Addressing Social Determinants of Health & Diabetes Self-Management in Vulnerable Populations
Addressing Social Determinants of Health & Diabetes Self-Management in Vulnerable Populations
批准号:
9789264
负责人:
Stephanie Lenay Fitzpatrick
金额:
$23.7万
依托单位国家:
美国
项目类别:
财政年份:
2018
资助国家:
美国
项目状态:
已结题
起止时间:
2018-09-20 至 2021-08-31
关键词:
AddressAfrican AmericanBlood Glucose Self-MonitoringCardiovascular systemCaringCommunicationCommunitiesCommunity HealthCommunity Health AidesCommunity NetworksComplications of Diabetes MellitusDataDiabetes MellitusDiseaseEconomicsEmergency department visitEthnic OriginFeasibility StudiesFutureHealthHealth systemHealthcare SystemsHispanicsHousingHuman ResourcesIndividualInterventionInterviewKnowledgeLeadershipLengthLinkLiteratureLow incomeMeasuresMedicaidMedicalMeta-AnalysisMethodologyMinority AccessModelingOrganizational ChangeOutcomeParticipantPatient Self-ReportPatientsPharmaceutical PreparationsPharmacy facilityPilot ProjectsPrimary Health CareProcessProcess MeasureProgram SustainabilityProviderQuestionnairesRaceRandomizedResearchResearch DesignResearch PersonnelResourcesSelf ManagementSocial WorkSocioeconomic StatusStructureTestingTimeTrainingTransportationUse EffectivenessVisitVulnerable Populationsarmbasecomparative effectivenesscompare effectivenesscomparison groupdesigndiabetes managementdiabetes riskeconomic needeffective interventioneffectiveness trialethnic minority populationevidence basefeasibility trialfollow-upfood insecurityhealth care servicehealth care service utilizationhealth care settingshigh riskimprovedmedication compliancepatient populationprogramsracial and ethnicrandomized trialrecruitretention ratesocialsocial health determinantssuccesstrial designtwo-arm study
中文摘要
项目摘要/摘要:少数民族和低收入人群的比例在上升
英文摘要
PROJECT SUMMARY/ABSTRACT: Racial/ethnic minorities and low-income individuals are at increased
risk for diabetes complications and adverse cardiovascular outcomes. The disparities in diabetes
management have been linked to social determinants of health (e.g., food insecurity, inadequate housing,
and trouble paying for medical needs). Previous diabetes management studies with racial/ethnic minorities
and low-income individuals have generally demonstrated a reduction in A1C when utilizing lay health
workers, such as patient navigators and community health workers (CHWs), to address social and economic
needs and/or deliver diabetes self-management training. However, methodological limitations, such as lack
of randomization or a comparison group and use of lay health workers in different capacities across studies,
make it difficult to determine the most effective approach for integrating these personnel in health care
settings to help with patient diabetes management.
The purpose of this feasibility study is to inform the design of a future large-scale, randomized trial that will
test if there is added benefit to addressing both social and economic needs and diabetes self-management
to improve diabetes management long-term among vulnerable populations. In this pilot, we will randomize
100 African American, Hispanic, and/or Medicaid (all race/ethnicities) patients from Kaiser Permanente
Northwest (KPNW) with A1C ≥ 8 and poor follow-up in primary care to one of two 6-month interventions: 1)
patient navigation only; or 2) patient navigation + diabetes self-management training. In both study arms,
KPNW practice-embedded patient navigators will screen for medical, social and economic needs and
connect participants to internal and external resources. In the second study arm, navigators will also refer
participants to CHWs embedded in local community-based organizations, who will deliver diabetes self-
management training. Feasibility of the full-scale trial will be based on several measures including
recruitment, retention, success rate of referrals to navigators and CHWs, and whether medical, social, and/or
economic needs are met. Qualitative interviews will be conducted with various stakeholders to assess
intervention acceptability and determinants of implementation. Preliminary effects on A1C, diabetes-related
care gaps, health care utilization, and medication adherence will also be examined. This pragmatic study
design involves a collaborative effort among researchers, health system staff, health system senior
leadership, and local community-based organizations. Findings from the full-scale trial will contribute critical
knowledge on the most effective, sustainable model of care for integrating lay health workers in the efforts to
improve diabetes management among high risk patient populations.
期刊论文(0)
专著(0)
科研奖励(0)
会议论文
Maternal OutcoMes (MOMs) Program: Testing Integrated Maternal Care Model Approaches to Reduce Disparities in Severe Maternal Morbidity
-
批准号:10835372
-
项目类别:
-
资助金额:$83.79万
-
财政年份:2023
-
负责人:Stephanie Lenay Fitzpatrick
-
依托单位:
Evaluating the implementation of the diabetes prevention program in an integrated health system
-
批准号:9408277
-
项目类别:
-
资助金额:$52.0万
-
财政年份:2017
-
负责人:Stephanie Lenay Fitzpatrick
-
依托单位:
Evaluating the implementation of the diabetes prevention program in an integrated health system
-
批准号:9980394
-
项目类别:
-
资助金额:$45.58万
-
财政年份:2017
-
负责人:Stephanie Lenay Fitzpatrick
-
依托单位:
Behavioral Responders & Non-Responders to Behavioral Treatment for Obesity
-
批准号:8807201
-
项目类别:
-
资助金额:$15.5万
-
财政年份:2015
-
负责人:Stephanie Lenay Fitzpatrick
-
依托单位:
海外基金