Mentored implementation to initiate a diabetes program in an underserved community: a pilot study
| العنوان: | Mentored implementation to initiate a diabetes program in an underserved community: a pilot study |
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| المؤلفون: | Amber B. Amspoker, Salim S. Virani, Ashok Balasubramanyam, Craig A. Johnston, Joshua D Landrum, Aanand D. Naik, John P. Foreyt, Elizabeth M Vaughan, Christie M. Ballantyne |
| المصدر: | BMJ Open Diabetes Research & Care, Vol 9, Iss 1 (2021) BMJ Open Diabetes Research & Care |
| بيانات النشر: | BMJ Publishing Group, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Research design, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, Blood Pressure, Pilot Projects, Type 2 diabetes, Telehealth, community medicine, Diseases of the endocrine glands. Clinical endocrinology, Mentorship, Medicine, Humans, Glycated Hemoglobin, business.industry, Mentors, Health services research, medicine.disease, RC648-665, health services research, Diabetes Mellitus, Type 2, Cohort, medication adherence, Physical therapy, Observational study, Clinical care/Education/Nutrition, telemedicine, business, Body mass index |
| الوصف: | IntroductionCommunity clinics often face pragmatic barriers, hindering program initiation and replication of controlled research trial results. Mentoring is a potential strategy to overcome these barriers. We piloted an in-person and telehealth mentoring strategy to implement the Telehealth-supported, Integrated Community Health Workers (CHWs), Medication-access, group visit Education (TIME) program in a community clinic.Research design and methodsParticipants (n=55) were low-income Latino(a)s with type 2 diabetes. The study occurred in two, 6-month phases. Phase I provided proof-of-concept and an observational experience for the clinic team; participants (n=37) were randomized to the intervention (TIME) or control (usual care), and the research team conducted TIME while the clinic team observed. Phase II provided mentorship to implement TIME, and the research team mentored the clinic team as they conducted TIME for a new single-arm cohort of participants (n=18) with no previous exposure to the program. Analyses included baseline to 6-month comparisons of diabetes outcomes (primary outcome: hemoglobin A1c (HbA1c)): phase I intervention versus control, phase II (within group), and research-run (phase I intervention) versus clinic-run (phase II) arms. We also evaluated baseline to 6-month CHW knowledge changes.ResultsPhase I: compared with the control, intervention participants had superior baseline to 6-month improvements for HbA1c (mean change: intervention: −0.73% vs control: 0.08%, p=0.016), weight (p=0.044), target HbA1c (p=0.035), hypoglycemia (p=0.021), medication non-adherence (p=0.0003), and five of six American Diabetes Association (ADA) measures (pConclusionsA novel, mentored approach to implement TIME into a community clinic resulted in improved diabetes outcomes. Larger studies of longer duration are needed to fully evaluate the potential of mentoring community clinics. |
| اللغة: | English |
| تدمد: | 2052-4897 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::91e2ec26ab1d5af1e3c6d8c42243b039Test https://drc.bmj.com/content/9/1/e002320.fullTest |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....91e2ec26ab1d5af1e3c6d8c42243b039 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 20524897 |
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