Alliance to Reduce Disparities in Diabetes

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

Authors
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

Abstract
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.