Diabetes control improved when inner-city patients received graphic feedback about glycosylated hemoglobin levels

Chapin, Rebecca B.; Williams, Derrick C.; Adair, Richard

doi:10.1046/j.1525-1497.2003.20367.x

Cited by 27 publications

(34 citation statements)

References 25 publications

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“…Some of the studies targeted more than one level; specifically, 12 (21,22,25,(27)(28)(29)(30)(32)(33)(34)(35)(36) of 17 studies targeted the intervention at the patient level, 1 intervention (24) targeted the provider level, and 7 interventions (20 -23,25,26,31) targeted the system level. Three (27,29,30) of 17 studies described or referenced previous work (37,38) related to a needs assessment that had guided the development or adaptation of the intervention to their specific socially disadvantaged population (27,29,30). This generally included conducting meetings with staff involved with the patient group, conducting a needs assessment using community focus groups with the target population, testing of educational materials to ensure cultural appropriateness, or adapting the educational materials to low health literacy standards.…”

Section: Methodological Qualitymentioning

confidence: 99%

“…Among the 17 studies, 7 (21,22,24,27,28,31,36) targeted l o w S E S p o p u l a t i o n s a n d 1 0 (20,23,25,26,29,30,(32)(33)(34)(35) focused on specific ethno-racial groups, including African Americans (23,25,26,30,32,33), Mexican Americans (29,34), and Native A m e r i c a n s ( 3 3 ) . T e n s t u d i e s (21,22,25,28,29,30,(32)(33)(34)36) were randomized controlled trials, two (26,27) were prospective controlled trials, and five (20,23,24,31,35) were comparative studies. Four studies (29,32,34,35) were community based, 10 (20,(22)…”

Section: Description Of Studiesmentioning

confidence: 99%

“…T e n s t u d i e s (21,22,25,28,29,30,(32)(33)(34)36) were randomized controlled trials, two (26,27) were prospective controlled trials, and five (20,23,24,31,35) were comparative studies. Four studies (29,32,34,35) were community based, 10 (20,(22)(23)(24)(25)(26)(27)(28)30,31) took place in primary care settings, and 3 (21,33,36) were hospital based.…”

Section: Description Of Studiesmentioning

confidence: 99%

“…Ten (21,22,24,(27)(28)(29)(30)33,34,36) of 17 studies described how specific aspects of the intervention were tailored to the socially disadvantaged population and described how the intervention was designed to meet the needs of the specific study population. Eight (21,22,24,29,30,33,34,36) of 17 studies considered literacy and language of the populations.…”

Section: Description Of Features Of the Interventionsmentioning

confidence: 99%

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A Systematic Review of Interventions to Improve Diabetes Care in Socially Disadvantaged Populations

Glazier

Bajcar²,

Kennie³

et al. 2006

Diabetes Care

340

333

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OBJECTIVE -To identify and synthesize evidence about the effectiveness of patient, provider, and health system interventions to improve diabetes care among socially disadvantaged populations.RESEARCH DESIGN AND METHODS -Studies that were included targeted interventions toward socially disadvantaged adults with type 1 or type 2 diabetes; were conducted in industrialized countries; were measured outcomes of self-management, provider management, or clinical outcomes; and were randomized controlled trials, controlled trials, or before-and-after studies with a contemporaneous control group. Seven databases were searched for articles published in any language between January 1986 and December 2004. Twenty-six intervention features were identified and analyzed in terms of their association with successful or unsuccessful interventions.RESULTS -Eleven of 17 studies that met inclusion criteria had positive results. Features that appeared to have the most consistent positive effects included cultural tailoring of the intervention, community educators or lay people leading the intervention, one-on-one interventions with individualized assessment and reassessment, incorporating treatment algorithms, focusing on behavior-related tasks, providing feedback, and high-intensity interventions (Ͼ10 contact times) delivered over a long duration (Ն6 months). Interventions that were consistently associated with the largest negative outcomes included those that used mainly didactic teaching or that focused only on diabetes knowledge.CONCLUSIONS -This systematic review provides evidence for the effectiveness of interventions to improve diabetes care among socially disadvantaged populations and identifies key intervention features that may predict success. These types of interventions would require additional resources for needs assessment, leader training, community and family outreach, and follow-up. Diabetes Care 29:1675-1688, 2006D iabetes affects at least 171 million people worldwide and is dramatically increasing in many countries as a consequence of increased obesity, sedentary lifestyle, and aging populations (1). Certain population subgroups are at higher risk of acquiring diabetes including nonwhite ethno-racial groups and those with low socioeconomic status (SES) (2). These same groups are often at higher risk of late diagnosis, poor diabetes control and self-management, the development of diabetes-associated complications, and more frequent emergency room visits and hospitalizations (3-8).Interventions to improve diabetes outcomes can be directed at individuals with diabetes, health providers, or the health system. Patient-level interventions include those directed at improved selfmanagement, including medication taking, diet, exercise, self-monitoring, and appropriate use of health care services (9). Continuing professional education and knowledge translation activities are examples of strategies intended to improve health provider care (10 -13). Health system changes with the potential to improve access to care and quality...

