A community health worker led diabetes self-management education program: Reducing patient and system burden.
J Diabetes Complications
; 38(8): 108794, 2024 Aug.
Article
en En
| MEDLINE
| ID: mdl-38878424
ABSTRACT
AIMS:
Conduct a secondary analysis of the TIME (Telehealth-supported, Integrated Community Health Workers (CHWs), Medication access, diabetes Education) made simple trial (SIMPLE) to evaluate healthcare utilization and explore variables that may have influenced HbA1c.METHODS:
Participants (N = 134 [67/group]) were low-income, uninsured Hispanics with or at risk for type 2 diabetes mellitus. We included in-person and telehealth clinician visits, other visits, missed visits, orders placed, and guideline-adherence (e.g., vaccinations, quarterly HbA1c for uncontrolled diabetes). Using multivariable models, we explored for associations between HbA1c changes and these measures.RESULTS:
The control arm had higher missed visits rates (intervention 45 %; control 56 %; p = 0.007) and missed telehealth appointments (intervention 10 %; control 27.4 %; p = 0.04). The intervention group received more COVID vaccinations than the control (p = 0.005). Other health measures were non-significant between groups. Intervention individuals' HbA1c improved with more missed visits (-0.60 %; p < 0.01) and worsened with improved guideline-adherent HbA1c measurements (HbA1c 1.2 %; p = 0.057). The control group had non-significant HbA1c associations.CONCLUSIONS:
Findings suggest that the SIMPLE trial's improved HbA1c levels stemmed from a CHW-driven intervention and not additional healthcare contact. Exploratory outcomes resulted in seemingly counterintuitive HbA1c associations with missed visits and guideline-adherent measurements; these may suggest that an intervention that enhances communication provides support to reduce the amount of follow-up needed by participants without sacrificing clinical improvements.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Hemoglobina Glucada
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Educación del Paciente como Asunto
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Telemedicina
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Agentes Comunitarios de Salud
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Diabetes Mellitus Tipo 2
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Automanejo
Límite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Diabetes Complications
Asunto de la revista:
ENDOCRINOLOGIA
Año:
2024
Tipo del documento:
Article
País de afiliación:
Estados Unidos