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Mil Familias Cohort Establishment: a Study to Understand Determinants of Diabetes and Its Complications Among US Latinos

Completed
Conditions
Type2 Diabetes Mellitus
Cardiovascular Diseases
Registration Number
NCT03830840
Lead Sponsor
Sansum Diabetes Research Institute
Brief Summary

The Mil Familias Cohort Establishment involves enrolling 1000 Latino families with at least one member in the family having type 2 diabetes, including children and youth, and measuring the 5 determinants of human health: genetics, biology, behavior, psychology, and society/environment.

Detailed Description

The vision of Mil Familias is to reduce the burden of cardio-metabolic disease among Latino families in Santa Barbara County and beyond. The aim is to establish an observational cohort of 1,000 Latino families, with at least one family member currently living with diabetes, in order to understand better the impact of the 5 determinants of human health (genetics, biology, behavior, psychology, and society/environment) in this population. Once the 1,000-family cohort is established, evidence-based intervention studies will be developed and implemented based on new knowledge, with collaborators from the healthcare, public policy, academic, pharmaceutical, medical device and technology industries. The strategy involves 4 coordinated and iterative components to achieve its mission:

1. Especialistas: Trusted, bilingual community health workers specially-trained in diabetes education, clinical research methodologies, and care referral. The Especialistas will engage directly with participants to conduct research activities, answer questions, and when necessary, refer participants to appropriate, local community resources.

2. Data: Facilitated by Especialistas, each individual participant will contribute information on up to 100 different variables relating to their genetics, biology, psychology, behavior and society/environment, thus creating a one-of-a-kind database and associated specimen biobank on Latino health and lifestyle ("Living Information Bank").

3. Interventions: Based on the data, evidence-based, collaborative, culturally-relevant prevention and treatment strategies are planned to develop once the cohort of 1,000 families has been established.

4. Allies: This community-based participatory research study requires engagement from key stakeholders from the Latino community, healthcare sectors, hospitals, payers, businesses, people with diabetes and philanthropists. Organizations and individuals support Mil Familias by contributing their resources, experiences, and skill-sets.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
405
Inclusion Criteria
  1. Males or females ≥ 7 years of age at enrollment.

  2. Self-reported Latino heritage.

  3. Co-resides with immediate family member (as defined above) OR self with established diagnosis of Type 2 Diabetes for at least one year prior to enrollment date.

  4. Signed and dated written informed consent by the date of enrollment.

  5. Based on the research staff's judgment, subject or subject's representative must have a good understanding, ability, and willingness to adhere to the protocol, including performance of self-monitored data collection during the wearable device portion.

Exclusion Criteria
  1. Life expectancy < 6 months.
  2. Any active clinically significant physical or mental disease or disorder, which in the investigator's opinion could interfere with the participation of the trial.
  3. Language barriers precluding comprehension of study activities and informed consent.
  4. Participation in other trials involving medication or device within 1 month prior to enrollment.
  5. Known or suspected abuse of alcohol, narcotics, or illicit drugs. -

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Success (evaluated by Yes/No format) recruiting and establishing an observational cohort of 1,000 Latino families with at least one family member living with type 2 diabetes by deploying the methods proven feasible by Mil Familias Operational Pilot.3 years

The Mil Familias Cohort Establishment will expand upon the Mil Familias Operational Pilot cohort and infrastructure to collect and store the up to 100 proposed variables across the 5 determinants of human health to support long-term Mil Familias implementation. The variables pertaining to each participant will be collected and stored at the initial visit and then annually for up to 3 years. Socio-demographic characteristics of the cohort will be described at enrollment by type 2 diabetes status, including age, gender, self-identified race/ethnicity, number of people in household, education, insurance, income, occupation, HbA1c, and country of birth.

Secondary Outcome Measures
NameTimeMethod
Heart rate measured by Physical examPhysical exam encounter and annually up to 3 years

Heart rate measured in beats per minute by physical exam

Laboratory blood draw for evaluation of lipidsLaboratory encounter and annually up to 3 years

Lipids will measured in a laboratory blood draw sample.

