title: The Cholesterol, Hypertension, and Glucose Education (CHANGE) study for African Americans with diabetes: study design and methodology.
abstract: BACKGROUND
  Cardiovascular disease (CVD) and diabetes account for over one third of the mortality difference between African Americans and white patients. The increased CVD risk in African Americans is due in large part to the clustering of multiple CVD risk factors.
  
  
  OBJECTIVE
  The current study is aimed at improving CVD outcomes in African-American adults with diabetes by addressing the modifiable risk factors of systolic blood pressure , glycosylated hemoglobin, and low-density lipoprotein cholesterol.
  
  
  METHODS
  A sample of African American patients with diabetes (N = 400) will receive written education material at baseline and be randomized to one of 2 arms: (1) usual primary care or (2) nurse-administered disease-management intervention combining patient self-management support and provider medication management. The nurse administered intervention is delivered monthly over the telephone. The nurses also interacts with the primary care providers at 3, 6, and 9 months to provide concise patient updates and facilitate changes in medical management. All patients are followed for 12 months after enrollment. The primary outcomes are change in glycosylated hemoglobin, systolic blood pressure, and low-density lipoprotein cholesterol over 12-months. Secondary outcomes include change in overall cardiovascular risk, aspirin use, and health behaviors.
  
  
  CONCLUSIONS
  Given the continued racial disparities in CVD, the proposed study could result in significant contributions to cardiovascular risk reduction in African-American patients.
authors.affiliation: Center for Health Services Research in Primary Care, Durham VAMC, Durham, NC 27705, USA. ben.powers@duke.edu
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Powers
authors.forename: Joy L
authors.initials: JL
authors.lastname: King
authors.forename: Robin
authors.initials: R
authors.lastname: Ali
authors.forename: Aviel
authors.initials: A
authors.lastname: Alkon
authors.forename: Lynn
authors.initials: L
authors.lastname: Bowlby
authors.forename: David
authors.initials: D
authors.lastname: Edelman
authors.forename: Pamela
authors.initials: P
authors.lastname: Gentry
authors.forename: Janet M
authors.initials: JM
authors.lastname: Grubber
authors.forename: Celine
authors.initials: C
authors.lastname: Koropchak
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Maciejewski
authors.forename: Felicia
authors.initials: F
authors.lastname: McCant
authors.forename: Gwendolyn
authors.initials: G
authors.lastname: McKoy
authors.forename: Michael
authors.initials: M
authors.lastname: Newell
authors.forename: Eugene Z
authors.initials: EZ
authors.lastname: Oddone
authors.forename: Maren K
authors.initials: MK
authors.lastname: Olsen
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Rose
authors.forename: Gloria
authors.initials: G
authors.lastname: Trujillo
authors.forename: Hayden B
authors.initials: HB
authors.lastname: Bosworth
mesh_terms: D001741:Black or African American; D001786:Blood Glucose; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology*; D008078:Cholesterol, LDL / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D019468:Disease Management; D006442:Glycated Hemoglobin / Q000032:analysis; D015438:Health Behavior; D054624:Health Status Disparities; D006801:Humans; D006973:Hypertension / Q000209:etiology; D010353:Patient Education as Topic; D010358:Patient Participation; D012107:Research Design; D012307:Risk Factors; D040242:Risk Reduction Behavior; D013599:Systole; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin