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Trial registered on ANZCTR
Registration number
ACTRN12622000323729
Ethics application status
Approved
Date submitted
3/02/2022
Date registered
21/02/2022
Date last updated
2/03/2023
Date data sharing statement initially provided
21/02/2022
Date results provided
2/03/2023
Type of registration
Prospectively registered
Titles & IDs
Public title
Effect of a home-based physical activity program on metabolic syndrome in Ghanaian adults with type 2 diabetes mellitus: a feasibility randomized controlled trial
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Scientific title
Effect of a home-based physical activity program on metabolic syndrome in Ghanaian adults with type 2 diabetes mellitus: a feasibility randomized controlled trial
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Secondary ID [1]
306156
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
type 2 diabetes
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metabolic syndrome
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Condition category
Condition code
Metabolic and Endocrine
322400
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0
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Diabetes
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Metabolic and Endocrine
322594
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0
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Metabolic disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
In addition to their usual diabetes care, participants in the intervention group will undergo a 12-week home-based physical activity program. The exercise goal for the intervention group (IG) is at least 120 minutes/week of exercise over at least three days/week. In total, the IG will engage in 36 sessions of exercise over the 12-week period, with each session lasting between 35-45 minutes. Each exercise session will be structured as follows:
1. 3 minutes of warm-up (stretching exercises);
2. 30 minutes of aerobic exercise (walking) at moderate pace (4.5-5.1km/h = 3.5 MET) or brisk pace (5.6 km/h = 4.3 MET) (Ainsworth et al., 2011).
3. 10 minutes of resistance exercise (exercises targeting upper and lower large body muscles using TheraBand). The specific resistance exercise prescribed in this program will be: chest press, shoulder curls targeting the upper body muscles, and leg press will target lower body muscles;
4. 2 minutes of cool-down (stretching exercises).
Participants in the control will maintain their usual diabetes care including hypoglycaemic medication, recommended diet, and foot care. They will be encouraged to continue their usual PA levels. They will not be contacted during the RCT and will attend all medical appointments as organized by hospital staff.
During the participants’ weekly visit to the physiotherapy centre, the physical therapist (PT) will assess exercise adherence and safety using the PT checklist for exercise adherence and safety. The PT will ask participants about which exercise they performed during the week, as well as the length and frequency of those exercises. The PT will also ask about any exercise-related complication/s they encountered when undertaking exercise. All exercise sessions completed at the physiotherapy centre will also be documented by the PT. Participants will be given an Exercise Diary to be used to document home exercises. They will record in the diary the type of exercise, frequency, duration, and any complication experienced.
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Intervention code [1]
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Rehabilitation
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Comparator / control treatment
Control group will continue with their usual diabetes care in Ghana which involves hypoglycemic medication, nutrition advise, exercise advise, foot care, regular follow-up visit to hospital. Currently, there is no structured physical activity program for people with type 2 diabetes in Ghana.
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Control group
Active
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Outcomes
Primary outcome [1]
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The primary outcome is a change in Metabolic syndrome markers (blood pressure, triglycerides, waist circumference, fasting blood glucose, and high density lipoprotein) in Ghanaian adults with T2DM who participate in a 12-week PA program, compared to those who receive usual diabetes care. Blood pressure will be assessed using sphygmomanometer. Triglycerides, fasting blood glucose, and high-density lipoprotein will be assessed by blood test. Waist circumference will be taken by measuring the mid-point between the lower costal margin and iliac crest.
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Assessment method [1]
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Timepoint [1]
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12-weeks follow-up after starting the treatment.
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Secondary outcome [1]
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a change in quality of life (QoL) in Ghanaian adults with T2DM who participate in a 12-week PA program, compared to those who receive usual diabetes care. QoL will be assessed using the Short Form Health Survey – version 2 (SF-12V2).
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Assessment method [1]
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Timepoint [1]
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12-weeks follow-up after starting the treatment.
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Secondary outcome [2]
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assess feasibility of implementation, determined by measures of safety. Safety will be assessed as a composite of the physical therapist's checklist for exercise adherence and safety and the participants’ exercise diary. Both tools were designed by the research team specifically for this study.
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Assessment method [2]
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Timepoint [2]
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Daily assessment and 12 weeks follow-up after starting treatment.
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Secondary outcome [3]
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assess feasibility of implementation, determined by measures of adherence. Adherence will be assessed as a composite of the physical therapist's checklist for exercise adherence and safety and the participants’ exercise diary. Both tools were designed by the research team specifically for this study.
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Assessment method [3]
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Timepoint [3]
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Daily assessment and 12 weeks follow-up after starting treatment.
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Eligibility
Key inclusion criteria
1. Diagnosis of T2DM and MetS, confirmed by the NDMRC nurse or physician;
2. Approval provided by the physician for the patient to participate in an exercise program;
3. Residence in Ghana for at least 2 years;
4. At least 18 years of age; and
5. Sedentary (not achieving 600 metabolic equivalent of task - minutes/week, based on international physical activity questionnaire - short form (IPAQ-SF) assessment
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Current medical conditions that preclude physical activity:
• significant cardiac/respiratory diseases (e.g., decompensated heart failure),
• severe osteoarthritis or arthritis,
• angina episodes during rest or with minimal exertion,
• uncontrolled arrythmias,
• psychotic disorder or cognitive deficits,
• liver or kidney failure,
• advanced renal disease
• unstable coronary artery disease,
• significant vision loss,
• cancer
• stroke
• neuromuscular problems (e.g., multiple sclerosis, chronic muscle fatigue, muscular dystrophy, Parkinson’s, cerebral palsy).
