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A Remotely Delivered Episodic Future Thinking Intervention to Improve Management of Type 2 Diabetes

Virginia Polytechnic Institute and State University logo

Virginia Polytechnic Institute and State University

Status and phase

Completed
Phase 2
Phase 1

Conditions

Type 2 Diabetes

Treatments

Behavioral: Control Thinking
Behavioral: Episodic future thinking

Study type

Interventional

Funder types

Other
NIH

Identifiers

NCT03732209
1R21NR018349-01 (U.S. NIH Grant/Contract)
2696

Details and patient eligibility

About

The goals of this project are to assess the efficacy of remotely delivered episodic future thinking for reducing delay discounting and improving management of type 2 diabetes, including glycemic control, weight loss, medication adherence, dietary intake, physical activity, and blood pressure. This will be accomplished by randomly assigning participants (N = 64) to episodic future thinking or control thinking groups, while tracking outcome measures before, during, and after the 4-month intervention, as well at a 6-month follow-up visit. Participants in both groups will also receive access to an information-based weight loss intervention.

Full description

Participants (N = 64) will be randomly assigned to either an episodic future thinking group or control thinking groups. Participants will generate episodic future events or control information, as well as related text-based cues, and will be prompted via smartphone or web application to engage in episodic future or control thinking frequently in their natural environment (e.g., at home or work, before meal times, and in high-risk situations) for a 4-month period. Participants in both groups will be provided with one-on-one, phone-based case management and provided with instructional materials and behavioral tools for weight loss and diabetes management. Instructional materials will include: 1) a modified version of the Traffic Light Diet, which utilizes red, yellow, and green labels for food to guide participants toward the goal of consuming low energy dense, low glycemic, high nutrient dense foods; 2) the Traffic Light Activity Program, which also utilizes red, yellow, and green labels for different levels of caloric expenditure, and 3) tools for self-monitoring of weight, diet, and/or physical activity.

Participants will complete four laboratory-based assessment sessions in which the investigators assess body weight, height, waist and hip circumference, glycemic control (HbA1C), adherence to oral glucose-lowering medication, delay discounting, reinforcing efficacy of food, and blood pressure. These assessments will be completed before the intervention (Week 0), during the intervention (8 weeks), and immediately after the intervention (Week 16), as well after a 2-month post-intervention follow-up (Week 24). The latter three assessments sessions will also include questions to measure participants' perceived effectiveness and ease of use of the intervention. Participants will also complete several remote assessments, including dietary intake and physical activity (during Weeks 0, 8, and 16; via accelerometer), as well as delay discounting and reinforcing efficacy of food (during Weeks 3, 8, and 16).

Enrollment

59 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • Overweight or obese (BMI of 25 or greater)
  • Poorly controlled type 2 diabetes (HbA1C of 8% or greater)
  • Prescribed or recommended oral glucose-lowering medication

Exclusion criteria

  • Current insulin therapy for type 2 diabetes
  • History of gestational diabetes
  • Pregnant or lactating
  • Not ambulatory
  • Intellectual impairment
  • Unmanaged medical or psychiatric disorder
  • Abnormal glucose related to medications (e.g, glucocorticoids)

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

Double Blind

59 participants in 2 patient groups

Episodic future thinking
Experimental group
Description:
Participants will generate positive future events and related text cues that will be accessed via an electronic app to engage in episodic future thinking.
Treatment:
Behavioral: Episodic future thinking
Control thinking
Sham Comparator group
Description:
Participants will generate non-future-oriented information and related text cues that will be accessed via an electronic app to engage in control thinking..
Treatment:
Behavioral: Control Thinking

Trial documents
1

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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