Weight measured by Physical examPhysical exam encounter and annually up to 3 years

Weight measured in kilograms or pounds by physical exam

Number of healthcare visits and the difficulty in traveling to the healthcare provider assessed by questionnaireIntroductory interview/ demographics/ contacts and annually up to 3 years

Number of visits to a healthcare provider in the last year and difficulty in traveling to a healthcare provider measured by interview questionnaire

Laboratory blood draw for evaluation of thyroid functionLaboratory encounter and annually up to 3 years

Thyroid function will measured in a laboratory blood draw sample.

Height measured by Physical examPhysical exam encounter and annually up to 3 years

Height measured in centimeters or inches by physical exam

Waist circumference measured by Physical examPhysical exam encounter and annually up to 3 years

Waist circumference measured in centimeters or inches by physical exam

Socio-demographics assessed by questionnaire.Introductory interview/ demographics/ contacts and annually up to 3 years

Socio-demographics measured by questionnaire - including age, gender, self-identified race/ethnicity, contact information, number in household, income, education, marital status, occupation, caring for elder, night shifts, insurance status, insurance type and payer, influenza immunization status, immigration status, alcohol \& tobacco use, birth place,and duration of time in the United States (\<5 years, 5-9 years, 10-14 years, 15-19 years, 20-24 years, ≥25 years).

Laboratory blood draw for evaluation of Complete Blood CountLaboratory encounter and annually up to 3 years

Complete Blood Count will measured in a laboratory blood draw sample.

Laboratory blood draw for evaluation of Comprehensive Metabolic PanelLaboratory encounter and annually up to 3 years

Comprehensive Metabolic Panel will measured in a laboratory blood draw sample.

Laboratory blood draw for evaluation of Insulin autoantibody related to diabetesLaboratory encounter and annually up to 3 years

Insulin autoantibody, U/mL, will measured in a laboratory blood draw sample.

Questions regarding personal opinions regarding the burden of diabetes on Latinos measured by specific questionsIntroductory interview/ demographics/ contacts and annually up to 3 years

Personal opinion regarding type 2 diabetes burden on Latinos measured by 3 questions - why is diabetes common in Latinos, what can be done to prevent diabetes in Latinos, and what things make it difficult to get help with diabetes when it is needed?

Daily sugary drink consumptionIntroductory interview/ demographics/ contacts and annually up to 3 years

Daily sugary drink consumption is measured by the 2 questions in the Sugar Sweetened Beverages module of the Behavioral Risk Factor Surveillance System Questionnaire from the Centers for Disease Control.

Laboratory blood draw for evaluation of Glutamic Acid Decarboxylase (GAD) antibodies related to diabetesLaboratory encounter and annually up to 3 years

Glutamic Acid Decarboxylase (GAD) antibodies, U/mL, will measured in a laboratory blood draw sample.

Laboratory blood draw for evaluation of InsulinLaboratory encounter and annually up to 3 years

Insulin, milliunits/L, will measured in a laboratory blood draw sample.

Microalbumin measured in a urine sampleLaboratory encounter and annually up to 3 years

Urine sample collected for measuring microalbumin mg/L

Total daily tortilla consumptionIntroductory interview/ demographics/ contacts and annually up to 3 years

The number of flour and/or corn tortillas consumed daily for the past 30 days is estimated

Number of times per week eating meals prepared away from homeIntroductory interview/ demographics/ contacts and annually up to 3 years

NHANES 2017-2018 question asked - During the past 7 days, how many meals did you get that were prepared away from home in places such as restaurants, fast food places, food stands, grocery stores, or from vending machines?

Laboratory blood draw for evaluation of C-Peptide related to diabetesLaboratory encounter and annually up to 3 years

C-Peptide, ng/mL, will measured in a laboratory blood draw sample.

Laboratory blood draw for evaluation of C-Reactive protein related to diabetesLaboratory encounter and annually up to 3 years

C-Reactive protein, mg/L, will measured in a laboratory blood draw sample.

