Evaluating Outcomes for Ethnically Diverse Patients With Type 2 Diabetes Participating in a Diabetes Education Program
| Status: | Recruiting |
|---|---|
| Conditions: | Diabetes, Diabetes |
| Therapuetic Areas: | Endocrinology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 2/13/2019 |
| Start Date: | August 4, 2017 |
| End Date: | December 31, 2019 |
| Contact: | Harsimran Harsimran, PhD |
| Email: | harsimran.singh@hoag.org |
| Phone: | (949)764-7357 |
Evaluating Patient Engagement and Other Outcomes for Ethnically Diverse Patients With Type 2 Diabetes Participating in a Structured, Physician Supported, Patient-centered Diabetes Education Program
The proposed study has been developed to evaluate patient, physician, and provider (educator)
centered barriers to and facilitators for engaging in the Diabetes Self Management Education
and Support (DSMES) and developing a patient-centered, physician supported DSMES program that
could potentially address barriers shared by the patients and their healthcare professionals
(Phase 1). The feasibility and efficacy of the newly developed program will be evaluated with
an ethnically diverse cohort of 90 patients with type 2 diabetes (30 Caucasians, Asians, and
Hispanics each) (Phase 2). A variety of outcomes including clinical, behavioral and
psycho-social measures will be used to assess program acceptability and effectiveness.
centered barriers to and facilitators for engaging in the Diabetes Self Management Education
and Support (DSMES) and developing a patient-centered, physician supported DSMES program that
could potentially address barriers shared by the patients and their healthcare professionals
(Phase 1). The feasibility and efficacy of the newly developed program will be evaluated with
an ethnically diverse cohort of 90 patients with type 2 diabetes (30 Caucasians, Asians, and
Hispanics each) (Phase 2). A variety of outcomes including clinical, behavioral and
psycho-social measures will be used to assess program acceptability and effectiveness.
Diabetes is a chronic and a progressive metabolic disorder which necessitates active patient
involvement to effectively manage nutrition, physical activity, and medication for optimal
outcomes. Self-management is a critical aspect of diabetes care and a variety of studies have
established the need for people with diabetes to be knowledgeable about their condition and
be actively involved in its management to effectively reduce the risk of future health
complications and improve other outcomes. Diabetes self-management education and support
(DSMES) can help patients effectively engage in and perform their diabetes-related self-care
activities. However, only a small number of patients with diabetes participate in DSMES. A
few studies in this area have highlighted both physician and patient-related factors that
could affect the receipt of DSMES. Patients' involvement in a DSMES program continues to be
largely prompted by a physician referral and it has been suggested that improving physician
involvement in the DSMES process could enhance overall patient engagement and adherence to
such programs.
As part of the proposed mixed methods study, in Phase 1, in-depth surveys (or interviews)
will be undertaken with: (a) physicians caring for people with type 2 diabetes, (b) DSMES
providers (e.g., certified diabetes educators, diabetes nurses, dietitians), and (b) patients
with type 2 diabetes regarding their perception of diabetes education programs, barriers, and
facilitators to engagement. Findings from Phase 1 will be shared with the education team at a
diabetes center in a community hospital in Orange County, California to inform changes to
their currently existing diabetes education curriculum to make it more patient-centered and
improve physician engagement and support. As part of Phase 2, the newly developed program
will be implemented with a diverse cohort of 90 patients with type 2 diabetes. Patient
participation (attendance) in the DSMES process will be documented as a primary marker of
patient engagement while their clinical and psycho-social outcomes will serve as secondary
indicators. Among other outcomes, physician, educator, and patient satisfaction with the
newly developed referral process will also be assessed as a measure of intervention
acceptability and success.
involvement to effectively manage nutrition, physical activity, and medication for optimal
outcomes. Self-management is a critical aspect of diabetes care and a variety of studies have
established the need for people with diabetes to be knowledgeable about their condition and
be actively involved in its management to effectively reduce the risk of future health
complications and improve other outcomes. Diabetes self-management education and support
(DSMES) can help patients effectively engage in and perform their diabetes-related self-care
activities. However, only a small number of patients with diabetes participate in DSMES. A
few studies in this area have highlighted both physician and patient-related factors that
could affect the receipt of DSMES. Patients' involvement in a DSMES program continues to be
largely prompted by a physician referral and it has been suggested that improving physician
involvement in the DSMES process could enhance overall patient engagement and adherence to
such programs.
As part of the proposed mixed methods study, in Phase 1, in-depth surveys (or interviews)
will be undertaken with: (a) physicians caring for people with type 2 diabetes, (b) DSMES
providers (e.g., certified diabetes educators, diabetes nurses, dietitians), and (b) patients
with type 2 diabetes regarding their perception of diabetes education programs, barriers, and
facilitators to engagement. Findings from Phase 1 will be shared with the education team at a
diabetes center in a community hospital in Orange County, California to inform changes to
their currently existing diabetes education curriculum to make it more patient-centered and
improve physician engagement and support. As part of Phase 2, the newly developed program
will be implemented with a diverse cohort of 90 patients with type 2 diabetes. Patient
participation (attendance) in the DSMES process will be documented as a primary marker of
patient engagement while their clinical and psycho-social outcomes will serve as secondary
indicators. Among other outcomes, physician, educator, and patient satisfaction with the
newly developed referral process will also be assessed as a measure of intervention
acceptability and success.
Inclusion Criteria:
Patients of White, Asian, or Hispanic origin (30 in each group) Fluent in English (for the
White and Asian group) Fluent in Spanish (for the Hispanic group) Age > 18 years Physician
referral for DSME/S Formal diagnosis of type 2 diabetes
Exclusion Criteria:
Current or planned pregnancy. Any medical or other condition that the investigator feels
would interfere with study participation.
Mental incapacity precluding adequate understanding or cooperation. Potential participants
who are imprisoned or hospitalized
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