Alliance to Reduce Disparities in Diabetes

Evaluation: The Diabetes Equity Project (Dallas, TX)

Research Questions and Measures

RESEARCH QUESTION MEASURES
Does the implementation of a CHW-led diabetes education and self-management program (DEP) in five community clinics improve diabetes knowledge, glycemic control, and quality of life in a population of uninsured, underserved and predominantly Hispanic patients with diabetes in Dallas, Texas?
  • Pre- to post-intervention changes in HbA1c, BMI, and cholesterol for all DEP participants at baseline and 12-month follow-up
  • Pre- to post-intervention changes in diabetes knowledge, perceived competence in the management of diabetes (Perceived Competence for Diabetes Scale)¹ and quality of life (EQ-5D)² for all DEP participants at baseline and 12-month follow-up
  • Comparison of clinical indicators (HbA1c, BMI, cholesterol) for DEP participants and a control group of patients with diabetes receiving care at the same clinics
What is the impact of the DEP on emergency and inpatient department utilization, hospitalizations, and costs due to complications from uncontrolled diabetes? Analysis of pre- and post-intervention emergency department and inpatient utilization and cost data from North Texas hospitals obtained from the Dallas Fort Worth Hospital Council for DEP participants and a control group of patients with diabetes receiving care at the same clinics. Data is collected at baseline and 12-month follow-up.
What are the perceptions of patients, community health workers (CHWs), and providers regarding barriers to diabetes management and the effectiveness of the DEP program? Semi-structured one-on-one qualitative interviews with DEP patients, CHWs, and clinicians assessing:
  • Patients’ level of satisfaction with the DEP and impact of the DEP on their knowledge of diabetes, competency regarding diabetes management, and health outcomes
  • Common barriers to diabetes management faced by DEP patients and ability of DEP to address these barriers
  • The role of CHWs in improving diabetes-related outcomes for patients
  • The role of CHWs in a health care system’s care coordination strategy

References

  1. Williams, G.C., McGregor, H.A., Zeldman, A., Freedman, Z.R., & Deci, E.L. (2004). Testing a self-determination theory process model for promoting glycemic control through diabetes self-management. Health Psychology, 23(1), 58-66.
  2. The EuroQol group. (1990). EuroQol--a new facility for the measurement of health-related quality of life. Health Policy, 16(3), 199-208.

 

Presentations and Publications

2014 Presentations

Kane, E.P., Snead, C.A., Schmidt, K.L., Barnes, S.A., & Collinsworth, A.W. (2014, December). The Effectiveness of the CHW-led Diabetes Equity Project. Poster presentation at the 2014 Minority Health and Health Disparities Grantees' Conference, National Harbor, MD.

2014 Publications

Collinsworth, A., Vulimiri, M., Snead, C., & Walton, J. (2014). Community health workers in primary care practice: Redesigning health care delivery systems to extend and improve diabetes care in underserved populationsHealth Promotion Practice, 15(2S), 51S-61S.

2013 Presentations

Kane, E., Chavira, C., Collinsworth, A.,  Schmidt, K., & Snead, C. (2013, May). Addressing health literacy beyond the clinical encounter: The use of community health workers in diabetes education. Poster presented at the Institute for Healthcare Advancement's 12th Annual Health Literacy Conference, Irvine, CA.

2013 Publications

Collinsworth, A.W., Vulimiri, M., Schmidt, K.L., & Snead, C.A. (2013). Effectiveness of a community health worker-led diabetes self-management education program and implications for CHW involvement in care coordination strategiesDiabetes Educator, 39(6), 792-799.

2012 Publications

Walton, J.W., Snead, C.A., Collinsworth, A.W., & Schmidt, K.L. (2012). Reducing diabetes disparities through the implementation of a community health worker–led diabetes self-management education program. Journal of Family and Community Health, 35(2), 161-171.

Walton, J. (2012, January). AHA Equity of Care, Eliminating Health Care Disparities: Implementing the National Call to Action Using Lessons Learned, "Case Study: Beyond REAL Data - Community Actions to Improve Diabetes Care and Outcomes." Project Access Dallas 2011 Annual Report, Quality in Diabetes Care, Diabetes Equity Project.

2012 Presentations

Vulimiri, M., Collinsworth, A., Snead, C., & Walton, J. (2012, November). Patient and provider perspectives of community-based health promoter-led diabetes intervention. Poster presented at The Sixth Annual Conference on Health Disparities, Little Rock, AR.

Collinsworth, A. (2012, June). Community health workers' perspectives regarding their role in a health care system's care coordination model for diabetes. Presentation at the Academy Health Annual Research Meeting, Orlando, FL.

Walton, J. (2012, April). Diabetes Equity Project. Presentation at Massachusetts General Hospital Disparities Leadership Program, Boston, MA.

Walton, J. (2012, March). Diabetes Equity Project. Presentation at the Alliance to Reduce Disparities in Diabetes National Policy Summit: Learning from the Local Experience, Washington DC.

2011 Presentations

Walton, J., Snead, C., Collinsworth, A., & Schmidt, K. (2011, December). Reducing diabetes disparities through the implementation of a community health worker-led diabetes self-management education program. Presentation at the Institute for Healthcare Improvement's 23rd Annual National Forum on Quality Improvement in Health Care, Orlando, FL.

Lopez, M., & Snead, C. (2011, November) Diabetes Equity Project. Presentation at the Expanding Role of Promotora(s)/Community Health Workers in Healthcare Reform Conference, Austin, TX.

Walton, J. (2011, July). Best Practices for Community Health Needs Assessments and Implementation Strategies: Monitoring and Evaluation. Presentation at the CDC Public Health Forum, Atlanta, GA.

(2011, April). Diabetes Equity Project: Dallas, TX. Presentation at the CDC 2011 Diabetes Translational Conference, Minneapolis, MN.