Creatinine measured in a urine sampleLaboratory encounter and annually up to 3 years

Urine sample collected for measuring creatinine

Stool samples for microbiome analysisLaboratory encounter and annually up to 3 years

Stool/fecal samples will be collected for microbiome analysis

Temperature measured by Physical examPhysical exam encounter and annually up to 3 years

Temperature measured in degrees by physical exam

Medical history, family medical history, and medication status and history assessed by interviewPhysical exam encounter and annually up to 3 years

Medical history including date of diabetes diagnosis, family medical history, and current medications verified by visual inspection and medication history assessed by interview questionnaire

Diabetes management measured by the Diabetes Symptom Self-Care InventoryQuestionnaires encounter and annually up to 3 years

Ability to manage diabetes self-care assessed by the Diabetes Symptom Self-Care Inventory (DSSCI)

Health literacy measured by the Short Assessment of Health Literacy (SAHL)Questionnaires encounter and annually up to 3 years

SAHL is a participant reported questionnaire to measure health literacy

Laboratory blood draw for evaluation of HbA1c related to diabetesLaboratory encounter and annually up to 3 years

HbA1c % will measured in a laboratory blood draw sample.

Determination of diabetes related foot diseaseQuestionnaires encounter and annually up to 3 years

Questionnaire for determination of diabetes related foot disease (Q-DFD)

Risk Perception Survey For Developing Diabetes (RPS-DD)Questionnaires encounter and annually up to 3 years

Diabetes risk perception will be measured by the Risk Perception Survey For Developing Diabetes (RPS-DD)

Foot self care confidence measured by questionnaireQuestionnaires encounter and annually up to 3 years

Foot Care Confidence Scale (FCCS) is an instrument designed to measure the confidence (self-efficacy) of individuals with type 2 diabetes to perform foot self care

Trust in physician measured by the Trust in Physician (TPS) questionnaireQuestionnaires encounter and annually up to 3 years

The TPS is a questionnaire and scale to determine trust in the physician

Social needs screening assessed by the Health Leads Screening toolkitQuestionnaires encounter and annually up to 3 years

The Health Leads Screening tookit (Boston, MA) will be used to determine social needs - housing instability, childcare, utility needs, financial resource strain, transportation, and exposure to violence.

Laboratory blood draw for evaluation of Islet antigen 2 (IA-2) antibody related to diabetesLaboratory encounter and annually up to 3 years

Islet antigen 2 (IA-2) antibody, U/mL, will measured in a laboratory blood draw sample.

Microalbumin/creatinine ratio measured in a urine sampleLaboratory encounter and annually up to 3 years

Urine sample collected for measuring the microalbumin/creatinine ratio

Foot examination evaluated by Questions and Physical examPhysical exam encounter and annually up to 3 years

Foot examination with yes or no questions and by physical exam

Neuropathy Questions during Physical examPhysical exam encounter and annually up to 3 years

Questions about neuropathy

Retinopathy questions during Physical examPhysical exam encounter and annually up to 3 years

Questions about retinopathy

Quality of life measured by the Short Form Health Survey (SF-12)Questionnaires encounter and annually up to 3 years

The SF-12 is a participant reported questionnaire to measure quality of life

Adverse Childhood Experiences (ACE) quantified by ACE questionnaireQuestionnaires encounter and annually up to 3 years

Adverse Childhood Experiences (ACEs) refers to a range of events that a child can experience, which lead to stress and can result in trauma and chronic stress responses. An ACE score will be quantified by a specific ACE questionnaire.

Spirituality measured by a Spiritual Well Being ScaleQuestionnaires encounter and annually up to 3 years

FACIT" (Functional Assessment of Chronic Illness Therapy) Sp-12 is a questionnaire for measuring spiritual well being. Questions are scored from 0 = Not at all to 4 = Very much. Sub-scales are created for meaning, peace, and faith with score ranges of 0 - 16. Adding these 3 scores gives a total score and the range is 0 - 48 with low scores indicating low spiritual well being and high scores indicating higher spiritual well being.

