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Trial registered on ANZCTR
Registration number
ACTRN12622000379718
Ethics application status
Approved
Date submitted
25/02/2022
Date registered
4/03/2022
Date last updated
22/02/2024
Date data sharing statement initially provided
4/03/2022
Type of registration
Prospectively registered
Titles & IDs
Public title
The feasibility, safety, and efficacy of GRoup Exercise for people with type 2 diAbetes using Telehealth: The GREAT Study
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Scientific title
The feasibility, safety, and efficacy of GRoup Exercise for people with type 2 diAbetes using Telehealth: The GREAT Study
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Secondary ID [1]
306531
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
GREAT
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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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Condition category
Condition code
Metabolic and Endocrine
322806
322806
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0
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Diabetes
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Potential participants will initially make content via email or phone if they are willing to volunteer to take part in the study. Potential participants will initially be screened to ensure they meet all eligibility criteria. After providing written informed consent, the participants will attend the baseline assessment session at the University. Within 72 hours of this session, they will be asked to repeat tests in their home environment, while being supervised by an Accredited Exercise Physiologist via telehealth.
The 8-week telehealth exercise program will be delivered in groups of five by an Accredited Exercise Physiologist using Zoom, including two-way audio-visual communication. Each session will be 1 hour and will occur once weekly – 45 minutes will be dedicated to the exercise program and 15 minutes to education. Each 45-minute exercise program will include both aerobic and resistance training, following the Exercise and Sports Science Australia guidelines for people with type 2 diabetes (i.e., moderate to vigorous intensity, assessed by Borg RPE scale). The exercises will be selected based on the availability of equipment/space and individual participant needs within the group; examples may include squats, push-ups, banded rows, and/or balance exercises. Adherence will be monitored through attendance checklists. The sessions will occur once weekly, though participants will be provided with additional resources for completing self-directed exercise external to the supervised sessions (e.g., Exercise and Sports Science Australia Exercise Right at Home website). The frequency, intensity, duration and mode of self-directed exercise will be at the discretion of the participants, and will not be monitored.
In addition to the structured exercise component, the program will also include 15 minutes of education to help participants transition to self-management. These will be delivered by electronic slide presentations at the end of each session, and will cover such topics as health behaviour change, exercise guidelines for T2D, goal setting, medications, and dietary guidelines. To enhance the likelihood of long-term behaviour change, the education sessions will target key constructs from Bandura’s Social Cognitive Theory (i.e., self-efficacy, goals, beliefs, and social support).
After the 8-week program, all participants will attend the University for a final assessment session.
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Intervention code [1]
322959
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Lifestyle
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Feasibility of delivering group exercise interventions via telehealth (recruitment rate, retention rate, reasons for attrition, participant acceptability, practicality). This will be assessed via audits of study records, attendance lists, and semi-structured, individual interviews at the conclusion of the program.
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Assessment method [1]
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Timepoint [1]
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The total duration of the study will be 10 weeks – this includes two baseline assessment visits in week 1, eight weeks of supervised telehealth-delivered exercise in weeks 2-9, and a final assessment visit in week 10
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Secondary outcome [1]
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Glycated haemoglobin (HbA1c; blood test)
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Assessment method [1]
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Timepoint [1]
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Participants will be assessed face-to-face and via telehealth at baseline, and face-to-face only following the 8-week intervention.
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Secondary outcome [2]
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Fasting blood glucose (blood test)
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Assessment method [2]
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Timepoint [2]
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Participants will be assessed face-to-face and via telehealth at baseline, and face-to-face only following the 8-week intervention.
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Secondary outcome [3]
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Cholesterol profile (blood test)
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Assessment method [3]
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Timepoint [3]
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Participants will be assessed face-to-face and via telehealth at baseline, and face-to-face only following the 8-week intervention.
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Secondary outcome [4]
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Waist and hip girths (tape measure)
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Assessment method [4]
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Timepoint [4]
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Participants will be assessed face-to-face and via telehealth at baseline, and face-to-face only following the 8-week intervention.
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Secondary outcome [5]
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Blood pressure (automatic sphygmomanometer)
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Assessment method [5]
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Timepoint [5]
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Participants will be assessed face-to-face and via telehealth at baseline, and face-to-face only following the 8-week intervention.
