Adapting and assessing the feasibility of a diabetes self-management education and support telehealth intervention for rural populations to reduce disparities in diabetes care

调整和评估糖尿病自我管理教育的可行性，并支持对农村人口的远程医疗干预，以减少糖尿病护理方面的差异

• 批准号: 10213960
• 负责人: MICHELLE L LITCHMAN
• 金额: $ 19.96万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-10 至 2022-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10213960
• 关键词: Address; Adoption; Behavior; Behavioral; Caring; Cause of Death; Chronic; Clinic; Clinical; Colorado; Communities; Complex; Data; Diabetes Mellitus; Diagnosis; Diet; Dimensions; Disease; Education; Educational Intervention; Effectiveness; Ensure; Environment; Evaluation; Evaluation Research; Exercise; Family; Feedback; Friends; Goals; Health Personnel; Health Services Accessibility; Home environment; Hour; Individual; Intervention; Interview; Knowledge; Language; Location; Maintenance; Medical; Methods; Modeling; Outcome; Participant; Patient Care; Patient Participation; Patient-Focused Outcomes; Patients; Pharmaceutical Preparations; Practice based research; Prevalence; Primary Health Care; Process; Program Effectiveness; Progressive Disease; Provider; Regimen; Research; Research Methodology; Research Personnel; Resources; Rural; Rural Community; Rural Health; Rural Population; Self Management; Site; Surveys; Testing; Time; Translating; Translations; Travel; Universities; Utah; Videoconferencing; Visit; Work; behavior change; clinical practice; community based participatory research; cost; diabetes distress; diabetes management; diabetes self-management; disparity reduction; evidence base; experience; follow-up; glucose monitor; health disparity; improved; innovation; intervention program; medical specialties; member; multidisciplinary; peer support; personalized care; programs; psychosocial; rural area; rural disparities; standard of care; telehealth; tool; treatment as usual

Project Summary Diabetes prevalence is higher in rural areas that have lower resources to diabetes self-management education and support (DSMES), a cornerstone to optimal diabetes management. A time efficient DSMES program delivered via telehealth by multidisciplinary experts that also encourages care partner and peer support is a creative solution to increasing access to DSMES and reducing disparities. This study is guided by the Research, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Specifically, participants and care partners will receive a one-time, 8-hour telehealth intervention at the rural clinic where they receive their usual care, from the multidisciplinary team. The rural clinical practices will provide feedback in three rounds, with iterative practice-level changes, to address process and/or workflow issues. Our overall objective is to adapt, implement, refine, and evaluate a time efficient DSMES program delivered via telehealth by a team of multidisciplinary experts that encourages care partner and peer support to improve A1C and diabetes self-management in rural communities to reduce disparities. Our multidisciplinary team includes researchers and clinical healthcare providers with experience in diabetes care, DSMES delivery, community- engaged research, practice-based research, and rural health issues. The University of Utah and High Plains Research Network provide a strong environment for this particular study. The proposed study will 1) adapt the exiting Diabetes One-Day Program (D1D) for use in rural communities (Rural Diabetes One-Day Program or R-D1D), 2) implement, refine, and evaluation R-D1D at the participant and practice level, and 3) conduct an exploratory evaluation of the RE-AIM dimensions of effectiveness (patient outcomes) and maintenance (practice outcomes). Our ultimate goal is to reduce health disparities in rural populations by increasing access to diabetes specialty care using telehealth. Preliminary data support the D1D intervention, but will require adaptation to translate for rural populations, then iterative refinement at the practice level to support long-term maintenance. Such a tested, accepted intervention should have a beneficial effect on diabetes self- management across multiple rural locations.

项目总结