Impact of a community-based approach to patient engagement in rural, low-income adults with type 2 diabetes

被引:19
|
作者
Glenn, Lynn E. [1 ]
Nichols, Michelle [2 ]
Enriquez, Maithe [1 ]
Jenkins, Carolyn [2 ]
机构
[1] Univ Missouri, Sinclair Sch Nursing, Columbia, MO USA
[2] Med Univ South Carolina, Coll Nursing, South Carolina Clin & Translat Res Inst, Charleston, SC 29425 USA
基金
美国国家卫生研究院;
关键词
community health worker; diabetes mellitus type 2; health promotion; patient activation; patient activation measure; patient engagement; poverty; rural population; self-management; SELF-MANAGEMENT PROGRAM; HEALTH WORKER INTERVENTION; IMPROVE GLYCEMIC CONTROL; ACTIVATION MEASURE PAM; EDUCATION-PROGRAMS; MEXICAN-AMERICANS; RANDOMIZED-TRIAL; CARE UTILIZATION; UNITED-STATES; OUTCOMES;
D O I
10.1111/phn.12693
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Objective This secondary analysis examined the relationships between Patient Activation Measure (PAM) scores, use of health services, and HgA1C. Design A feasibility study was conducted for a community-based intervention for high-risk adults with uncontrolled diabetes. Data were collected at baseline and monthly, including PAM and modified Diabetes Self-Management Assessment Report Tool. Intervention Participants (n = 58) were randomized to a 3-month nurse (RN) telephone management or community health worker (CHW) in-home intervention, focusing on medication adherence, timely follow-up, diabetes self-management coaching, and linkage to resources. Results Sample was mostly female (73%), African-American (90%), low income (75%), high school education or less (80%), and mean age of 59 years. A positive association between PAM score and self-reported diabetes care recommendations was found (r = .356, p = .014) and significant correlation between baseline PAM score and HgA1C levels (r = -.306, p = .029). A paired samples t test showed statistically significant increases in PAM scores in the CHW intervention group (mean increase +8.5, CI [+2.49 to +14.65]); baseline (M = 60.31, SD = 13.3) to end of study ([M = 68.89, SD = 16.39], t(22) = 2.924, p = .008 [two-tailed]). Conclusion A community-based approach to diabetes management demonstrated a positive effect on patient activation. Although disparities in health care access among rural, low-income populations exist, community-based interventions show potential for improving patient engagement in diabetes management and recommended health services.
引用
收藏
页码:178 / 187
页数:10
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