Alliance to Reduce Disparities in Diabetes

Chicago Team at the Minority Health and Health Disparities Grantees' Conference

Integrating Interventions to Improve Diabetes Care and Outcomes

2014 Minority Health and Health Disparities Grantees' Conference
December 1-3, 2014
National Harbor, MD

Authors
M.E. Peek, N.A. Geary, Y. Gao, D.J. Rowell, Y. O’Neal, T.S. Roberson, J.L. Whyte, N.Q. Bergeron, & M.H. Chin

Abstract
Purpose: The drivers of health care disparities in diabetes are multifactorial, and few studies have integrated interventions at multiple levels (e.g. person, organization) across both the health care system and community to address disparities in care.

Design Methods: From 2008 to 2012, we implemented a multi-level intervention in two university clinics and four federally-qualified health centers on the South Side of Chicago, a predominantly African American community. Patients were invited to participate in culturally-tailored diabetes empowerment classes, providers were trained in cultural competency and patient-centered communication, clinics implemented quality improvement projects, and patients were linked to community-based resources that support health. 
To evaluate the intervention, we collected cross-sectional data about diabetes-related care processes (e.g., influenza vaccinations, diabetes education, and HbA1c testing) and health outcomes (e.g., HbA1c levels, blood pressure, and LDL levels) from each clinic site from 2008 to 2012.

Results: A total of 2527 medical charts were reviewed across 5 years. Compared to 2008, significant improvements were seen. Patients were more likely to be offered an influenza vaccination (p<.001) receive diabetes education (p<.001) and receive an HbA1c test (p<.01). Patients were more likely to have HbA1c values less than 8% (p<.05), and LDL levels less than 100 (p<.01). An unexpected small increase in blood pressure was observed (p<.05).

Conclusion: Our results suggest that integrating interventions at multiple levels have the potential to improve diabetes care and outcomes over time, and potentially reduce disparities in diabetes care.