2801-LB: Primary Outcomes of a Combined Diabetes Education and Skills Training and Social Needs Resolution Pilot Study for African Americans Aged 50 Years and Older with Poorly Controlled Type 2 Diabetes

Introduction and Objective: African Americans (AAs) are 60% more likely to have diabetes compared to White adults. The aim of this pilot randomized controlled trial was to test the preliminary efficacy of a telephone-delivered diabetes education and skills training, and social needs resolution intervention (DMSN) on hemoglobin A1C (HbA1C) in older AAs. Methods: One hundred AAs aged 50 years and older with poorly controlled type 2 diabetes (T2DM) (HbA1C ≥8%) were randomized 1:1 to the DMSN intervention and enhanced usual care (EUC) arms. Participants in the intervention received 6 monthly phone calls and participants in the EUC arm received mailed diabetes education materials. Preliminary analyses were performed on the intention-to-treat sample, and missing data were imputed using multiple imputation, assuming missing at random. Baseline HbA1C adjusted analysis of covariance was used to assess differences between groups in HbA1C at 6-months, and longitudinal linear mixed effects models using a random intercept and slope were used to compare trajectories of HbA1C over time between DMSN and EUC. Given this was a pilot study, a p-value <0.1 was used to define statistical significance. Results: There were 100 AAs aged 50 and older assigned to the DMSN intervention (n=47) or EUC (n=53) groups; 79% and 78% retention were achieved at 3- and 6-months post randomization, respectively. The majority of participants were aged 50-64 years (63%), female (71%) and had an annual income <$35,000 (75%). Results showed HbA1C was marginally significantly lower in the intervention compared to the enhanced usual care groups [-0.70% (-1.44, 0.04) p=0.12], and there was no difference in the rate of decline between groups. Conclusion: Older African Americans with poorly controlled T2DM at baseline who were assigned to the DMSN intervention had marginally significantly lower HbA1C levels at 6-months post-randomization compared to older AAs in the enhanced usual care group.