Hazard

Adult hearing loss is one of the most common chronic health conditions in the United States, especially affecting adults living in rural areas who face greater challenges in accessing testing and treatment. This clinical trial aims to develop and evaluate a community-based hearing healthcare patient navigation program specifically for rural adults in Kentucky. The main goal is to see if this program can increase the number of rural adults who receive diagnostic hearing tests. The study will pilot test the Patient Navigation Program with 500 adults from 10 rural primary care clinics. Participants presenting for routine visits will be invited to join, and those who screen positive for hearing loss will be contacted by a Patient Navigator. The navigator will provide support every two weeks, helping with education, screening, diagnosis, and treatment over 12 months. Each session will last about 10 to 30 minutes. Participants will undergo baseline assessments and post-intervention data collection either after completing a diagnostic audiogram or at 12 months following enrollment. Researchers will measure the number of participants who obtain a diagnostic audiogram within 12 months of joining the study. The study is designed to support hearing healthcare access and monitor participant progress over the one-year period.

Researchers are evaluating a health services research intervention called the Quality Implementation of Lung Cancer Screening QUILS System, aimed at improving lung cancer screening programs across Kentucky. The study focuses on optimizing statewide lung cancer screening to reduce late-stage lung cancer diagnoses, especially in high-risk areas like Kentuckys Central Appalachian region. This effort is motivated by data showing that lung cancer screening implementation in Kentucky has already contributed to a faster decline in late-stage diagnoses compared to the national average. The intervention involves lung cancer screening program teams receiving the QUILS System, which includes completing the QUILS Index Assessment, participating in QUILS Audit and Feedback presentations, accessing the QUILS Resource Portal, and developing site-specific action plans. Participants also engage in formative evaluation interviews to support the implementation process. This approach is designed to integrate best practices and quality improvement elements into existing screening programs. Participants, who are members or administrators of lung cancer screening programs, will be involved in surveys, audit feedback sessions, and interviews over the course of the study. Researchers will assess changes in the QUILS Index Assessment scores from baseline to month 9 to measure improvements in lung cancer screening quality. The study spans from April 2025 to June 2028, aiming to enhance screening effectiveness and reduce lung cancer burden through program quality improvements.

Researchers are working to improve lung cancer screening programs through an optimization pathway called the QUILS System. This initiative involves assessing current screening programs to identify elements that enhance quality and patient retention. The study focuses on delivering feedback reports to help programs prioritize improvements for better lung cancer screening outcomes. The study uses the QUILS System, which includes statewide coalition engagement through surveys, interviews, educational outreach, and collaborative activities. These efforts aim to raise awareness, improve coordination, support policy, and promote equitable and high-quality lung cancer screening programs. Participants in the study include physicians, nurses, administrators, and other staff involved in lung cancer screening programs. They will engage in the QUILS Index Assessment Survey, receive audit feedback presentations, and participate in formative evaluation interviews. The primary outcome is the change in the QUILS Index Assessment Score one year after the study start. The overall study period extends until June 2028.

Researchers are evaluating peer coaching models to support self-care in older adults with unmanaged Type 2 Diabetes Mellitus T2DM living in rural Appalachian Kentucky. This study aims to understand how effective peer coaching is in promoting diabetes self-management and which aspects of the peer support are most helpful. The intervention builds on the unique social connections within the community and is designed to improve self-care behaviors in this population. The study involves peer coaches who have well-managed T2DM and peer participants with unmanaged T2DM. Peer coaches receive training to develop coaching skills before the intervention begins. Peer participants are assigned to one of four groups based on whether they select or are matched with a peer coach, and the frequency of contact is either weekly or every two weeks. Peer coaches maintain records of interactions, and researchers will compare different coaching approaches and contact frequencies to assess their impact. Participants engage in the intervention over six months, with assessments at baseline, the end of intervention 6 months, and follow-ups at 3 and 6 months post-intervention. Researchers collect various measures including changes in blood sugar control HbA1c, diabetes empowerment, quality of life, social support, depression, diabetes-related problems, self-management behaviors, daily living activities, social networks, diabetes knowledge, problem-solving skills, medication adherence, and frailty. Stakeholders are involved at key points to provide feedback, and selected participants contribute to interviews after the study concludes.

Researchers are evaluating the impact of peer coaching models on self-management of Type 2 Diabetes Mellitus T2DM in older adults living in rural Appalachian communities of Kentucky. The study aims to determine whether peer coaching helps improve diabetes care and which aspects of the peer support are most effective. The trial involves peer coaches who have managed their diabetes well and peer participants with unmanaged diabetes, focusing on social support and self-care behaviors. The study has four groups based on how peer participants are paired with coaches and the frequency of contact participants either self-select or are matched with a peer coach, with contact occurring weekly or every two weeks. Peer coaches receive training before starting their role. The intervention lasts for six months with ongoing communication and goal-setting between participants and coaches. Stakeholders will be engaged before, during, and after the intervention to provide feedback and enhance understanding. Participants will be assessed at baseline, at the end of the six-month intervention, and again at three and six months post-intervention. Researchers will collect measures including blood sugar control HbA1c, diabetes empowerment, quality of life, social support, depression, diabetes-related problems, self-management behaviors, daily living activities, social networks, diabetes knowledge, problem-solving skills, medication adherence, and frailty. Records of peer contact and coaching topics will be kept to analyze the interventions effectiveness. The total study duration for participants spans at least one year including follow-up assessments.