Patient navigators can benefit diabetes outcomes
A new study seeks to determine whether significant improvement in glycemic controlâthe management of blood sugar levels in a person with diabetes mellitusâcan be achieved when regular mentoring or coaching is part of the process.
University of Alabama at Birmingham (UAB) School of Nursing assistant professor Michele Talley, PhD, and researchers are testing their hypothesis with a $30,000 grant from the UAB Center for the Study of Community Health, as part of their work at the Providing Access to Healthcare (PATH) Clinic, which the school supports in partnership with UAB Hospital and the UAB Health System.
"A lot of times, people assume that patients donât adhere to treatment simply because they donât want to or they lack the discipline to do it," said Talley, adult acute care nurse practitioner-BC, assistant professor/ director for MSN program, adult/acute health, chronic care and foundations department, UAB. "I may have been guilty of that myself 10 years ago, but what I have come to realize is that often a lack of knowledge about diabetes is the real issue."
The study, 'Impact of Community Health Advisors for Uninsured Adults with Diabetes at PATH," will be conducted in 2 phases and is currently in the recruitment stage of phase 1 for a focus group discussion regarding diabetes self-care topics. The participants will come for a focus group meeting (10 men for one group and 10 women for the second focus group).
"The interviewer will be using a semi-structured interview guide to obtain feedback on the topics of interest to the participants regarding diabetes self-care," Talley said. "After obtaining this feedback, we will begin phase 2 of the study."
During phase 2, a total of 60 participants will be recruited. Thirty participants will participate in the intervention group and another 30 participants will comprise the control group. The intervention group will be divided into groups of 6 and a community health advisor (CHA) will be assigned to them.
The CHAs, provided through a partnership with the Deep South Cancer Network, are laypeople from the community whom Talley will train in behaviors of interest identified by the first focus groups.
The participants in the intervention group will have regular access to a CHA throughout the 12-week study, including face-to-face meetings in weeks one and 12 and weekly contact by phone in weeks two through 11. During these sessions, the CHAs will educate the participants on the previously identified self-care behaviors of interest.
The outcome variables will include: improved glycemic control (measured by A1c), compliance (measured by adherence to self-care behaviors via self-report on the cards), and decreased hospital and/or emergency department utilization (measured by self-reported emergency department visits and length of stay in days).