Novel Interventions to Increase Uptake of Diabetes Self-Management Support Training within Primary Care

提高初级保健中糖尿病自我管理支持培训采用率的新颖干预措施

基本信息

批准号：
10602477
负责人：
KATRINA E DONAHUE
金额：
$ 31.1万
依托单位：
UNIV OF NORTH CAROLINA CHAPEL HILL
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-04-06 至 2025-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10602477
关键词：
Address Age Blood Glucose Caring Case Manager Clinical Communities Diabetes Mellitus Diagnosis Diet Modification Disease Distress Education Electronic Health Record Enrollment Ethnic Origin Exercise Feasibility Studies Future Goals Health Health Personnel Health behavior change Healthcare Systems Hour Housing Individual Institution Insurance Intervention Interview Knowledge Learning Life Life Style Methods Morbidity - disease rate Motivation Observational Study Outcome Participant Patients Persons Pharmaceutical Preparations Physicians Predictive Factor Primary Care Probability Provider Public Health Qualifying Race Randomized Recommendation Research Design Resources Self Care Self Efficacy Self Management Services Skin Care Social support Specialist Structure Testing Time Training Training Support Transportation Uncertainty Work adequate sleep clinical decision support clinical encounter coping design diabetes education diabetes self-management electronic health record system evidence base food insecurity foot glucose monitor glycemic control hazard health care settings health literacy healthy lifestyle improved longitudinal analysis medical specialties member mortality novel patient population patient-level barriers peer peer support pragmatic randomized trial primary care clinic primary care clinician programs referral services response secondary outcome skills social social health determinants support tools tool treatment as usual trial design unconscious bias uptake

项目摘要

Abstract Living with diabetes can be challenging, however Diabetes Self-Management Education and Support (DSMES) is well known to help persons with diabetes (PWDM) learn to cope with the uncertainties of life with diabetes. Unfortunately, DSMES is underutilized in the current health care setting. This is a multifactorial problem with the two largest issues being providers not referring patients and patients not attending the DSMES programs. These programs and the health care workers who support them have the potential to modify the disease course for many PWDM, including potentially modifying long term morbidity and mortality. We are proposing a feasibility study to test the impact of best practice advisories (BPAs) delivered to the health care provider and the diabetes care and education specialists via the electronic health record when a PWDM is identified as qualifying for DSMES. We will determine if the BPAs influence the time to referral for DSMES as well as the factors that predict whether a patient is referred to DSMES. We also propose to assess the impact of a peer support on motivating PWDM to attend DSMES and make healthier lifestyle choices. We hypothesize that if PWDM are able to connect with a peer who is also living with diabetes, they may be more likely to attend DSMES. Finally, we will assess qualitatively how the health care providers felt about the use of the BPA reminders, explore how the PWDM felt about the utility of the peer supporters, and the overall relevance of the diabetes education they received. From these lessons learned we will work with our stakeholders to design a large, pragmatic randomized trial designed to increase the uptake of DSMES, a vital piece of the diabetes puzzle.

抽象的患有糖尿病可能具有挑战性，但是糖尿病自我管理教育和支持 (DSMES) 众所周知，它可以帮助糖尿病患者 (PWDM) 学会应对糖尿病患者生活的不确定性。不幸的是，DSMES 在当前的医疗保健环境中并未得到充分利用。这是一个多因素问题两个最大的问题是提供者不转介患者以及患者不参加 DSMES 计划。这些计划和支持这些计划的医护人员有可能改变这种疾病对许多 PWDM 来说，包括可能改变长期发病率和死亡率。我们正在提议一个可行性研究，以测试向医疗保健提供者提供的最佳实践建议 (BPA) 的影响，以及当 PWDM 被确定为以下情况时，糖尿病护理和教育专家可以通过电子健康记录获得 DSMES 资格。我们将确定 BPA 是否影响转诊至 DSMES 的时间以及预测患者是否转诊至 DSMES 的因素。我们还建议评估同行的影响支持激励 PWDM 参加 DSMES 并选择更健康的生活方式。我们假设如果 PWDM 能够与同样患有糖尿病的同伴建立联系，他们可能更有可能参加 DSMES。最后，我们将定性评估医疗保健提供者对使用 BPA 的感受提醒，探讨 PWDM 对同伴支持者的效用有何感受，以及同伴支持者的整体相关性他们接受的糖尿病教育。从这些经验教训中，我们将与利益相关者合作设计一个大型、务实的随机试验，旨在增加 DSMES（糖尿病的重要组成部分）的吸收谜。