Advancing Diabetes Self-Management in the Mexican American Population

Thompson, Joan; Horton, Claire; Flores, Carlos

doi:10.1177/0145721707304077

Cited by 80 publications

(73 citation statements)

References 13 publications

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“…While not surprising, these results provide some evidence that increased delivery of intervention components can lead to improvement in A1C. Although individual patient data on intervention component exposure was not available, previous research has demonstrated a relationship with improvement in A1C and dosage of community health worker (CHW) contact (Thompson, Horton, & Flores, 2007).…”

Section: Researchmentioning

confidence: 75%

Measuring the Implementation and Effects of a Coordinated Care Model Featuring Diabetes Self-management Education Within Four Patient-Centered Medical Homes

et al. 2015

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Minority individuals experience a disproportionately greater incidence and prevalence of type 2 diabetes. Innovative approaches are needed to reduce health disparities and associated harms among vulnerable populations with diabetes. This thesis examines the effects of the implementation of a coordinated care model with underserved populations in Patient Centered Medical Homes (PCMH) at four sites (Florida, Ohio, Oklahoma, and Tennessee). The model featured diabetes self-management education (DSME) and a patient support intervention delivered within the PCMH context. The components of the comprehensive intervention included DSME, support for managing diabetes and distress, enhanced access and linkage to care, and improvement to quality of care. The primary dependent measures in this study included four clinical health measures-glycosylated hemoglobin (A1C), blood pressure, body mass index, and lipids-and the AADE7 Self-Care Behaviors TM . Coordinated care teams that delivered the intervention included primary care physicians, nurse care coordinators, certified diabetes educators, health behavior coaches, and diabetes patient supporters. Community health workers and medical assistants provided additional individualized support to patients. Care teams provided DSME as well as customized and coordinated patient support within a PCMH setting.This study was part of a larger participatory evaluation of the Bristol-Myers Squibb Foundation's Together on Diabetes initiative. A statistically significant decrease was seen in A1C, the primary clinical health outcome. This decrease was seen across all four implementation sites; ranging from a decrease of 0.4% to 0.9% after 6 months. This improved A1C level was associated with implementation of the DSME and support intervention. Substantial policy and practice changes were also brought about at two of the four PCMH sites. Use of DSME within the PCMH model is a promising strategy for reducing clinical markers for diabetes among vulnerable populations.iv Systems changes, including policy and practice changes, have the potential to have lasting effects within PCMH practice for reducing the burden of diabetes.

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Section: Researchmentioning

confidence: 75%

Measuring the Implementation and Effects of a Coordinated Care Model Featuring Diabetes Self-management Education Within Four Patient-Centered Medical Homes

et al. 2015

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“…Of 16 studies reviewed, investigators noted that significant reductions in hemoglobin A1C values were reported in eight studies. A recent review of literature published in 2011 and 2012 assessing the evidence emerging from community-based participatory research approaches involving CHWs provided evidence of improved glycemic control or reduced risk of disease progression (2,3,7,19,43,60,61,111,116,127). Cancer screening.…”

Section: Evidence For Community Health Worker Effectiveness In the Unmentioning

confidence: 99%

Community Health Workers in Low-, Middle-, and High-Income Countries: An Overview of Their History, Recent Evolution, and Current Effectiveness

Perry

Zulliger

Rogers

2014

Annu. Rev. Public Health

688

671

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Over the past half-century, community health workers (CHWs) have been a growing force for extending health care and improving the health of populations. Following their introduction in the 1970s, many large-scale CHW programs declined during the 1980s, but CHW programs throughout the world more recently have seen marked growth. Research and evaluations conducted predominantly during the past two decades offer compelling evidence that CHWs are critical for helping health systems achieve their potential, regardless of a country's level of development. In low-income countries, CHWs can make major improvements in health priority areas, including reducing childhood undernutrition, improving maternal and child health, expanding access to family-planning services, and contributing to the control of HIV, malaria, and tuberculosis infections. In many middle-income countries, most notably Brazil, CHWs are key members of the health team and essential for the provision of primary health care and health promotion. In the United States, evidence indicates that CHWs can contribute to reducing the disease burden by participating in the management of hypertension, in the reduction of cardiovascular risk factors, in diabetes control, in the management of HIV infection, and in cancer screening, particularly with hard-to-reach subpopulations. This review highlights the history of CHW programs around the world and their growing importance in achieving health for all.

