Diabetes Prevention and Care Capacity at Urban Indian Health Organizations.
Diabetes Prevention and Care Capacity at Urban Indian Health Organizations.
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DOI：
10.3389/fpubh.2021.740946
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发表时间：
2021
影响因子：
5.2
通讯作者：
Manson SM
中科院分区：
文献类型：
--
作者：
Fort MP;Reid M;Russell J;Santos CJ;Running Bear U;Begay RL;Smith SL;Morrato EH;Manson SM
美国印第安人和阿拉斯加原住民(AI/AN)遭受着不成比例的糖尿病和心血管疾病的负担。印度城市卫生组织(UIHO)是为城市AI/AN人群提供糖尿病服务的重要来源。两种循证干预措施--糖尿病预防(DP)和心脏健康(HH)--已在农村保留地实施和评估。这项工作考察了UIHO在实施糖尿病计划方面的能力、挑战和优势。方法：我们应用原始调查，辅以公开的数据，评估UIHO在糖尿病预防和护理方面的八个组织能力域、优势和挑战。我们总结和比较了DP和HH实施者与非实施者在每个组织能力领域的项目(Fisher‘s和Kruskal-Wallis精确测试)，并对优势和挑战进行了专题分析。结果：在2017年提供服务的33个UIHO中，来自30个站点的个人(占UIHO的91%)回复了调查。8名UIHO(27%)参加过DP(n=6)或HH(n=2)。实施者报告的工作人员比非实施者多(117.0比53.5；p=0.02)。实施者的预算更大，约占总收入的1000万美元，而非实施者为250万美元(p=0.01)。UIHO的优势包括：有形基础设施、敬业的领导和工作人员以及社区关系。需要加强的领域包括：工作人员培训和留用，确保充足和一致的资金，以及数据基础设施。结论：加强跨组织能力领域的UIHO对于实施循证糖尿病干预措施、增加其接受度以及对生活在美国城市地区的AI/AN人群持续这些干预措施将是重要的。
American Indian and Alaska Native (AI/AN) people suffer a disproportionate burden of diabetes and cardiovascular disease. Urban Indian Health Organizations (UIHOs) are an important source of diabetes services for urban AI/AN people. Two evidence-based interventions—diabetes prevention (DP) and healthy heart (HH)–have been implemented and evaluated primarily in rural, reservation settings. This work examines the capacity, challenges and strengths of UIHOs in implementing diabetes programs. Methods: We applied an original survey, supplemented with publicly-available data, to assess eight organizational capacity domains, strengths and challenges of UIHOs with respect to diabetes prevention and care. We summarized and compared (Fisher's and Kruskal-Wallis exact tests) items in each organizational capacity domain for DP and HH implementers vs. non-implementers and conducted a thematic analysis of strengths and challenges. Results: Of the 33 UIHOs providing services in 2017, individuals from 30 sites (91% of UIHOs) replied to the survey. Eight UIHOs (27%) had participated in either DP (n = 6) or HH (n = 2). Implementers reported having more staff than non-implementers (117.0 vs. 53.5; p = 0.02). Implementers had larger budgets, ~$10 million of total revenue compared to $2.5 million for non-implementers (p = 0.01). UIHO strengths included: physical infrastructure, dedicated leadership and staff, and community relationships. Areas to strengthen included: staff training and retention, ensuring sufficient and consistent funding, and data infrastructure. Conclusions: Strengthening UIHOs across organizational capacity domains will be important for implementing evidence-based diabetes interventions, increasing their uptake, and sustaining these interventions for AI/AN people living in urban areas of the U.S.
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影响因子：
3.4
作者：
Moore, Susan L.;Fischer, Ilana;Havranek, Edward P.
通讯作者：
Havranek, Edward P.
影响因子：
3.4
作者：
Bonomi, AE;Wagner, EH;VonKorff, M
通讯作者：
VonKorff, M
DOI：
10.1186/s13012-016-0506-3
发表时间：
2016-10-19
期刊：
Implementation science : IS
影响因子：
--
作者：
May CR;Johnson M;Finch T
通讯作者：
Finch T
影响因子：
16.2
作者：
Jiang L;Manson SM;Beals J;Henderson WG;Huang H;Acton KJ;Roubideaux Y;Special Diabetes Program for Indians Diabetes Prevention Demonstration Project
通讯作者：
Special Diabetes Program for Indians Diabetes Prevention Demonstration Project
影响因子：
7.2
作者：
Stirman, Shannon Wiltsey;Baumann, Ana A.;Miller, Christopher J.
通讯作者：
Miller, Christopher J.