Evidence-Based Interventions for High Blood Pressure and Glycemic Control Among Illinois Health Systems.

INTRODUCTION: Evidence-based interventions (referral, team-based care, self-management, and self-monitoring) for chronic disease management are well documented and widely used by Federally Qualified Health Centers (FQHCs). However, how these interventions are implemented varies substantially. METHODS: The Illinois Health Information Systems Survey was deployed to 49 FQHCs. Responses were grouped into 4 distinct policies, systems, and processes (P/S/P) categories: internal policies/workflows, huddles (brief meetings), electronic health record alerts/tracking tools, and case manager/coordinator interaction. Responses were then direct-matched to the 2016 Health Resources and Services and Administration Uniform Data System clinical quality indicator (QI) percent scores. Descriptive statistics were generated and level of significance (P < .05) was tested for hypertension and type 2 diabetes mellitus. RESULTS: The total number of P/S/Ps in place for hypertension ranged from 0 to 13 (mean, 6.9) and 0 to 8 for diabetes (mean, 5.1). Meeting or exceeding the national mean QI percent score for controlled blood pressure (62.4%) was significant among FQHCs with 9 or more P/S/Ps compared with those with 8 or fewer P/S/Ps. A positive association in clinical QI percent score was found among organizations that had 3 or more P/S/Ps (for all 4 intervention areas), although none were significant. CONCLUSION: An assessment of the types of P/S/Ps used to implement evidence-based interventions for hypertension and diabetes management is a first in Illinois. Initial results support some relationship between the number of P/S/Ps implemented and clinical QI percent score for both hypertension and diabetes.

Prevalence of Frequent Mental Distress Among Illinois Adults With Chronic Conditions: Estimates From the Behavioral Risk Factor Surveillance System, 2011 to 2017.

PURPOSE: The objective of this study was to examine frequent mental distress (FMD) by demographics, chronic conditions, and health risk factors among Illinois adults. DESIGN: Descriptive analyses included χ2 and pairwise t tests to examine how FMD status differed by selected characteristics and Cox proportional hazards regression analysis to examine the association between FMD and chronic conditions and risk factors. SETTING: Illinois Behavioral Risk Factor Surveillance System, 2011 to 2017 (n = 37 312). PARTICIPANTS: Adults who self-report FMD (n = 3455) were included. MEASURES: Prevalence of high blood pressure, coronary heart disease, chronic obstructive pulmonary disease, arthritis, asthma, high blood cholesterol, cancer, kidney disease, stroke, diabetes, weight status, physical activity status, smoking status, and drinking status. RESULTS: A significantly higher FMD prevalence was found among females (11.7%; 95% confidence interval [CI]: 11.1-12.4), non-Hispanic blacks (13.4, 95% CI: 11.9-15.0), adults with less than a high school degree (14.4%; 95% CI: 12.6-16.3), adults with an annual income of less than $15 000 (21.4%; 95% CI: 19.4-23.5), and adults with a disability (23.3%, 95% CI: 21.9-24.7). Adjusted prevalence of FMD was significantly higher among adults for 8 of 10 chronic conditions and 4 of 5 health risk factors studied. CONCLUSIONS: Social stigmas related to depression and anxiety may lead to the underreporting of FMD. Chronic disease management programs in Illinois should consider integrating mental health services.