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“…Such programs, with emerging evidence for prevention of severe disease, reduction in acute hospital presentations, and minimising of development of chronic disease states, include diabetes education, obesity and eating disorder prevention, antismoking, cardiovascular risk, mental health promotion, illness prevention and early intervention strategies, provided in individual, family and group formats. [26][27][28][29][30][31] Some of these programs can, and should, be run initially as special public activities in other communal venues, for example, local town halls, church halls etc. But if participants are to return for more detailed information sessions or personal advice, which are highly desirable interim outcomes, they need to be able to access a local, attractive, welcoming, well maintained community health centre, convenient to shops, transport and parking.…”

Section: Persistent Long-term and Recurrent Conditionsmentioning

confidence: 99%

The future of community-centred health services in Australia: lessons from the mental health sector

Rosen

Gurr

Fanning

2010

Aust. Health Review

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Abstract* It is apparent that hospital-dominated health care produces limited health outcomes and is an unsustainable health care system strategy. * Community-centred health care has been demonstrated to be a more cost-efficient and cost-effective alternative to hospitalcentred care, particularly for prevention and care of persistent, long-term or recurrent conditions. Nevertheless, hospitalcentred services continue to dominate health care services in Australia, and some state governments have presided over a retreat from, or even dismantling of, community health services. * The reasons for these trends are explored. * The future of community health services in Australia is uncertain, and in some states under serious threat. We consider lessons from the partial dismantling of Australian community mental health services, despite a growing body of Australian and international studies finding in their favour. * Community-centred health services should be reconceptualised and resourced as the centre of gravity of local, effective and affordable health care services for Australia. A growing international expert consensus suggests that such communitycentred health services should be placed in the centre of their communities, closely linked or collocated where possible with primary health care, and functionally integrated with their respective hospital-based services.What is known about the topic? Community-centred health care has been widely demonstrated to be a more cost-efficient and cost-effective alternative to hospital-centred care, particularly for prevention and care of persistent, long-term or recurrent conditions, e.g. in mental health service systems. A growing international expert consensus suggests that such communitycentred health services should be placed in the centre of their communities, closely linked or collocated where possible with primary health care, and functionally integrated with their respective hospital-based services. What does this paper add? Despite this global consensus, hospital-centred services continue to dominate health care services in Australia, and some state governments have presided over a retreat from, or even dismantling of, community health services. The reasons for these trends and possible solutions are explored. What are the implications for practitioners? Unless this trend is reversed, the loss of convenient public access to community health services at shopping and transport hubs and the consequent compromising of intensive home-based clinical care, will lead to a deterioration of preventative interventions and the health care of long-term conditions, contrary to international studies and reviews.

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Advancing Diabetes Self-Management in the Mexican American Population

Abstract: The pilot study demonstrates that community health workers, as an integral part of the health care team, are effective agents in providing self-management support to persons with diabetes.

Cited by 80 publications

References 13 publications

Measuring the Implementation and Effects of a Coordinated Care Model Featuring Diabetes Self-management Education Within Four Patient-Centered Medical Homes

Measuring the Implementation and Effects of a Coordinated Care Model Featuring Diabetes Self-management Education Within Four Patient-Centered Medical Homes

Community Health Workers in Low-, Middle-, and High-Income Countries: An Overview of Their History, Recent Evolution, and Current Effectiveness

The future of community-centred health services in Australia: lessons from the mental health sector

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