Stress measured by the 4 item Perceived Stress Scale (PSS)Questionnaires encounter and annually up to 3 years

PSS is a participant reported questionnaire to measure stress. The scale ranges from 0 = never to 4 = very often. The final score ranges from 0 - 16, with higher scores indicating more stress.

Drug abuse measured by the Drug Abuse Screening Test (DAST) - 20Questionnaires encounter and annually up to 3 years

The purpose of the DAST-20 is to provide a brief, simple, practical, but valid method for identifying individuals who are abusing psychoactive drugs; and to yield a quantitative index score of the degree of problems related to drug use and misuse

Food security assessed by U.S. Household Food Security Survey Module: Six-item short formQuestionnaires encounter and annually up to 3 years

Food security or insecurity assessed by a six-item short form developed by the Economic Research Service, United States Department of Agriculture (USDA), September 2012

Cheek cells and saliva for genomic analysisLaboratory encounter and annually up to 3 years

Cheek epithelial cells from a swab and saliva samples will be collected for genetic analysis

Blood pressure measured by Physical examPhysical exam encounter and annually up to 3 years

Blood pressure, systolic and diastolic, measured in mmHg by physical exam

Dental exam Questions during Physical examPhysical exam encounter and annually up to 3 years

Questions about dental exams

Eye exam Questions during Physical examPhysical exam encounter and annually up to 3 years

Questions about eye exams

Menopausal status, pregnancy status, and gestational diabetes history for women determined by interviewPhysical exam encounter and annually up to 3 years

Menopausal status, pregnancy status (number of live births, number of stillbirths, birthweights of live births, and any diagnosis of type 1 diabetes), and gestational diabetes history for female participants will be determined by interview

Acculturation measured by the Brief Acculturation Scale for Hispanics (BASH)Questionnaire encounter and annually up to 3 years

BASH is a participant reported questionnaire to measure acculturation. Responses are scored as 1 = only Spanish, 2 = Spanish more than English, 3 = Spanish and English equally, 4 = English more than Spanish, and 5 = only English. Items are summed and divided by the number of items. Low acculturation is less than or equal to 3.0, and high acculturation is greater than or equal to 3.0.

Depression measured by the Patient Health Questionnaire-9Questionnaires encounter and annually up to 3 years

The Patient Health Questionnaire (PHQ)-9 is the Major Depressive Disorder (MDD) module of the full PHQ

Family diabetes management measured by questionnaireQuestionnaires encounter and annually up to 3 years

Family diabetes Self-Efficacy for management of diabetes measured by questionnaire (FSE)

Measurement of health numeracyQuestionnaires encounter and annually up to 3 years

Newest Vital Sign (NVS) is a tool to assess health literacy and numeracy in English and Spanish

National survey of children's health (NSCH) for all children and youthQuestionnaires encounter and annually up to 3 years

The NSCH, a validated survey of children's health and translated into Spanish, will assess health of children and youth

Perceived Ethnic Discrimination measured by the Brief Perceived Ethnic Discrimination Questionnaire - Community version (PEDQ-CV)Questionnaires encounter and annually up to 3 years

PEDQ-CV is a participant reported questionnaire to measure perceived ethnic discrimination

Sleep quality measured by the Oviedo Sleep Questionnaire (OSQ)Questionnaires encounter and annually up to 3 years

The OSQ is a participant reported questionnaire to measure sleep quality

Functional support measured by the SSQ6Questionnaires encounter and annually up to 3 years

Social Support Questionnaire - Short Form (SSQ6) measures functional social support

Support structure measured by Medical Outcomes Study Social Support Survey (mMOS-SS)Questionnaires encounter and annually up to 3 years

The eight-item modified Medical Outcomes Study Social Support Survey (mMOS-SS) measures support structure by counting the number of people supporting and satisfaction with that support

Trial Locations

Locations (1)

Sansum Diabetes Research Institute

🇺🇸

Santa Barbara, California, United States

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