Integrated Second Language Learning for Chronic Care: A Model to Improve Primary Care for Hispanics With Diabetes
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Diabetes Mellitus
- Sponsor
- Ohio State University
- Enrollment
- 64
- Locations
- 2
- Primary Endpoint
- Change in Patient Hemoglobin A1C from Baseline to 6 Months
- Status
- Completed
- Last Updated
- 3 years ago
Overview
Brief Summary
Language barriers continue to impede access to quality care for limited English proficient populations. Recent research has demonstrated that access to language concordant providers increases quality of care. This project evaluates the efficacy and acceptability of a model intervention to improve second language proficiency, patient-centered communication, and clinical competency of nurse practitioner students who care for Spanish-speaking patients with diabetes.
Detailed Description
The purpose of this randomized controlled 2-group study is to test the effect of an innovative educational intervention called Integrated Language Learning for Chronic Care (IL2L) on successful self-management of diabetes. It pursues an integrated development of second language and interpersonal communication skills that will facilitate productive interactions between Spanish-speaking nurse practitioners (NP) and limited English proficiency Hispanic patients with diabetes. The intervention targets the acquisition of language skills that facilitate communicative functions known to be effective in engaging chronically ill patients. It accelerates acquisition of these skills by adding a longitudinal clinical instruction dimension. Further, the investigators propose that the efficacy of the intervention can be demonstrated at the provider level through improved linguistic and interpersonal performance and at the patient level through improved diabetes outcomes in response to language concordance. In support of these claims, the investigators seek to achieve the following specific aims: Aim 1: To determine the efficacy of the IL2L for Chronic Care intervention on physical and mental health outcomes for Spanish-speaking patients with diabetes. Our hypothesis is: H1: Patients in the IL2L care group will report better physical health (HbA1C, lipids, and weight), mental health (depression and anxiety) and satisfaction with their healthcare than patients in the non-IL2L care group. Aim 2: To determine the efficacy of the IL2L for Chronic Care intervention on provider language proficiency and interpersonal communication skills. Our hypothesis is:H2: Providers exposed to the IL2L intervention will demonstrate improved Spanish language skills and interpersonal communication skills upon completion of the intervention.Specific Aim 3: To assess the acceptability of the IL2L for Chronic Care model within a graduate level nurse practitioner curriculum in a leading College of Nursing. The study will employ a mixed-methods model to assess the efficacy and accessibility of the IL2L for Chronic Care educational intervention in The Ohio State University's College of Nursing nurse practitioner program. To achieve Aim 1, the investigators will use a randomized control trial to demonstrate efficacy of the IL2L for Chronic Care model at the patient level. The investigators will compare a group of patients exposed to providers who underwent the IL2L intervention (intervention group) and a group of patients who are undergoing standard care (comparison group). To achieve Aim 2, the investigators will use a qualitative data interaction analysis system to demonstrate improvement in Spanish language proficiency and interpersonal communication skills. To achieve Aim 3, the investigators will use a combination of quantitative and qualitative measures within the RE-AIM model to assess the acceptability of the IL2L for chronic care model at the program level in a nurse practitioner program in a leading College of Nursing. The study has been approved by the institutional review boards of both universities prior to implementation and patients and student providers provide written informed consent.
Investigators
Eligibility Criteria
Inclusion Criteria
- Not provided
Exclusion Criteria
- Not provided
Outcomes
Primary Outcomes
Change in Patient Hemoglobin A1C from Baseline to 6 Months
Time Frame: From baseline to 6 months
Hemoglobin A1C is measured via a blood test and measures the patient's average plasma glucose concentration over the past 3 months and is reported as a percentage. In general, normal A1C levels for people without diabetes is 4% to 5.6% while a level of 5.7% of 6.4% indicates prediabetes, and 6.5% or above indicates diabetes.
Secondary Outcomes
- Change in Patient Self-Efficacy from Baseline to 6 Months as Assessed by the DSES(From baseline to 6 months)
- Change in Patient Anxiety from Baseline to 6 Months as Assessed by the GAD-7(From baseline to 6 months)
- Change in Patient Weight from Baseline to 6 Months(From baseline to 6 months)
- Change in Patient Waist Circumference from Baseline to 6 Months(From baseline to 6 months)
- Change in Patient Total Cholesterol from Baseline to 6 Months(From baseline to 6 months)
- Change in Patient Depression from Baseline to 6 Months as Assessed by the PHQ-9(From baseline to 6 months)
- Change in Health Coach Spanish Language Proficiency from Baseline to 6 Months as Assessed by the ACTFL(From baseline to 6 months)
- Change in Patient Body Mass Index from Baseline to 6 Months(From baseline to 6 months)
- Change in Health Coach Interpersonal Communication from Baseline to 6 Months as Assessed by the RIAS(From baseline to 6 months)
- Change in Patient Blood Pressure from Baseline to 6 Months(From baseline to 6 months)