RTI International at the Minority Health and Health Disparities Grantees' Conference
Evaluation of the Alliance to Reduce Disparities in Diabetes
2014 Minority Health and Health Disparities Grantees' Conference
December 1-3, 2014
National Harbor, MD
D.B. Kamerow, R.R. Moultrie, M.A. Lewis, C.M. Bann, S.A. Karns, C.L. Hobbs, J.A. Burton, J. Brenner, N. Fleming, P. Johnson, K. Langwell, & M. Peek
Purpose: We report on the evaluation of The Alliance to Reduce Disparities in Diabetes a multi-site initiative focused on integrating innovative professional and patient education and quality of care improvements to support diabetes self-management for vulnerable patients. The five Alliance programs focused on reducing disparities in diabetes care and enhancing diabetes outcomes through clinical and community interventions. Sites enrolled a multiethnic and multiracial patient population with Type 2 diabetes and implemented multilevel and multicomponent interventions to enhance patient skills, clinician cultural competencies, and health care systems changes.
Methods: Sites provided clinical outcomes (hemoglobin A1c [HbA1c], blood pressure [BP]) and patient-reported outcomes (diabetes competence, quality of life, resources and supports for self-management, and diabetes self-care behaviors) over time. A generalized linear model accounted for clustering of participants by site, and examined changes in program participants and a comparison group.
Results: Of the 1,827 participants with baseline and follow-up data, program participants experienced significant decreases in HbA1c and blood pressure, meeting targets for better quality care than a comparison cohort(p<0.001). Patients with greater resources and support for diabetes self-management benefited more from the programs (p=0.005), as did those who attended more self-management classes (p=0.019). All patient-reported outcomes (quality of life, self-care behaviors, and diabetes competence) improved significantly (all p<.001) from baseline to the final measurement.
Conclusion: Alliance programs improved clinical outcomes, met more quality indicators, and enhanced patient self-care behaviors, competence for managing diabetes, quality of life, and the use of self-management supports. We conclude that the Alliance programs reduced diabetes disparities care.