Skip to main content
Journal cover image

The Cholesterol, Hypertension, And Glucose Education (CHANGE) study: results from a randomized controlled trial in African Americans with diabetes.

Publication ,  Journal Article
Crowley, MJ; Powers, BJ; Olsen, MK; Grubber, JM; Koropchak, C; Rose, CM; Gentry, P; Bowlby, L; Trujillo, G; Maciejewski, ML; Bosworth, HB
Published in: Am Heart J
July 2013

BACKGROUND: Cardiovascular disease (CVD) and diabetes account for one-third of the mortality difference between African American and white patients. We evaluated the effect of a CVD risk reduction intervention in African Americans with diabetes. METHODS: We randomized 359 African Americans with type 2 diabetes to receive usual care or a nurse telephone intervention. The 12-month intervention provided monthly self-management support and quarterly medication management facilitation. Coprimary outcomes were changes in systolic blood pressure (SBP), hemoglobin A1c (HbA1c), and low-density lipoprotein cholesterol (LDL-C) over 12 months. We estimated between-intervention group differences over time using linear mixed-effects models. The secondary outcome was self-reported medication adherence. RESULTS: The sample was 72% female; 49% had low health literacy, and 37% had annual income <$10,000. Model-based estimates for mean baseline SBP, HbA1c, and LDL-C were 136.8 mm Hg (95% CI 135.0-138.6), 8.0% (95% CI 7.8-8.2), and 99.1 mg/dL (95% CI 94.7-103.5), respectively. Intervention patients received 9.9 (SD 3.0) intervention calls on average. Primary providers replied to 76% of nurse medication management facilitation contacts, 18% of these resulted in medication changes. There were no between-group differences over time for SBP (P = .11), HbA1c (P = .66), or LDL-C (P = .79). Intervention patients were more likely than those receiving usual care to report improved medication adherence (odds ratio 4.4, 95% CI 1.8-10.6, P = .0008), but adherent patients did not exhibit relative improvement in primary outcomes. CONCLUSIONS: This intervention improved self-reported medication adherence but not CVD risk factor control among African Americans with diabetes. Further research is needed to determine how to maximally impact CVD risk factors in African American patients.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

July 2013

Volume

166

Issue

1

Start / End Page

179 / 186

Location

United States

Related Subject Headings

  • United States
  • Survival Rate
  • Self Care
  • Prevalence
  • Patient Education as Topic
  • Middle Aged
  • Male
  • Hypertension
  • Humans
  • Glycated Hemoglobin
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Crowley, M. J., Powers, B. J., Olsen, M. K., Grubber, J. M., Koropchak, C., Rose, C. M., … Bosworth, H. B. (2013). The Cholesterol, Hypertension, And Glucose Education (CHANGE) study: results from a randomized controlled trial in African Americans with diabetes. Am Heart J, 166(1), 179–186. https://doi.org/10.1016/j.ahj.2013.04.004
Crowley, Matthew J., Benjamin J. Powers, Maren K. Olsen, Janet M. Grubber, Celine Koropchak, Cynthia M. Rose, Pamela Gentry, et al. “The Cholesterol, Hypertension, And Glucose Education (CHANGE) study: results from a randomized controlled trial in African Americans with diabetes.Am Heart J 166, no. 1 (July 2013): 179–86. https://doi.org/10.1016/j.ahj.2013.04.004.
Crowley MJ, Powers BJ, Olsen MK, Grubber JM, Koropchak C, Rose CM, et al. The Cholesterol, Hypertension, And Glucose Education (CHANGE) study: results from a randomized controlled trial in African Americans with diabetes. Am Heart J. 2013 Jul;166(1):179–86.
Crowley, Matthew J., et al. “The Cholesterol, Hypertension, And Glucose Education (CHANGE) study: results from a randomized controlled trial in African Americans with diabetes.Am Heart J, vol. 166, no. 1, July 2013, pp. 179–86. Pubmed, doi:10.1016/j.ahj.2013.04.004.
Crowley MJ, Powers BJ, Olsen MK, Grubber JM, Koropchak C, Rose CM, Gentry P, Bowlby L, Trujillo G, Maciejewski ML, Bosworth HB. The Cholesterol, Hypertension, And Glucose Education (CHANGE) study: results from a randomized controlled trial in African Americans with diabetes. Am Heart J. 2013 Jul;166(1):179–186.
Journal cover image

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

July 2013

Volume

166

Issue

1

Start / End Page

179 / 186

Location

United States

Related Subject Headings

  • United States
  • Survival Rate
  • Self Care
  • Prevalence
  • Patient Education as Topic
  • Middle Aged
  • Male
  • Hypertension
  • Humans
  • Glycated Hemoglobin