Evaluation of a Behavioral Intervention With Multiple Components Among Low-Income and Uninsured Adults With Obesity and Diabetes

Ahn, SangNam; Lee, Joonhyung; Bartlett-Prescott, Jenny; Carson, Lisa; Post, Lindsey; Ward, Kenneth D.

doi:10.1177/0890117117696250

Cited by 20 publications

(24 citation statements)

References 97 publications

(111 reference statements)

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“…Although patients' HgbA1cs improved, other behaviours need further encouragement to address obesity among other co-morbidities. This is consistant with findings in the literature showing the need for interventions other than medications to improve diabetes related outcomes (Ahn et al, 2017;Boinapally, Fussman, & Imes, 2011;CDC, 2012). The dental exams showed a slight upward trend with foot exams increasing even more.…”

Section: Discussionsupporting

confidence: 69%

Improving outcomes in adults with diabetes through an interprofessional collaborative practice program

Nagelkerk

Thompson

Bouthillier

et al. 2017

Journal of Interprofessional Care

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In 2014, the Midwest Interprofessional Practice, Education and Research Center partnered with a Federally Qualified Health Center (FQHC) to implement an interprofessional collaborative practice (IPCP) education program to improve the health of adult patients with diabetes and to improve practice efficiency. This partnership included integrating an interprofessional team of students with the practice team. Twenty-five students and 20 staff engaged in the IPCP program, which included completion of educational modules on IPCP and implementation of daily huddles, focus patient visits, phone calls, team-based case presentations, medication reconciliation, and student-led group diabetes education classes. This study used a sequential mixed methods design. Tools used for collecting data from staff and students included demographic forms, the Interdisciplinary Education Perception Scale (IEPS), the Entry-level Interprofessional Questionnaire, the Collaborative Practice Assessment Tool, and pre/post module knowledge tests completed at baseline and at one-year post implementation. Patient clinical indicators included HgbA1c, glucose, lipid panel laboratory assessments, body mass index, blood pressure, and documentation of annual dental, foot, and eye examinations. Practice efficiency was measured by the average number of patients seen per provider per hour. Both students and staff showed significant knowledge gains in IPCP on Team Dynamics and Tips for Behavioural Changes knowledge tests (p < .05). Patients who had an HgbA1c of ≥ 7% significantly decreased their HgbA1c (p < .05) and glucose (p < .01). However, BMI and annual dental and eye examinations did not improve. Providers demonstrated an increase in the number of patients seen per hour. This IPCP intervention showed improvement in practice efficiencies and select patient outcomes in a family practice clinic.

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Section: Discussionsupporting

confidence: 69%

Improving outcomes in adults with diabetes through an interprofessional collaborative practice program

Nagelkerk

Thompson

Bouthillier

et al. 2017

Journal of Interprofessional Care

View full text Add to dashboard Cite

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“…The negative association of family income of <5000 SR with obesity is probably due to the limited food sources available for families suffering from poverty. Our results of family income do not agree with others in Western countries that showed low family income is associated with increased incidence of obesity for adolescents [ 19 , 20 , 21 ]. The disparity in results is probably due to the fact that, in Western low-income families, the quality of food, rather than the quantity, is limited as in the case of developing countries.…”

Section: Discussioncontrasting

confidence: 99%

Some Socioeconomic Factors and Lifestyle Habits Influencing the Prevalence of Obesity among Adolescent Male Students in the Hail Region of Saudi Arabia

et al. 2018

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A cross-sectional study was conducted to investigate the effect of some socioeconomic factors and lifestyle habits on the prevalence of obesity among adolescent male students in the Hail region, Saudi Arabia. A questionnaire was filled by 1495 male adolescents distributed among 12 schools in the Hail region. Body weight and height were taken, and the Z-score of students was measured using Anthroplus software with a cutoff 1–2 and +2 standard deviations to determine overweight and obesity, respectively. The study revealed that 21.3% of students were overweight and 27% were obese, respectively. There was a negative association between family size of >8 and obesity (OR: 0.68, CI: 0.48–0.92, p = 0.05). Family income of <5000 SR was negatively associated with obesity (OR: 0.59, CI: 0.36–0.97, p = 0.03). Whether a subject’s mother worked (odds ratio (OR): 1.43, confidence interval CI: 1.03–1.99, p = 0.03) as well as the subject’s mother’s education—whether she can read and write, has a middle school degree, or has done postsecondary studies—were positively associated with obesity. Exercise, regardless of the duration, was negatively associated with obesity. In addition, sleeping <6 h/day had a positive association with obesity. Conclusion: a >8 family size and a low family income were negatively associated with obesity, while having an educated and working mother was positively associated with obesity.

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“…38 Also, a behavioral intervention for PA and dietary education reduced weight and improved blood glucose levels among low-income adults with obesity and diabetes. 39 However, the majority of PA interventions have been conducted either with specific target populations (ie, children, students, or older adults) or in particular institutions (ie, schools, workplaces) [40][41][42][43] rather than using population-wide efforts targeting all community residents. Nonetheless, such community-wide healthy food interventions that have been implemented within specific neighborhoods have demonstrated significant dietary improvements among residents.…”

Section: Discussionmentioning

confidence: 99%

Neighborhood Influences on Physical Activity Among Low-Income African American Adults With Type 2 Diabetes Mellitus

et al. 2020

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Purpose The purpose of the study was to explore the influences of the neighborhood environment on physical activity (PA) among people living with type 2 diabetes mellitus (T2DM) in a community with limited resources. Methods Participants were adults with T2DM and their family members or friends who help in the management of T2DM and who were living in a low-income African American (AA) community. Health care providers working in the neighborhood were also included. Using an emergent design, qualitative data were collected through 7 focus group discussions (N = 63) and 13 in-depth interviews. Verbatim transcriptions were analyzed via thematic coding to explore contextual factors that limit PA and meaning around neighborhood features that promote or discourage PA. Results Levels of PA were strongly limited by neighborhood insecurity and a lack of recreational facilities in the neighborhood. People with T2DM and physical/mobility disabilities were more affected by the neighborhood environment than those without disabilities, particularly due to perceived safety concerns and social stigma. Despite socioeconomic inequalities within neighborhoods, participants showed resilience and made efforts to overcome social-environmental barriers to PA, applied various coping strategies, and received social support. Conclusions Results suggested that in an underserved neighborhood, individual barriers to physical activity were amplified by neighborhood-level factors such as crime, especially among individuals who have T2DM and disabilities. Socioeconomic inequalities should be addressed further to improve management of T2DM and its complications.

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Evaluation of a Behavioral Intervention With Multiple Components Among Low-Income and Uninsured Adults With Obesity and Diabetes

Abstract: Multiple component behavioral intervention in community settings, particularly when delivered by registered dietitians, shows promise to combat the dual epidemic of obesity and diabetes among low-income and uninsured patients.

Cited by 20 publications

References 97 publications

Improving outcomes in adults with diabetes through an interprofessional collaborative practice program

Improving outcomes in adults with diabetes through an interprofessional collaborative practice program

Some Socioeconomic Factors and Lifestyle Habits Influencing the Prevalence of Obesity among Adolescent Male Students in the Hail Region of Saudi Arabia

Neighborhood Influences on Physical Activity Among Low-Income African American Adults With Type 2 Diabetes Mellitus

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