12-month follow-up, there were no significant differences in HbA1c changes between CareAvenue and control group (p = 0.24). There were also no significant between-group differences in systolic blood pressure (p = 0.29), met social needs (p = 0.25), CRN (p = 0.18), and perceived financial burden (p = 0.31). In subgroup analyses, participants with household incomes 100-400% FPL (1.93 (SE = 0.76), p < 0.01), 201-400% FPL (1.30 (SE = 0.62), p < 0.04), and > 400% FPL (1.27 (SE = 0.64), p < 0.05) had significantly less A1c decreases compared to the control group.

conclusionsOn average, CareAvenue participants did not achieve better A1c lowering, met needs, CRN, or perceived financial burden compared to control participants. CareAvenue participants with higher incomes achieved significantly less A1c reductions than control. Further research is needed on social needs interventions that consider tailored approaches to population subgroups. CLINICAL TRIALS REGISTRY: ClinicalTrials.gov ID NCT03950973, May 2019.

Indexed as

Diabetes Mellitus, Type 2AdultAgedDiabetes Mellitus, Type 1FemaleGlycated HemoglobinHumansMaleMiddle AgedSelf-ManagementTelemedicineGlycated Hemoglobindiabetesrandomized controlled trialunmet social needs

Identifiers

PMID38467918
PMCPMC11436526

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.