Lynn E Glenn1, Michelle Nichols2, Maithe Enriquez1, Carolyn Jenkins2. 1. University of Missouri Sinclair School of Nursing, Columbia, MO, USA. 2. Medical University of South Carolina College of Nursing, South Carolina Clinical and Translational Research Institute, Charleston, SC, USA.
Abstract
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.
RCT Entities:
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.
Authors: R Q Wolever; M Dreusicke; J Fikkan; T V Hawkins; S Yeung; J Wakefield; L Duda; P Flowers; C Cook; E Skinner Journal: Diabetes Educ Date: 2010-06-09 Impact factor: 2.140
Authors: Elizabeth Ciemins; Patricia Coon; Rory Peck; Barbara Holloway; Sung-Joon Min Journal: Telemed J E Health Date: 2011-08-22 Impact factor: 3.536