Cecilia C Low Wang, Ray Estacio, Stephanie Coronel-Mockler, Nick Flattery, Pete D Hanson, Rebecca N Adams, Amy L McKenzie, David Harrison, Marc P Bonaca
{"title":"科罗拉多州社区Virta干预（VICTOR）改善农村社区糖尿病和心血管风险的试点研究-初步结果。","authors":"Cecilia C Low Wang, Ray Estacio, Stephanie Coronel-Mockler, Nick Flattery, Pete D Hanson, Rebecca N Adams, Amy L McKenzie, David Harrison, Marc P Bonaca","doi":"10.1016/j.eprac.2025.03.013","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Innovative strategies combining local community health workers (CHWs) and digital health may improve type 2 diabetes (T2D) care and cardiovascular risk in rural communities. To conduct a cluster-randomized, open-label, multisite study to evaluate the hypothesis that in rural communities served by CHW in the Colorado Heart Healthy Solutions (CHHS) program, referral to a digital continuous care intervention (CCI) would improve hemoglobin A1c (A1c) in patients with T2D as compared with CHHS alone.</p><p><strong>Methods: </strong>Adults in the CHHS program with T2D taking at least 1 antihyperglycemic medication, A1c ≥ 7.5%, body mass index ≥25 kg/m<sup>2</sup> and who provided electronic informed consent were cluster-randomized to CHHS vs CCI+CHHS. The primary outcome was change in A1c from baseline to end of phase 1 (3 months).</p><p><strong>Results: </strong>Fifty-one individuals had evaluable data. Mean ± SD age was 59.6 ± 10 years, body mass index 34.4 ± 7 kg/m<sup>2</sup>, and A1c 8.9 ± 1.3% at baseline. The change in A1c from baseline was not significant between groups. However, A1c decreased from baseline to end of phase 1 by -1.2% in CHHS and -1.5% in CCI+CHHS, P < .001 in each group. A higher proportion of individuals in CCI+CHHS achieved 5% or greater weight loss (P < .05), and significant net decrease in number and/or dose of antihyperglycemic medications (P < .05).</p><p><strong>Conclusions: </strong>Combining a CHW program with referral to CCI did not result in greater A1c reduction, but led to improvements in A1c, weight, and medication burden in individuals with T2D in a rural setting.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7000,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Virta Intervention in CommuniTies in ColORado (VICTOR) Pilot Study to Improve Diabetes and Cardiovascular Risk in Rural Communities - Primary Results.\",\"authors\":\"Cecilia C Low Wang, Ray Estacio, Stephanie Coronel-Mockler, Nick Flattery, Pete D Hanson, Rebecca N Adams, Amy L McKenzie, David Harrison, Marc P Bonaca\",\"doi\":\"10.1016/j.eprac.2025.03.013\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Innovative strategies combining local community health workers (CHWs) and digital health may improve type 2 diabetes (T2D) care and cardiovascular risk in rural communities. To conduct a cluster-randomized, open-label, multisite study to evaluate the hypothesis that in rural communities served by CHW in the Colorado Heart Healthy Solutions (CHHS) program, referral to a digital continuous care intervention (CCI) would improve hemoglobin A1c (A1c) in patients with T2D as compared with CHHS alone.</p><p><strong>Methods: </strong>Adults in the CHHS program with T2D taking at least 1 antihyperglycemic medication, A1c ≥ 7.5%, body mass index ≥25 kg/m<sup>2</sup> and who provided electronic informed consent were cluster-randomized to CHHS vs CCI+CHHS. The primary outcome was change in A1c from baseline to end of phase 1 (3 months).</p><p><strong>Results: </strong>Fifty-one individuals had evaluable data. Mean ± SD age was 59.6 ± 10 years, body mass index 34.4 ± 7 kg/m<sup>2</sup>, and A1c 8.9 ± 1.3% at baseline. The change in A1c from baseline was not significant between groups. However, A1c decreased from baseline to end of phase 1 by -1.2% in CHHS and -1.5% in CCI+CHHS, P < .001 in each group. A higher proportion of individuals in CCI+CHHS achieved 5% or greater weight loss (P < .05), and significant net decrease in number and/or dose of antihyperglycemic medications (P < .05).</p><p><strong>Conclusions: </strong>Combining a CHW program with referral to CCI did not result in greater A1c reduction, but led to improvements in A1c, weight, and medication burden in individuals with T2D in a rural setting.</p>\",\"PeriodicalId\":11682,\"journal\":{\"name\":\"Endocrine Practice\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2025-04-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Endocrine Practice\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.eprac.2025.03.013\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Endocrine Practice","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.eprac.2025.03.013","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Virta Intervention in CommuniTies in ColORado (VICTOR) Pilot Study to Improve Diabetes and Cardiovascular Risk in Rural Communities - Primary Results.
Objective: Innovative strategies combining local community health workers (CHWs) and digital health may improve type 2 diabetes (T2D) care and cardiovascular risk in rural communities. To conduct a cluster-randomized, open-label, multisite study to evaluate the hypothesis that in rural communities served by CHW in the Colorado Heart Healthy Solutions (CHHS) program, referral to a digital continuous care intervention (CCI) would improve hemoglobin A1c (A1c) in patients with T2D as compared with CHHS alone.
Methods: Adults in the CHHS program with T2D taking at least 1 antihyperglycemic medication, A1c ≥ 7.5%, body mass index ≥25 kg/m2 and who provided electronic informed consent were cluster-randomized to CHHS vs CCI+CHHS. The primary outcome was change in A1c from baseline to end of phase 1 (3 months).
Results: Fifty-one individuals had evaluable data. Mean ± SD age was 59.6 ± 10 years, body mass index 34.4 ± 7 kg/m2, and A1c 8.9 ± 1.3% at baseline. The change in A1c from baseline was not significant between groups. However, A1c decreased from baseline to end of phase 1 by -1.2% in CHHS and -1.5% in CCI+CHHS, P < .001 in each group. A higher proportion of individuals in CCI+CHHS achieved 5% or greater weight loss (P < .05), and significant net decrease in number and/or dose of antihyperglycemic medications (P < .05).
Conclusions: Combining a CHW program with referral to CCI did not result in greater A1c reduction, but led to improvements in A1c, weight, and medication burden in individuals with T2D in a rural setting.
期刊介绍：
Endocrine Practice (ISSN: 1530-891X), a peer-reviewed journal published twelve times a year, is the official journal of the American Association of Clinical Endocrinologists (AACE). The primary mission of Endocrine Practice is to enhance the health care of patients with endocrine diseases through continuing education of practicing endocrinologists.
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