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Section: Methodological Qualitymentioning

confidence: 99%

Section: Description Of Studiesmentioning

confidence: 99%

Section: Description Of Studiesmentioning

confidence: 99%

Section: Description Of Features Of the Interventionsmentioning

confidence: 99%

See 2 more Smart Citations

A Systematic Review of Interventions to Improve Diabetes Care in Socially Disadvantaged Populations

Glazier

Bajcar²,

Kennie³

et al. 2006

Diabetes Care

340

333

View full text Add to dashboard Cite

show abstract

“…An estimated 50 -80% of adults with diabetes have significant diabetes-specific knowledge and skill deficits (7,26,44). Potentially effective strategies to complement verbal communication to patients on actual and target disease values include providing clear graphical representations of these values (21,22,45) and encouraging patients to record and track laboratory and other measurements in diabetes logbooks or "passports" (46 -48). Such strategies may be especially important to convey clinical information to patients with low health literacy and little formal education (49,50).…”

Section: Hba 1c and Diabetes Carementioning

confidence: 99%

The Relationship Between Knowledge of Recent HbA1c Values and Diabetes Care Understanding and Self-Management

et al. 2005

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OBJECTIVE -Knowledge of one's actual and target health outcomes (such as HbA 1c values) is hypothesized to be a prerequisite for effective patient involvement in managing chronic diseases such as diabetes. We examined 1) the frequency and correlates of knowing one's most recent HbA 1c test result and 2) whether knowing one's HbA 1c value is associated with a more accurate assessment of diabetes control and better diabetes self-care understanding, self-efficacy, and behaviors related to glycemic control. RESULTS -Of the respondents, 66% reported that they did not know their last HbA 1c value and only 25% accurately reported that value. In multivariate analyses, more years of formal education and high evaluations of provider thoroughness of communication were independently associated with HbA 1c knowledge. Respondents who knew their last HbA 1c value had higher odds of accurately assessing their diabetes control (adjusted odds ratio 1.59, 95% CI 1.05-2.42) and better reported understanding of their diabetes care (P Ͻ 0.001). HbA 1c knowledge was not associated with respondents' diabetes care self-efficacy or reported self-management behaviors. RESEARCH DESIGN AND METHODS CONCLUSIONS -Respondents who knew theirHbA 1c values reported better diabetes care understanding and assessment of their glycemic control than those who did not. Knowledge of one's HbA 1c level alone, however, was not sufficient to translate increased understanding of diabetes care into the increased confidence and motivation necessary to improve patients' diabetes self-management. Strategies to provide information to patients must be combined with other behavioral strategies to motivate and help patients effectively manage their diabetes. Diabetes Care 28:816 -822, 2005A growing body of evidence suggests that patients with chronic diseases who are engaged and active participants in their health care have better health outcomes (1-4). For example, patients who have completed chronic disease self-management training programs have improved self-efficacy and physical functioning and less acute care use than nonparticipants (2,5-8). Chronic illness care self-efficacy is positively associated with health outcomes (9 -15). Similarly, collaborating with health care providers and engaging in shared clinical decision making are associated with better selfcare behaviors and disease outcomes (1,6,14,16 -20).Less is known, however, about the specific skills, knowledge, beliefs, and motivations that patients need to most effectively participate in their chronic disease management. Patient knowledge of actual and target disease management outcomes (e.g., HbA 1c test results) is hypothesized to be an important prerequisite for effective patient "activation." Providing immediate feedback of HbA 1c values to insulin-taking diabetic adults and their providers (21) and graphical information to patients on their HbA 1c and other laboratory values has been found to improve glycemic control and other diabetes outcomes (22). Organizations such as the American Diabetes A...

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Current literature in diabetes

2003

Diabetes Metabolism Res

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of diabetes/metabolism. Each bibliography is divided into 17 sections: 1 Books, Reviews & Symposia; 2 General; 3 Genetics; 4 Epidemiology; 5 Immunology; 6 Prediction; 7 Prevention; 8 Intervention: a) General; b) Pharmacology; 9 Pathology: a) General; b) Cardiovascular; c) Neurological; d) Renal; 10 Endocrinology & Metabolism; 11 Nutrition; 12 Animal Studies; 13 Techniques. Within each section, articles are listed in alphabetical order with respect to author (4 Weeks journals ‐ Search completed at 5th March 2003)

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Diabetes control improved when inner-city patients received graphic feedback about glycosylated hemoglobin levels

Cited by 27 publications

References 25 publications

A Systematic Review of Interventions to Improve Diabetes Care in Socially Disadvantaged Populations

A Systematic Review of Interventions to Improve Diabetes Care in Socially Disadvantaged Populations

The Relationship Between Knowledge of Recent HbA1c Values and Diabetes Care Understanding and Self-Management

Current literature in diabetes

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