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Secondary outcome [6]
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Physical activity levels (International Physical Activity Questionnaire, Accelerometer)
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Assessment method [6]
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Timepoint [6]
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Participants will be assessed face-to-face and via telehealth at baseline, and face-to-face only following the 8-week intervention.
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Secondary outcome [7]
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Diet (24 hour recall)
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Assessment method [7]
406817
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Timepoint [7]
406817
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Participants will be assessed face-to-face and via telehealth at baseline, and face-to-face only following the 8-week intervention.
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Secondary outcome [8]
406818
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Lower body muscular endurance (2-minute step test)
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Assessment method [8]
406818
0
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Timepoint [8]
406818
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Participants will be assessed face-to-face and via telehealth at baseline, and face-to-face only following the 8-week intervention.
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Secondary outcome [9]
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Upper body functional strength (30sec bicep curl test)
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Assessment method [9]
406819
0
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Timepoint [9]
406819
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Participants will be assessed face-to-face and via telehealth at baseline, and face-to-face only following the 8-week intervention.
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Secondary outcome [10]
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Submaximal exercise capacity (6 minute walk test)
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Assessment method [10]
406820
0
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Timepoint [10]
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Participants will be assessed face-to-face and via telehealth at baseline, and face-to-face only following the 8-week intervention.
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Secondary outcome [11]
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Safety - participants will be instructed to report to the research team any adverse events that occur during the study period. The type, incidence, and severity of adverse events will be determined based on the Common Terminology Criteria for Adverse Events.
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Assessment method [11]
406821
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Timepoint [11]
406821
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Participants will be assessed face-to-face and via telehealth at baseline, and face-to-face only following the 8-week intervention.
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Eligibility
Key inclusion criteria
Participants will require a glycated haemoglobin (HbA1c) level of greater than or equal to 7.0% at baseline, and access to a device with a camera (e.g., computer/laptop/tablet). Potential participants will be screened using the Adult Pre-Exercise Screening System to ensure safety.
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Minimum age
18
Years
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Maximum age
65
Years
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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
People will be ineligible if they have any condition as per the absolute contraindications to exercise outlined by the American College of Sports Medicine8 including, but not limited to: unstable angina; recent (within the past four weeks) myocardial infarction; coronary artery disease; uncompensated heart failure; New York Heart Association functional classification II-IV; severe valvular illness; pulmonary disease; uncontrolled hypertension (systolic blood pressure > 200 mmHg and/or diastolic blood pressure > 110 mmHg); renal failure (chronic kidney disease stages IV-V); cardiomyopathy. People will also be ineligible for: having type 1 diabetes, meeting the physical activity guidelines (150minutes/week moderate intensity or 75minutes/week vigorous intensity exercise), planned medical operations during the research period, a physical condition whereby exercise training would be inappropriate, pregnant or expecting to be pregnant during the study period, non-English speaking, and cognitive impairment that limits the ability to understand verbal instructions.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised 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
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
7/03/2022
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Actual
22/04/2022
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Date of last participant enrolment
Anticipated
2/10/2023
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Actual
29/09/2023
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Date of last data collection
Anticipated
31/12/2023
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Actual
7/12/2023
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Sample size
Target
25
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Accrual to date
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Final
16
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Recruitment in Australia
Recruitment state(s)
NSW
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Funding & Sponsors
Funding source category [1]
310873
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University
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Name [1]
310873
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University of Newcastle
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Address [1]
310873
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10 Chittaway Road
Ourimbah NSW 2258
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Country [1]
310873
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Australia
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Primary sponsor type
Individual
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Name
Dr Emily Cox
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Address
University of Newcastle
10 Chittaway Road
Ourimbah NSW 2258
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Country
Australia
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Secondary sponsor category [1]
312137
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Individual
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Name [1]
312137
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Professor Ronald Plotnikoff
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Address [1]
312137
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University of Newcastle
University Dr
Callaghan NSW 2308
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Country [1]
312137
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Australia
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Secondary sponsor category [2]
312141
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Individual
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Name [2]
312141
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Dr Myles Young
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Address [2]
312141
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University of Newcastle
University Dr
Callaghan NSW 2308
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Country [2]
312141
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Australia
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Secondary sponsor category [3]
312142
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Individual
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Name [3]
312142
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Dr Shelley Keating
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Address [3]
312142
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The University of Queensland
