Community to Clinic Navigation to Improve Diabetes Outcomes
社区到诊所导航以改善糖尿病治疗结果
基本信息
- 批准号:10224172
- 负责人:
- 金额:$ 55.04万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2017
- 资助国家:美国
- 起止时间:2017-08-01 至 2024-07-31
- 项目状态:已结题
- 来源:
- 关键词:AddressAffectAmericanAppalachian RegionBiometryBlood PressureBody mass indexChurchClinicClinicalCommunitiesCommunity Health AidesComplications of Diabetes MellitusDataDiabetes MellitusDiagnosisDissemination and ImplementationEducationEnvironmentEpidemicEvidence based interventionFocus GroupsFutureGlycosylated hemoglobin AGoalsHealthHealth care facilityHealthcareIndividualInfluentialsInterventionInterviewKentuckyLipidsLow incomeMediator of activation proteinNon-Insulin-Dependent Diabetes MellitusOutcomeParticipantPatientsPersonsPilot ProjectsPopulationPositioning AttributePrediabetes syndromeProtocols documentationRandomizedRandomized Controlled TrialsRecruitment ActivityResearchResearch ActivityRuralRural PopulationSelf ManagementSocial supportTalentsTestingTrainingVulnerable PopulationsWorkadverse outcomearmbasebehavioral outcomeclinical carecommunity centercommunity settingcost effectivenessdesigndiabetes controldiabetes self-managementevidence baseglycemic controlhealth care qualityhealth care service organizationhealth disparityhealth disparity populationshealth inequalitieshealth professional shortage areasimprovedimproved outcomeinnovationlow socioeconomic statusmeetingsmemberoutreachprimary outcomeprogramsrandomized trialrecruitrelative costrural dwellerssatisfactionself-management programsocialtheoriesunderserved communitywaist circumference
项目摘要
ABSTRACT
Reducing adverse outcomes from Type 2 Diabetes Mellitus (T2DM) requires optimal self-management and
appropriate clinical care.1 Combining an evidence-based intervention to improve diabetes self-management
with individually-tailored patient navigation to improve appropriate clinical care holds great promise. Only one
known randomized controlled trial has been tested that combines these two most essential components of
diabetes control. That trial resulted in improvements to glycemic control, blood pressure, and diabetes self-
management, but was implemented in a clinical setting.2 We aim to enhance this work by recruiting from and
locating most research activities in community-based settings to insure involvement of the most vulnerable,
hardest to reach populations who may not be receiving regular health care and by leveraging Community
Health Workers and Patient Navigators, who are essential and sustainable outreach workers in health care
professional shortage areas.
We propose testing a refined intervention, “Community to Clinic Navigation” (CCN), shown to be promising,
feasible, and acceptable in our pilot study. Given that Appalachian and rural residents maintain
disproportionately high rates of T2DM and suffer tremendous burdens from diabetic complications,3 this setting
provides a perfect opportunity to test the intervention with a hard to reach population while addressing health
inequities. We will administer a 3 arm group randomized design including (1) Diabetes Self-management
Program, DSMP only; (2) tailored Patient Navigation, PN only; and (3) the combined DSMP + PN: Community
to Clinic Navigation program, CCN. Outcomes include biometrics (HbA1c, BMI, blood pressure, lipids, waist
circumference); diabetes self-management and clinic attendance, as mediators of the primary outcomes; cost
effectiveness and participant satisfaction. Persons with diabetes will be recruited through churches and other
community venues. Our project leverages sustainable assets available in most health disparity communities--
faith organizations, community centers, federally qualified health clinics, strong social ties, and talented local
lay people who can be trained to educate and navigate those diagnosed with T2DM. Our sustained
involvement in Appalachian Kentucky positions our team to appropriately and efficiently test this promising
program with strong potential for future dissemination to other traditionally underserved environments.
