Tele-education model for primary care providers to advance diabetes equity: Findings from Project ECHO Diabetes.
Tele-education model for primary care providers to advance diabetes equity: Findings from Project ECHO Diabetes.
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DOI：
10.3389/fendo.2022.1066521
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发表时间：
2022
影响因子：
5.2
通讯作者：
Walker, Ashby F.
中科院分区：
文献类型：
--
作者：
Addala, Ananta;Filipp, Stephanie L.;Figg, Lauren E.;Anez-Zabala, Claudia;Lal, Rayhan A.;Gurka, Matthew J.;Haller, Michael J.;Maahs, David M.;Walker, Ashby F.
在美国，许多糖尿病患者无法持续接触内分泌学家，因此依赖初级保健提供者（PCP）进行糖尿病管理。ECHO项目（社区保健成果扩展）糖尿病是一种远程教育模式，旨在使PCP能够独立管理糖尿病，包括糖尿病技术启动和使用教育，以弥合糖尿病方面的差异。参与ECHO糖尿病项目并完成干预前和干预后调查的PCP（n=116）纳入本分析。在加州和佛罗里达，通过REDCap和纸质调查对参与的PCP进行调查。本调查旨在评估实践人口统计学、成人和儿童T1D管理方案、挑战、资源以及提供者对糖尿病管理的知识和信心。通过McNemar检验评估干预前后反应的差异和统计学意义。PCP报告在糖尿病教育和管理的所有领域都有所改善。与基线相比，PCP报告称，他们作为T1D提供者为社区服务的信心有所提高（治疗前vs治疗后：43.8% vs 68.8%，p=0.005），管理胰岛素治疗（前vs后：62.8% vs 84.3%，p=0.002），并确定干预后糖尿病窘迫症状（前vs后：62.8% vs 84.3%，p=0.002）。与干预前相比，供应商报告说，他们对糖尿病技术（包括处方技术）的各个方面的信心都有显着提高（41.2% vs 68.6%，p=0.001），管理胰岛素泵（41.2% vs 68.6%，p=0.001）和混合闭环（10.2% vs 26.5%，p=0.033），并在干预后解释探头数据（41.2% vs 68.6%，p=0.001）。参加ECHO糖尿病项目的PCP报告说，他们对糖尿病管理的信心增加，他们开药、管理和解决糖尿病技术问题的能力显著提高。这些数据支持使用远程教育的PCP，以提高糖尿病技术管理的信心，作为一个可行的战略，以促进公平的糖尿病管理和成果。
In the US, many individuals with diabetes do not have consistent access to endocrinologists and therefore rely on primary care providers (PCPs) for their diabetes management. Project ECHO (Extension for Community Healthcare Outcomes) Diabetes, a tele-education model, was developed to empower PCPs to independently manage diabetes, including education on diabetes technology initiation and use, to bridge disparities in diabetes. PCPs (n=116) who participated in Project ECHO Diabetes and completed pre- and post-intervention surveys were included in this analysis. The survey was administered in California and Florida to participating PCPs via REDCap and paper surveys. This survey aimed to evaluate practice demographics, protocols with adult and pediatric T1D management, challenges, resources, and provider knowledge and confidence in diabetes management. Differences and statistical significance in pre- and post-intervention responses were evaluated via McNemar’s tests. PCPs reported improvement in all domains of diabetes education and management. From baseline, PCPs reported improvement in their confidence to serve as the T1D provider for their community (pre vs post: 43.8% vs 68.8%, p=0.005), manage insulin therapy (pre vs post: 62.8% vs 84.3%, p=0.002), and identify symptoms of diabetes distress (pre vs post: 62.8% vs 84.3%, p=0.002) post-intervention. Compared to pre-intervention, providers reported significant improvement in their confidence in all aspects of diabetes technology including prescribing technology (41.2% vs 68.6%, p=0.001), managing insulin pumps (41.2% vs 68.6%, p=0.001) and hybrid closed loop (10.2% vs 26.5%, p=0.033), and interpreting sensor data (41.2% vs 68.6%, p=0.001) post-intervention. PCPs who participated in Project ECHO Diabetes reported increased confidence in diabetes management, with notable improvement in their ability to prescribe, manage, and troubleshoot diabetes technology. These data support the use of tele-education of PCPs to increase confidence in diabetes technology management as a feasible strategy to advance equity in diabetes management and outcomes.
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影响因子：
16.2
作者：
通讯作者：
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影响因子：
3.4
作者：
Addala A;Maahs DM;Scheinker D;Chertow S;Leverenz B;Prahalad P
通讯作者：
Prahalad P
DOI：
10.2337/cd19-0060
发表时间：
2020-04-01
期刊：
Clinical diabetes : a publication of the American Diabetes Association
影响因子：
--
作者：
Lal, Rayhan A;Cuttriss, Nicolas;Walker, Ashby F
通讯作者：
Walker, Ashby F
影响因子：
16.2
作者：
通讯作者：
--
影响因子：
7.4
作者：
Arora, Sanjeev;Geppert, Cynthia M. A.;Scaletti, Joseph V.
通讯作者：
Scaletti, Joseph V.