Study Spotlight: PaTH to Health: Diabetes Study

Patient Partners with the PaTH to Health: Diabetes study at their annual meeting.

Type 2 diabetes affects over 29 million people in the U.S. and carries a number of serious risks including heart disease and blindness. Such complications are preventable through proper medication and weight loss, but almost half of all people with diabetes struggle to control it.

Today, though, adults who have or are at high risk of developing type 2 diabetes and who are covered by the Affordable Care Act, Medicare, or Medicaid can receive Intensive Behavioral Therapy (IBT) in the form of up to 20 face-to-face visits for weight counseling with their primary care provider. The PaTH to Health: Diabetes study will look into the impact of these visits on diabetes and weight outcomes.

The study, which began in early 2016 and is set to continue until 2021, is led by Principal Investigator Jennifer Kraschnewski, MD, MPH, of Penn State. It is a secondary data analysis, meaning researchers will collect electronic health record (EHR) data and patient-reported outcomes from PaTH Network sites. The participating PaTH sites include Penn State (site PI: Cynthia Chuang), Geisinger (Sharon Larson), Johns Hopkins (Daniel Ford), University of Pittsburgh (Cindy Bryce), Temple University (Anuradha Paranjape), and University of Utah (Rachel Hess). Researchers will collect data on weight loss and diabetes incidence and outcomes as well as examine patient-reported data on physical function and activity, sleep, fruit and vegetable consumption, and social support. By analyzing patient characteristics, practice and provider characteristics, and rural versus urban effects, researchers will gain a better understanding of who receives and provides IBT.

The team will be able to evaluate the impact of preventative service coverage for IBT by looking at weight loss, diabetes incidence, and diabetes outcomes and comparing this data in three states: one that adopted Medicaid expansion immediately (Maryland), one that delayed Medicaid expansion until January 2015 (Pennsylvania), and one that has not adopted Medicaid expansion (Utah).

As with any PaTH-affiliated study, patient participation is key. Research Project Manager Jennifer M. Poger, M.Ed., leads the study’s patient engagement initiatives and is committed to ensuring its five patient partners have a voice.

As an example of this engagement, patient partners completed a Community-Partnered Research Ethics Training, which allows them to be added to Penn State’s Institutional Review Board protocol as Patient Co-Investigators. This training, adapted from the University of Pittsburgh Clinical and Translational Science Institute, provides patient partners with a deeper understanding of research and ethical principles, so they are better positioned to engage in key research activities. Poger says this helps solidify the partnership between patients and researchers.

"This opportunity demonstrates the valuable role patient partners play in research," she says. "It’s important to officially recognize their contributions to the research process and its outcomes."

"I’m thrilled to be a part of the first study at Penn State with patient partners as full co-investigators, providing an opportunity for patient engagement beyond what prior studies could do," says Dr. Kraschnewski. "Patient-engaged research, focused on outcomes stakeholders really care about, has the potential to advance public health in a way not previously possible."

In addition to the training, patient partners have been contributing content published in the study’s biannual newsletter. They have also provided input and perspective in the development of a study website slated to launch in May. The site will feature resources for the diabetes community such as diabetes management tools, preventative care, and recipes.

To learn more about the PaTH to Health: Diabetes study, visit our website and watch the video below.

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