Blair Drive
St Lucia QLD 4072
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Country [3]
312142
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Australia
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Secondary sponsor category [4]
312143
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Individual
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Name [4]
312143
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Ryan Drew
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Address [4]
312143
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University of Newcastle
10 Chittaway Road
Ourimbah NSW 2258
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Country [4]
312143
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Australia
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Secondary sponsor category [5]
312144
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Individual
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Name [5]
312144
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Dr Kim Edmunds
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Address [5]
312144
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The University of Queensland
Corner of Campbell Rd and University Drive
St Lucia QLD 4072
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Country [5]
312144
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
310434
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University of Newcastle Human Research Ethics Committee
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Ethics committee address [1]
310434
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University of Newcastle University Drive Callaghan NSW 2308
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Ethics committee country [1]
310434
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Australia
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Date submitted for ethics approval [1]
310434
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Approval date [1]
310434
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23/07/2021
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Ethics approval number [1]
310434
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H-2021-0204
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Summary
Brief summary
Almost 1million Australian adults (5.3% of the population aged over 18years) have type 2 diabetes (T2D). The benefits of exercise for people with T2D include improved glycaemic control, reduced body fat, increased fitness, and reduced pain. These benefits can be observed even with once weekly supervised sessions. Medicare subsidises eight group exercise classes annually for people with T2D. However, barriers such as lack of transport, financial cost and living in regional centres can preclude people from participating in-person. Telehealth may be an alternative approach to overcome these barriers. In response to COVID-19, Medicare are now subsidising one-on-one videoconference exercise services; this funding has not been extended to group services. In people with T2D, being physically active with others is an important motivator; specifically, the accountability, increased enjoyment, and sense of community that accompanies group training improves adherence, which ultimately improves health outcomes. The feasibility and efficacy of group services delivered via telehealth have not been evaluated in T2D, though a small study in liver transplant recipients has shown it to be an appropriate alternative to in-person services. Given the unique provision of care in T2D with the availability of subsidised group exercise sessions, investigating the application of telehealth in this context is crucial. Therefore, the aims of this study are to: 1. Establish the feasibility (i.e., practicality, recruitment, attendance, retention, safety, and acceptability) of delivering group exercise interventions via telehealth, compared with in-person, in people with T2D 2. Evaluate the preliminary efficacy of an 8week telehealth group exercise intervention on behavioural (physical activity levels) and clinical (bloods, body composition, physical function) outcomes, compared with an in-person group intervention, in people with T2D 3. Evaluate the impact of the mode of service delivery on behavioural and clinical outcomes 16weeks following an 8week group exercise intervention in people with T2D 4. Determine the validity and reliability of in-person clinician-measured versus telehealth-supervised participant self-measured assessments
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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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Dr Emily Cox
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Address
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School of Environmental and Life Sciences
University of Newcastle
10 Chittaway Road
Ourimbah NSW 2258
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Country
117654
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Australia
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Phone
117654
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+61 2 4985 4515
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Fax
117654
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Email
117654
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[email protected]
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Contact person for public queries
Name
117655
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Emily Cox
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Address
117655
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School of Environmental and Life Sciences
University of Newcastle
10 Chittaway Road
Ourimbah NSW 2258
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Country
117655
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Australia
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Phone
117655
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+61 2 4985 4515
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Fax
117655
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Email
117655
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[email protected]
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Contact person for scientific queries
Name
117656
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Emily Cox
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Address
117656
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School of Environmental and Life Sciences
University of Newcastle
10 Chittaway Road
Ourimbah NSW 2258
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Country
117656
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Australia
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Phone
117656
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+61 2 4985 4515
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Fax
117656
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Email
117656
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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)?
Yes
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What data in particular will be shared?
All of the individual participant data collected during the trial in a non-identifiable form. If the participant has given extended consent, group mean and standard deviations for all outcome data will be shared on request to the PI. For example for the purpose of meta analysis where data not reported in suitable format in the publication.
Data that will be shared are clinical outcome data.
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When will data be available (start and end dates)?
After publication of results (estimated to be Jan 2023) and will be available for 15 years (Jan 2038).
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Available to whom?
People from credentialed institutions upon request by email to PI- Dr Emily Cox
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Available for what types of analyses?
Meta-analysis or other pooled analysis of raw data. All data to be shared will be de-identified.
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How or where can data be obtained?
Upon request by email to PI - Dr Emily Cox
[email protected]
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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
No additional documents have been identified.
Download to PDF