TY - JOUR
T1 - Impact of a community-based approach to patient engagement in rural, low-income adults with type 2 diabetes
AU - Glenn, Lynn E.
AU - Nichols, Michelle
AU - Enriquez, Maithe
AU - Jenkins, Carolyn
N1 - Funding Information:
The primary feasibility study was supported by South Carolina Clinical and Translational Research Institute at Medical University of South Carolina through a grant from the NIH National Center for Advancing Translational Sciences (NCATS) Grant Number UL1TR001450, North Carolina Translational and Clinical Sciences Institute (NC TraCS) at University of North Carolina Chapel Hill which is supported by National Center for Advancing Translational Sciences, National Institutes of Health, Grant Number UL1TR002489, and South Carolina Department of Health and Human Services. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Publisher Copyright:
© 2019 Wiley Periodicals, Inc.
PY - 2020/3/1
Y1 - 2020/3/1
N2 - Objective: This secondary analysis examined the relationships between Patient Activation Measure (PAM) scores, use of health services, and HgA1C. Design: A feasibility study was conducted for a community-based intervention for high-risk adults with uncontrolled diabetes. Data were collected at baseline and monthly, including PAM and modified Diabetes Self-Management Assessment Report Tool. Intervention: Participants (n = 58) were randomized to a 3-month nurse (RN) telephone management or community health worker (CHW) in-home intervention, focusing on medication adherence, timely follow-up, diabetes self-management coaching, and linkage to resources. Results: Sample was mostly female (73%), African-American (90%), low income (75%), high school education or less (80%), and mean age of 59 years. A positive association between PAM score and self-reported diabetes care recommendations was found (r =.356, p =.014) and significant correlation between baseline PAM score and HgA1C levels (r = −.306, p =.029). A paired samples t test showed statistically significant increases in PAM scores in the CHW intervention group (mean increase +8.5, CI [+2.49 to +14.65]); baseline (M = 60.31, SD = 13.3) to end of study ([M = 68.89, SD = 16.39], t(22) = 2.924, p =.008 [two-tailed]). Conclusion: A community-based approach to diabetes management demonstrated a positive effect on patient activation. Although disparities in health care access among rural, low-income populations exist, community-based interventions show potential for improving patient engagement in diabetes management and recommended health services.
AB - Objective: This secondary analysis examined the relationships between Patient Activation Measure (PAM) scores, use of health services, and HgA1C. Design: A feasibility study was conducted for a community-based intervention for high-risk adults with uncontrolled diabetes. Data were collected at baseline and monthly, including PAM and modified Diabetes Self-Management Assessment Report Tool. Intervention: Participants (n = 58) were randomized to a 3-month nurse (RN) telephone management or community health worker (CHW) in-home intervention, focusing on medication adherence, timely follow-up, diabetes self-management coaching, and linkage to resources. Results: Sample was mostly female (73%), African-American (90%), low income (75%), high school education or less (80%), and mean age of 59 years. A positive association between PAM score and self-reported diabetes care recommendations was found (r =.356, p =.014) and significant correlation between baseline PAM score and HgA1C levels (r = −.306, p =.029). A paired samples t test showed statistically significant increases in PAM scores in the CHW intervention group (mean increase +8.5, CI [+2.49 to +14.65]); baseline (M = 60.31, SD = 13.3) to end of study ([M = 68.89, SD = 16.39], t(22) = 2.924, p =.008 [two-tailed]). Conclusion: A community-based approach to diabetes management demonstrated a positive effect on patient activation. Although disparities in health care access among rural, low-income populations exist, community-based interventions show potential for improving patient engagement in diabetes management and recommended health services.
KW - community health worker
KW - diabetes mellitus type 2
KW - health promotion
KW - patient activation
KW - patient activation measure
KW - patient engagement
KW - poverty
KW - rural population
KW - self-management
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U2 - 10.1111/phn.12693
DO - 10.1111/phn.12693
M3 - Article
C2 - 31833102
AN - SCOPUS:85076857491
SN - 0737-1209
VL - 37
SP - 178
EP - 187
JO - Public Health Nursing
JF - Public Health Nursing
IS - 2
ER -
