Translational Research at Community Health Centers

Rosal, Milagros C.; White, Mary Jo; Borg, Amy; Scavron, Jeffrey; Candib, Lucy M.; Ockene, Ira S.; Magner, Robert P.

doi:10.1177/0145721710380146

Cited by 42 publications

(44 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…20 Knowledge deficits in diabetes and its associated risk factors have also been found among Hispanic populations. 21 Many Hispanics may lack knowledge on the pen device for the administration of insulin due to the fact that they may not be able to access the health care system, receive education of this delivery system, or be able to afford this treatment option. This was particularly common in this sample, and may have been due to the fact that many Hispanic immigrants in the United States are socially and economically disadvantaged, have limited access to health care services, and have cultural and language barriers.…”

Section: Discussionmentioning

confidence: 99%

The Meaning of Insulin to Hispanic Immigrants With Type 2 Diabetes and Their Families

Amirehsani

Wallace

et al. 2012

Diabetes Educ

View full text Add to dashboard Cite

Purpose The purpose of this study was to explore the meaning of insulin among a sample of Hispanic immigrants with type 2 diabetes and their family members/significant others. Methods Forty-three Hispanics with type 2 diabetes and their family members/significant others were recruited in the southeastern United States for a family-based intervention study on diabetes-self management. Focus groups were conducted in which participants with diabetes and family members were asked to describe their perceptions of insulin. The sessions were audiotaped and transcribed, translated from Spanish into English and analyzed using standard content analysis. This paper reports the findings, as well as demographic information and hemoglobin A1C levels of participants. Results The meaning of insulin was described by both Hispanic immigrants with type 2 diabetes and their family members/significant others. Participants’ perceptions were categorized into three major themes: (1) negative perceptions of insulin therapy, (2) perceived barriers to insulin therapy, and (3) positive experiences with insulin emerged from qualitative data. Conclusions The Hispanic immigrants with diabetes and their family members/significant others in this study described perceptions and fears of insulin indicating a lack of understanding of the diabetes disease process and the progressive nature of diabetes. Strategies and further research are necessary to dispel negative perceptions and facilitate positive experiences with insulin for patients, and family members/significant others.

show abstract

Section: Discussionmentioning

confidence: 99%

The Meaning of Insulin to Hispanic Immigrants With Type 2 Diabetes and Their Families

Amirehsani

Wallace

et al. 2012

Diabetes Educ

View full text Add to dashboard Cite

show abstract

“…Patients were administered consent, baseline questionnaires, and enrolled in the study during each patient’s first group therapy session attended, therefore data for patients eligible but not interested in or declining treatment is unavailable. We intended to conduct a randomized controlled trial (RCT), but we encountered organizational and patient level barriers similar to barriers in other projects in low-income public sector settings [23]. At the organizational level, study materials, such as a paper or an online randomization table, were not always accessible to clinicians.…”

Section: Methodsmentioning

confidence: 99%

Automated Text Messaging as an Adjunct to Cognitive Behavioral Therapy for Depression: A Clinical Trial

