Shared Medical Visits for Spanish-speaking Patients With Type 2 Diabetes
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Diabetes Mellitus Type 2
- Sponsor
- University of Nebraska
- Enrollment
- 9
- Locations
- 1
- Primary Endpoint
- Hemoglobin A1c
- Status
- Completed
- Last Updated
- 2 years ago
Overview
Brief Summary
The investigators seek to apply a shared medical visit model and interdisciplinary approach to Spanish-speaking patients. The investigators will evaluate the patient's hemoglobin A1c as a marker of glycemic control and evaluate their mood with PHQ screening tools. The investigators seek to improve diabetes care for this group of underserved patients. Potential participants will be selected from the UNMC diabetes registry. Eligibility criteria includes adult patients over the age of eighteen years old with Type 2 diabetes, HgbA1c greater than 8%, whose preferred language is Spanish. Exclusion criteria include pregnancy, residency at a nursing home or other facility, substance abuse, and physician recommendation that study is not appropriate for the patient.
Detailed Description
Type 2 diabetes is an expanding epidemic, which is particularly pervasive in the Hispanic community. In 2014, the CDC reported that 21.9 million adults have been diagnosed with diabetes, a number which has nearly quadrupled since 1980. Diabetes is a particularly challenging chronic disease due to the need for self-management. This research study plans to explore how shared medical visits with Spanish-speaking patients with diabetes can improve their control of diabetes, develop self-management behaviors, and enhance overall perspective of having a chronic disease. The investigators will model this project after an ongoing with English speakers and they have demonstrated improvements in hemoglobin A1c levels and quality of life, and will now apply this model to Spanish-speaking patients. Eligibility and exclusion criteria are detailed in the brief summary. Eligible participants will be recruited for the study through use of phone call in Spanish, letter writing in Spanish, word of mouth, and direct referral from their providers throughout UNMC. Once the list of potential subjects is compiled, those patients will be contacted and the details of the study will be explained in Spanish. All the participating staff in the study speak Spanish. The participants, at any time, can withdraw from the study. Participants will receive education in diabetes health and lifestyle education. This will be a quantitative study using pre- and post-intervention measures to evaluate the outcomes of HgbA1c levels, scores on the validated 2-item and 9-item Patient Health Questionnaires (PHQ-2 and PHQ-9), and questionnaire which measures improvements in self-management behaviors. Researchers will to follow-up with the participants in the week following the visit to discuss lab results. At the end of the study, researcher will send a detailed letter to the patient's primary care provider regarding progress and management in shared medical visits.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Adult patients over the age of eighteen years old with Type 2 diabetes
- •HgbA1c greater than 8%
- •Preferred language is Spanish
Exclusion Criteria
- •Pregnancy
- •Residency at a nursing home or other facility
- •Substance abuse
- •Physician recommendation that study is not appropriate for the patient
Outcomes
Primary Outcomes
Hemoglobin A1c
Time Frame: Every three months, up to 1 year
Every 3 months we will measure hemoglobin A1c to assess for improvement in glycemic control.
Secondary Outcomes
- Improvement in self care behaviors(Every three months, up to 1 year)
- Blood pressure(Every 3 months, up to 1 year)
- Screening for complications of diabetes(Once annually, up to 1 year)
- Barriers to care for Spanish-speaking patients with diabetes(Every 3 months, up to 1 year)
- BMI(Every 3 months, up to 1 year)
- PHQ-2 and PHQ-0 Depression screening tool(Every three months, up to 1 year)