# Engaging Veterans and Family Supporters in PACT to Improve Diabetes Management

> **NIH VA I01** · VETERANS HEALTH ADMINISTRATION · 2020 · —

## Abstract

BACKGROUND: Veterans with diabetes must control cardiovascular risk factors in order to prevent disabling
and life-threatening complications. However, despite system wide advances in diabetes quality of care, over
30% of VHA patients with diabetes continue to have uncontrolled blood pressure, hyperglycemia, or
hyperlipidemia. The nationwide VA PACT (Patient-Aligned Care Teams) initiative seeks to provide VA primary
care patients with comprehensive, team-based support for following diabetes care regimens. PACT's success,
however, hinges on its ability to effectively engage patients in care. One relatively untapped resource for
supporting engagement in PACT is patients' family and friends. Three out of four adults with diabetes reach
out to an unpaid family member or friend (a `health supporter') for ongoing help with diabetes
management. These supporters help patients with medication adherence, tracking home glucose
measurements, maintaining a healthy eating plan, and often accompany patients to their medical visits.
However, while PACT emphasizes the importance of family members as part of the care team, PACT does not
have formal mechanisms to involve health supporters in PACT care. Health supporters report that, in order to
be more effective, they need more information on patient's medical care plans, clear channels for
communicating with PACT team members, and information on navigating PACT resources.
OBJECTIVES: The overall objective of this randomized trial is to test a strategy to strengthen the capacity of
supporters to help patients with high-risk diabetes engage in PACT care and successfully enact care plans.
The central hypothesis is that providing health care engagement tools to both health supporters and
patients will increase patient activation and improve management of diabetes complication risks.
METHODS: This will be a randomized controlled trial evaluating an intervention (Caring Others Increasing
EngageMent in PACT, or CO-IMPACT) designed to structure and facilitate health supporter involvement in
PACT so that patients can become more actively engaged in PACT care, and improve their diabetes treatment
processes and outcomes. 220 patients with diabetes receiving PACT primary care who 1) are at high risk for
diabetes complications due to hyperglycemia OR high blood pressure and 2) have a health supporter involved
in their diabetes care will be recruited along with their health supporter. Patient-supporter dyads will be
randomized to the CO-IMPACT intervention or usual PACT care for high-risk diabetes, for 12 months. The CO-
IMPACT protocol provides patient-supporter dyads: one coaching session on action planning, communicating
with providers, navigation skills and support skills; preparation by phone before patients' primary care visits;
after-visit summaries by mail; and biweekly automated phone calls to prompt dyad action on new patient
health concerns. CO-IMPACT builds on medical record-integrated patient activation tools in the...

## Key facts

- **NIH application ID:** 10166917
- **Project number:** 5I01HX001618-06
- **Recipient organization:** VETERANS HEALTH ADMINISTRATION
- **Principal Investigator:** Ann-Marie Rosland
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2015-06-01 → 2021-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10166917

## Citation

> US National Institutes of Health, RePORTER application 10166917, Engaging Veterans and Family Supporters in PACT to Improve Diabetes Management (5I01HX001618-06). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10166917. Licensed CC0.

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