Point-of-Care Hemoglobin A1C Testing System in Community Settings: Challenges, Opportunities, and Measurement Characteristics

Background: Point-of-care (POC) hemoglobin A1c (A1C) testing provides clinicians and diabetic patients real-time information on glycemic control. POC testing in community settings may expand reach, but feasibility is underexplored. We sought to describe challenges, opportunities, and quality control results of POC testing conducted in community food pantries. Methods: Food bank staff who were directly involved in POC testing provided feedback in telephone interviews, weekly team calls, and quarterly open-ended surveys. We evaluated device performance using test-retest comparisons (n = 58) and comparisons between POC results and laboratory results from medical records (n = 72). Lessons Learned: Study staff performed 1,771 POC A1c tests. Barriers were administrative, regulatory, and operational. Opportunities included ease of training and high participant satisfaction. There was high test-retest correlation (r = 0.97) and high correlation between POC results and laboratory results from medical records (r = 0.85). Conclusions: Community POC testing programs are feasible and relatively accurate, but implementation requires resources and capacity building.