• arthritis
• limb amputation
• bone or joint problems (arthritis, osteoporosis, osteoarthritis, bone fracture, dislocations, scoliosis, spondylolisthesis and spondylolysis).
2. Frailty index score < 3. Frailty assessment will be assessed using the PRISMA-7 frailty index.
3. Pregnancy.
4. Inability to travel to the NDMRC for supervised training; and,
5. No access to a mobile phone.
6. Not receiving medical clearance from a doctor. A medical clearance note will be completed by participant’s physician.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Data analysis will be performed using the latest version of SPSS. Descriptive statistics will be used to summarize feasibility outcomes, including frequencies, percentages, mean, SD, median, and interquartile range. Relevant parametric and non-parametric repeated measure analyses will be undertaken to measure between groups differences and changes in effect between and within the two groups. A p-value of <0.05 will be considered statistically significant
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
21/03/2022
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Actual
30/05/2022
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Date of last participant enrolment
Anticipated
21/06/2022
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Actual
25/07/2022
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Date of last data collection
Anticipated
30/09/2022
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Actual
28/10/2022
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Sample size
Target
90
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Accrual to date
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Final
87
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Recruitment outside Australia
Country [1]
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Ghana
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State/province [1]
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Accra
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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Deakin University
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Address [1]
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221 Burwood Highway, Burwood Victoria 3125
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Country [1]
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Australia
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Primary sponsor type
University
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Name
Deakin University
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Address
221 Burwood Highway, Burwood Victoria 3125
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
311663
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Deakin University Human Research Ethics Committee
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Ethics committee address [1]
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221 Burwood Highway, Burwood Victoria 3125
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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21/02/2022
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Approval date [1]
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13/05/2022
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Ethics approval number [1]
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2022-041
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Ethics committee name [2]
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Korle-Bu Institutional Review Board
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Ethics committee address [2]
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P. O. Box KB 77 Korle-Bu Accra, Ghana.
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Ethics committee country [2]
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Ghana
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Date submitted for ethics approval [2]
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08/02/2022
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Approval date [2]
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24/05/2022
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Ethics approval number [2]
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KBTH-IRB/00011/2022
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Summary
Brief summary
Background There is high prevalence of metabolic syndrome (MetS) among people with type 2 diabetes mellitus (T2DM). Aim To test the preliminary effect of a 12-week culturally appropriate home-based physical activity (PA) program on metabolic syndrome (MetS) markers in Ghanaian adults with T2DM. A secondary objective was to evaluate the feasibility of the PA program. Methods The PA program was evaluated using a feasibility randomised controlled trial (RCT). Eighty-seven adults with T2DM who seek care at the National Diabetes Management and Research Centre of the Korle-Bu Teaching Hospital, Accra were randomized into either Control Group (CG) (n=43) or Intervention Group (IG) (n=44). Participants in the IG received the PA program in addition to their usual diabetes care; those in the CG received their usual diabetes care. Measurements were performed at baseline and 12-week follow-up. The primary outcome was a change in MetS markers (blood pressure, triglycerides, waist circumference, fasting blood glucose, and high-density lipoprotein) in the IG, compared to the CG. Secondary outcomes were feasibility of implementation, determined by measures of safety and participation. Results Following the 12-week PA program, participants in the IG showed improvement in fasting blood glucose, waist circumference, and systolic blood pressure. There was no statistical difference between the IG and CG regarding high-density lipoprotein, triglycerides, and diastolic blood pressure. Mets prevalence was reduced in the IG compared to CG (51.2% Vs. 83.3%). MetS severity score also improved in the IG compared to the CG (8.8% vs. 0.5%). The IG had improvement in two of the eight SF-12 dimensions (physical function and vitality) compared to the CG, resulting in significant improvement in the physical component summary. There was no significant difference between the IG and CG regarding the mental component summary. Thirty-two (72.7%) participants completed the 12-week program (all 36 sessions at home and facility) indicating feasibility and acceptability. Another 11 (25%) of participants completed 80% of the exercise sessions. Reasons for missing sessions included tight work demands, other social commitments, not feeling well, and long travel hours for weekly facility exercise session. No adverse events were reported during the entire project. Conclusion It was feasible and safe in implementing the culturally appropriate PA program. The intervention has the potential to improve MetS and quality of life (QoL) in Ghanaian adults with T2DM. The findings can be used to inform the design of a future large-scale RCT.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Andrea Driscoll
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Address
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school of Nursing and Midwifery, Deakin University, 221 Burwood Highway, Burwood Victoria 3125
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Country
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Australia
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Phone
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+61 3 925 17212
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Mohammed Amin
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Address
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school of Nursing and Midwifery, Deakin University, 221 Burwood Highway, Burwood Victoria 3125
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Country
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Australia
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Phone
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+61 452074801
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Mohammed Amin
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Address
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school of Nursing and Midwifery, Deakin University, 221 Burwood Highway, Burwood Victoria 3125
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Country
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Australia
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Phone
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+61 452074801
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Fax
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Data collected will remain confidential. Publications and reports will be reported as grouped data, protecting participants’ anonymity
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Improving Metabolic Syndrome in Ghanaian Adults with Type 2 Diabetes through a Home-Based Physical Activity Program: A Feasibility Randomised Controlled Trial.
2023
https://dx.doi.org/10.3390/ijerph20085518
N.B. These documents automatically identified may not have been verified by the study sponsor.
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