摘要
减少2型糖尿病(T2 DM)的不良结局需要最佳的自我管理,
适当的临床护理。1结合循证干预措施,改善糖尿病自我管理
通过个性化定制的患者导航来改善适当的临床护理具有很大的前景。只有一
已经测试了已知的随机对照试验,其结合了这两个最基本的组分,
糖尿病控制该试验改善了血糖控制、血压和糖尿病自我控制,
管理,但在临床环境中实施。2我们的目标是加强这项工作,
将大多数研究活动安排在以社区为基础的环境中,以确保最弱势群体的参与,
最难接触到可能无法接受常规医疗保健的人群,
卫生工作者和患者导航员,他们是卫生保健中必不可少的可持续外展工作者
专业人才短缺。
我们建议测试一种改进的干预措施,“社区到诊所导航”(CCN),显示出有希望,
在我们的试点研究中是可行的和可接受的。考虑到阿巴拉契亚和农村居民
不成比例的高T2 DM发病率,并承受糖尿病并发症的巨大负担,3这种情况
提供了一个完美的机会,在解决健康问题的同时,
不平等。我们将进行3组随机设计,包括(1)糖尿病自我管理
程序,仅DSMP;(2)定制的患者导航,仅PN;和(3)组合的DSMP + PN:社区
到诊所导航计划CCN结果包括生物统计学(HbA 1c、BMI、血压、血脂、腰围)
周长);糖尿病自我管理和门诊就诊,作为主要结局的中介;成本
有效性和参与者满意度。糖尿病患者将通过教会和其他机构招募。
社区场馆。我们的项目利用了大多数健康差距社区的可持续资产--
信仰组织,社区中心,联邦合格的卫生诊所,强大的社会关系,和有才华的当地
非专业人员可以接受培训,以教育和指导那些诊断为T2 DM的人。我们持续
在阿巴拉契亚肯塔基州的参与,使我们的团队能够适当和有效地测试这一有前途的
该计划具有强大的潜力,未来传播到其他传统上服务不足的环境。
项目成果
期刊论文数量(1)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
The mediating/moderating role of cultural context factors on self-care practices among those living with diabetes in rural Appalachia.
- DOI:10.1186/s12889-021-11777-7
- 发表时间:2021-10-02
- 期刊:
- 影响因子:4.5
- 作者:Smalls BL;Adegboyega A;Combs E;Rutledge M;Westgate PM;Azam MT;De La Barra F;Williams LB;Schoenberg NE
- 通讯作者:Schoenberg NE
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Nancy E. Schoenberg其他文献
64: Correlates of intent to be vaccinated against HPV: An exploratory study of college aged women
- DOI:
10.1016/j.jadohealth.2006.11.118 - 发表时间:
2007-02-01 - 期刊:
- 影响因子:
- 作者:
Richard A. Crosby;Nancy E. Schoenberg;Claudia Hopenhayn - 通讯作者:
Claudia Hopenhayn
Nancy E. Schoenberg的其他文献
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{{ truncateString('Nancy E. Schoenberg', 18)}}的其他基金
Implementing an evidence-based mHealth diet and activity intervention: Make Better Choices 2 for rural Appalachians
实施循证移动健康饮食和活动干预:为阿巴拉契亚农村地区做出更好的选择 2
- 批准号:
10398946 - 财政年份:2020
- 资助金额:
$ 55.04万 - 项目类别:
Implementing an evidence-based mHealth diet and activity intervention: Make Better Choices 2 for rural Appalachians
实施循证移动健康饮食和活动干预:为阿巴拉契亚农村地区做出更好的选择 2
- 批准号:
10218271 - 财政年份:2020
- 资助金额:
$ 55.04万 - 项目类别:
Implementing an evidence-based mHealth diet and activity intervention: Make Better Choices 2 for rural Appalachians
实施循证移动健康饮食和活动干预:为阿巴拉契亚农村地区做出更好的选择 2
- 批准号:
10618205 - 财政年份:2020
- 资助金额:
$ 55.04万 - 项目类别:
Community to Clinic Navigation to Improve Diabetes Outcomes
社区到诊所导航以改善糖尿病治疗结果
- 批准号:
9383428 - 财政年份:2017
- 资助金额:
$ 55.04万 - 项目类别:
Community to Clinic Navigation to Improve Diabetes Outcomes
社区到诊所导航以改善糖尿病治疗结果
- 批准号:
9750672 - 财政年份:2017
- 资助金额:
$ 55.04万 - 项目类别:
Appalachians Together Restoring the Eating Environment (APPAL-TREE)
阿巴拉契亚人共同恢复饮食环境(APPAL-TREE)
- 批准号:
8500613 - 财政年份:2013
- 资助金额:
$ 55.04万 - 项目类别:
Appalachians Together Restoring the Eating Environment (APPAL-TREE)
阿巴拉契亚人共同恢复饮食环境(APPAL-TREE)
- 批准号:
8610946 - 财政年份:2013
- 资助金额:
$ 55.04万 - 项目类别:
Appalachians Together Restoring the Eating Environment (APPAL-TREE)
阿巴拉契亚人共同恢复饮食环境(APPAL-TREE)
- 批准号:
8845445 - 财政年份:2013
- 资助金额:
$ 55.04万 - 项目类别:
An Intergenerational CBPR Intervention to Reduce Appalachian Health Disparities
减少阿巴拉契亚健康差异的代际 CBPR 干预措施
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7462898 - 财政年份:2008
- 资助金额:
$ 55.04万 - 项目类别:
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