Skip to main content
Journal cover image

Changing CHANGE: adaptations of an evidence-based telehealth cardiovascular disease risk reduction intervention.

Publication ,  Journal Article
Zullig, LL; McCant, F; Silberberg, M; Johnson, F; Granger, BB; Bosworth, HB
Published in: Transl Behav Med
March 1, 2018

Relatively few successful medication adherence interventions are translated into real-world clinical settings. The Prevention of Cardiovascular Outcomes in African Americans with Diabetes (CHANGE) intervention was originally conceived as a randomized controlled trial to improve cardiovascular disease-related medication adherence and health outcomes. The purpose of the study was to describe the translation of the CHANGE trial into two community-based clinical programs. CHANGE 2 was available to Medicaid patients with diabetes and hypertension whose primary care homes were part of a care management network in the Northern Piedmont region of North Carolina. CHANGE 3 was available to low-income patients receiving care in three geographical areas with multiple chronic conditions at low or moderate risk for developing cardiovascular disease. Adaptations were made to ensure fit with available organizational resources and the patient population's health needs. Data available for evaluation are presented. For CHANGE 2, we evaluated improvement in A1c control using paired t test. For both studies, we describe feasibility measured by percentage of patients who completed the curriculum. CHANGE 2 involved 125 participants. CHANGE 3 had 127 participants. In CHANGE 2, 69 participants had A1c measurements at baseline and 12-month follow-up; A1c improved from 8.4 to 7.8 (p = .008). In CHANGE 3, interventionists completed 47% (n = 45) of calls to enroll participants at the 4-month encounter, and among those eligible for a 12-month call (n = 52), 21% of 12-month calls were completed with participants. In CHANGE 2, 40% of participants (n = 50) completed all 12 encounters. Thoughtful adaptation is critical to translate clinical trials into community-based clinic settings. Successful implementation of adapted evidence-based interventions may be feasible and can positively affect patients' disease control.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Transl Behav Med

DOI

EISSN

1613-9860

Publication Date

March 1, 2018

Volume

8

Issue

2

Start / End Page

225 / 232

Location

England

Related Subject Headings

  • Telemedicine
  • Randomized Controlled Trials as Topic
  • Program Development
  • Outcome Assessment, Health Care
  • North Carolina
  • Middle Aged
  • Male
  • Hypertension
  • Humans
  • Follow-Up Studies
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Zullig, L. L., McCant, F., Silberberg, M., Johnson, F., Granger, B. B., & Bosworth, H. B. (2018). Changing CHANGE: adaptations of an evidence-based telehealth cardiovascular disease risk reduction intervention. Transl Behav Med, 8(2), 225–232. https://doi.org/10.1093/tbm/ibx030
Zullig, Leah L., Felicia McCant, Mina Silberberg, Fred Johnson, Bradi B. Granger, and Hayden B. Bosworth. “Changing CHANGE: adaptations of an evidence-based telehealth cardiovascular disease risk reduction intervention.Transl Behav Med 8, no. 2 (March 1, 2018): 225–32. https://doi.org/10.1093/tbm/ibx030.
Zullig LL, McCant F, Silberberg M, Johnson F, Granger BB, Bosworth HB. Changing CHANGE: adaptations of an evidence-based telehealth cardiovascular disease risk reduction intervention. Transl Behav Med. 2018 Mar 1;8(2):225–32.
Zullig, Leah L., et al. “Changing CHANGE: adaptations of an evidence-based telehealth cardiovascular disease risk reduction intervention.Transl Behav Med, vol. 8, no. 2, Mar. 2018, pp. 225–32. Pubmed, doi:10.1093/tbm/ibx030.
Zullig LL, McCant F, Silberberg M, Johnson F, Granger BB, Bosworth HB. Changing CHANGE: adaptations of an evidence-based telehealth cardiovascular disease risk reduction intervention. Transl Behav Med. 2018 Mar 1;8(2):225–232.
Journal cover image

Published In

Transl Behav Med

DOI

EISSN

1613-9860

Publication Date

March 1, 2018

Volume

8

Issue

2

Start / End Page

225 / 232

Location

England

Related Subject Headings

  • Telemedicine
  • Randomized Controlled Trials as Topic
  • Program Development
  • Outcome Assessment, Health Care
  • North Carolina
  • Middle Aged
  • Male
  • Hypertension
  • Humans
  • Follow-Up Studies