Aguilera¹,

Bruehlman-Senecal²,

DeMasi³

et al. 2017

J Med Internet Res

114

119

View full text Add to dashboard Cite

BackgroundCognitive Behavioral Therapy (CBT) for depression is efficacious, but effectiveness is limited when implemented in low-income settings due to engagement difficulties including nonadherence with skill-building homework and early discontinuation of treatment. Automated messaging can be used in clinical settings to increase dosage of depression treatment and encourage sustained engagement with psychotherapy.ObjectivesThe aim of this study was to test whether a text messaging adjunct (mood monitoring text messages, treatment-related text messages, and a clinician dashboard to display patient data) increases engagement and improves clinical outcomes in a group CBT treatment for depression. Specifically, we aim to assess whether the text messaging adjunct led to an increase in group therapy sessions attended, an increase in duration of therapy attended, and reductions in Patient Health Questionnaire-9 item (PHQ-9) symptoms compared with the control condition of standard group CBT in a sample of low-income Spanish speaking Latino patients.MethodsPatients in an outpatient behavioral health clinic were assigned to standard group CBT for depression (control condition; n=40) or the same treatment with the addition of a text messaging adjunct (n=45). The adjunct consisted of a daily mood monitoring message, a daily message reiterating the theme of that week’s content, and medication and appointment reminders. Mood data and qualitative responses were sent to a Web-based platform (HealthySMS) for review by the therapist and displayed in session as a tool for teaching CBT skills.ResultsIntent-to-treat analyses on therapy attendance during 16 sessions of weekly therapy found that patients assigned to the text messaging adjunct stayed in therapy significantly longer (median of 13.5 weeks before dropping out) than patients assigned to the control condition (median of 3 weeks before dropping out; Wilcoxon-Mann-Whitney z=−2.21, P=.03). Patients assigned to the text messaging adjunct also generally attended more sessions (median=6 sessions) during this period than patients assigned to the control condition (median =2.5 sessions), but the effect was not significant (Wilcoxon-Mann-Whitney z=−1.65, P=.10). Both patients assigned to the text messaging adjunct (B=−.29, 95% CI −0.38 to −0.19, z=−5.80, P<.001) and patients assigned to the control conditions (B=−.20, 95% CI −0.32 to −0.07, z=−3.12, P=.002) experienced significant decreases in depressive symptom severity over the course of treatment; however, the conditions did not significantly differ in their degree of symptom reduction.ConclusionsThis study provides support for automated text messaging as a tool to sustain engagement in CBT for depression over time. There were no differences in depression outcomes between conditions, but this may be influenced by low follow-up rates of patients who dropped out of treatment.

show abstract

“…Moreover, attempts at translation typically command fewer resources to intensively follow and track participants, thus further jeopardizing retention success. To date, however, the strategies and potential predictors for retention success in translational initiatives remain underexplored (Davis et al 2009; Rosal et al 2010). …”

mentioning

confidence: 99%

Participant and Site Characteristics Related to Participant Retention in a Diabetes Prevention Translational Project

et al. 2014

View full text Add to dashboard Cite

Using multi-level analysis, this study investigated participant and site characteristics associated with participant retention in a multi-site diabetes prevention translational project among American Indian and Alaska Native (AI/AN) people. We analyzed data from the Special Diabetes Program for Indians Diabetes Prevention Program (SDPI-DP), a lifestyle intervention to prevent diabetes implemented in 36 AI/AN grantee sites. A total of 2,553 participants were recruited and started the intervention between 01/01/2006 and 07/31/2008. They were offered the 16-session Lifestyle Balance Curriculum from the Diabetes Prevention Program (DPP) in the first 16-24 weeks of intervention. Generalized estimating equation models and proportional hazards models with robust standard error estimates were used to evaluate the relationships of participant and site characteristics with retention. As of 07/31/2009, about 50% of SDPI-DP participants were lost to follow-up. Those who were younger, male, with lower household income, no family support person, and more baseline chronic pain were at higher risk for both short-term and long-term retention failure (i.e., not completing all 16 DPP sessions and loss to follow-up, respectively). Sites with large user populations and younger staff had lower likelihood of retaining participants successfully. Other site characteristics related to higher risk for retention failure included staff rating of participant disinterest in SDPI-DP and barriers to participant transportation and child/elder care. Future translational initiatives need to pay attention to both participant- and site-level factors in order to maximize participant retention.

show abstract

Translational Research at Community Health Centers

Abstract: CHCs are a prime setting for translation research aimed to eliminate diabetes health disparities. Successful recruitment and retention efforts must address institutional/organizational, research team, and patient-related challenges.

Cited by 42 publications

References 49 publications

The Meaning of Insulin to Hispanic Immigrants With Type 2 Diabetes and Their Families

The Meaning of Insulin to Hispanic Immigrants With Type 2 Diabetes and Their Families

Automated Text Messaging as an Adjunct to Cognitive Behavioral Therapy for Depression: A Clinical Trial

Participant and Site Characteristics Related to Participant Retention in a Diabetes Prevention Translational Project

Contact Info

Product

Resources

About