Alliance to Reduce Disparities in Diabetes

RTI International at the Minority Health and Health Disparities Grantees' Conference

"I thank you because you have saved my life..." Patient Perspectives on the Alliance to Reduce Disparities in Diabetes

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

Authors
S.L. Holt, M.A. Lewis, O.M. Taylor, A.D. Stine, J. Brenner, N. Fleming, P. Johnson, K. Langwell, & M. Peek

Abstract
Purpose: We report on patient experiences gathered as part of the evaluation of The Alliance to Reduce Disparities in Diabetes, a five-site initiative focused on integrating professional and patient education and quality of care improvements to support diabetes self-management for vulnerable patients. Our evaluation found that patients experienced significant decreases in HbA1c and blood pressure. Empowerment, increasing access, addressing local barriers, and care coordination were important to successful program implementation. To understand patient perspectives we interviewed a subgroup about their experiences with diabetes management before, during, and after involvement with Alliance programs.

Methods: Fifty semi-structured interviews were conducted with 10 patients from each site. Sixty-eight percent were female, and 51% were married. Average age was 54. The 30-minute interviews were transcribed and analyzed using NVivo. Framework Analysis guided theme identification across sites and patients.

Results: Prior to enrollment, many patients reported feeling depressed. Poor patient-provider communication contributed to a lack of knowledge about diabetes management. Most patients reported that Alliance programs taught them how to manage their diabetes more effectively. Patients noted that better communication with formal (clinicians) and informal (family) sources of care facilitated diabetes management. Provision of emotional support, advice, and a sense of companionship helped patients with feelings of hopelessness. Patients reported that because of improved diabetes self-management they felt better mentally and experienced a better quality of life.

Conclusion: The Alliance programs enhanced patients’ knowledge, attitudes, and ability to communicate effectively with family and clinicians. Patients reported experiencing better mental and physical well-being.