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Contemp Clin Trials. 2018 Jan;64:265-273. doi: 10.1016/j.cct.2017.08.020. Epub 2017 Sep 1.

The Healthy Hearts and Kidneys (HHK) study: Design of a 2×2 RCT of technology-supported self-monitoring and social cognitive theory-based counseling to engage overweight people with diabetes and chronic kidney disease in multiple lifestyle changes.

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New York University School of Medicine, Center for Healthful Behavior Change, United States. Electronic address:
New York University Steinhardt, Department of Nutrition, Food Studies and Food Studies, United States.
New York University Medical Center, Division of Nephrology, United States.
New York University Medical Center, Division of Cardiology, United States.
New York University School of Medicine, Division of Biostatistics, United States.
New York University School of Medicine, Center for Healthful Behavior Change, United States.


Patients with complex chronic diseases usually must make multiple lifestyle changes to limit and manage their conditions. Numerous studies have shown that education alone is insufficient for engaging people in lifestyle behavior change, and that theory-based behavioral approaches also are necessary. However, even the most motivated individual may have difficulty with making lifestyle changes because of the information complexity associated with multiple behavior changes. The goal of the current Healthy Hearts and Kidneys study was to evaluate, different mobile health (mHealth)-delivered intervention approaches for engaging individuals with type 2 diabetes (T2D) and concurrent chronic kidney disease (CKD) in behavior changes. Participants were randomized to 1 of 4 groups, receiving: (1) a behavioral counseling, (2) technology-based self-monitoring to reduce information complexity, (3) combined behavioral counseling and technology-based self-monitoring, or (4) baseline advice. We will determine the impact of randomization assignment on weight loss success and 24-hour urinary excretion of sodium and phosphorus. With this report we describe the study design, methods, and approaches used to assure information security for this ongoing clinical trial. Clinical Identifier: NCT02276742.


Behavior; Clinical trial; Diabetes mellitus, type 2; Diabetic nephropathy; Exercise; Phosphorus, dietary; Sodium, dietary; mHealth, weight loss

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