ENDO ECHO IMPROVES PRIMARY CARE PROVIDER AND COMMUNITY HEALTH WORKER SELF-EFFICACY IN COMPLEX DIABETES MANAGEMENT IN MEDICALLY UNDERSERVED COMMUNITIES

被引:49
作者
Bouchonville, Matthew F. [1 ]
Hager, Brant W. [2 ]
Kirk, Jessica B. [3 ]
Qualls, Clifford R. [4 ]
Arora, Sanjeev [5 ]
机构
[1] Univ New Mexico, Sch Med, Div Endocrinol Diabet & Metab, Albuquerque, NM 87131 USA
[2] Univ New Mexico, Sch Med, Dept Psychiat & Behav Sci, Albuquerque, NM 87131 USA
[3] Univ New Mexico, Hlth Sci Ctr, ECHO Inst, Albuquerque, NM 87131 USA
[4] Univ New Mexico, Hlth Sci Ctr, Clin & Translat Sci Ctr, Albuquerque, NM 87131 USA
[5] Univ New Mexico, Sch Med, Div Gastroenterol, Albuquerque, NM 87131 USA
关键词
FOLLOW-UP; DEPRESSION; OUTCOMES; QUALITY; COMPLICATIONS; EPIDEMIOLOGY; ASSOCIATION; DEATH;
D O I
10.4158/EP-2017-0079
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: To determine whether participation in a multidisciplinary telementorship model of healthcare delivery improves primary care provider (PCP) and community health worker (CHW) confidence in managing patients with complex diabetes in medically underserved regions. Methods: We applied a well-established healthcare delivery model, Project ECHO (Extension for Community Healthcare Outcomes), to the management of complex diabetes (Endo ECHO) in medically underserved communities. A multidisciplinary team at Project ECHO connected with PCPs and CHWs at 10 health centers across New Mexico for weekly videoconferencing virtual clinics. Participating PCPs and CHWs presented de-identified patients and received best practice guidance and mentorship from Project ECHO specialists and network peers. A robust curriculum was developed around clinical practice guidelines and presented by weekly didactics over the ECHO network. After 2 years of participation in Endo ECHO, PCPs and CHWs completed self-efficacy surveys comparing confidence in complex diabetes management to baseline. Results: PCPs and CHWs in rural New Mexico reported significant improvement in self-efficacy in all measures of complex diabetes management, including PCP ability to serve as a local resource for other healthcare providers seeking assistance in diabetes care. Overall self-efficacy improved by 130% in CHWs (P<.0001) and by 60% in PCPs (P<.0001), with an overall large Cohen's effect size. Conclusion: Among PCPs and CHWS in rural, medically underserved communities, participation in Endo ECHO for 2 years significantly improved confidence in complex diabetes management. Application of the ECHO model to complex diabetes care may be useful in resource-poor communities with limited access to diabetes specialist services.
引用
收藏
页码:40 / 46
页数:7
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