“培养自己的人才”的影响:通过培训医疗保健专业人员成为安全网实践中的认证糖尿病教育者来解决健康差距的试点项目。

The impacts of "growing our own": a pilot project to address health disparities by training health professionals to become certified diabetes educators in safety net practices.

机构信息

Primary Care Research Institute, Department of Family Medicine, State University of New York at Buffalo, Buffalo, New York (Dr Kahn, Dr Tumiel-Berhalter, Ms D’Aniello, Mr Danzo, Dr Fox, Mr Taylor, Ms Holland, Ms Glaser)

Jefferson Family Medicine Center, Department of Family Medicine, State University of New York at Buffalo, Buffalo, New York (Dr Fox, Dr Patel)

出版信息

Diabetes Educ. 2012 Jan-Feb;38(1):86-93. doi: 10.1177/0145721711427455. Epub 2011 Dec 6.

Abstract

PURPOSE

The purpose of the study was to examine the impact of incorporating certified diabetes educator trainees into medical practices on patient diabetes outcomes.

METHODS

This was a mixed methods practice-based evaluation study undertaken in 2 primary care practices in high-poverty neighborhoods in Buffalo, New York. The evaluation entailed a physician-referred patient cohort with pre- and postanalysis of chart review data corresponding to the American Diabetes Association's diabetes indicators. Patient charts were reviewed at baseline and 12 months. A brief survey was administered to the providers and staff to ascertain the extent to which the certified diabetes educator trainees were perceived as useful as part of the medical practice team.

RESULTS

Among 74 patients enrolled in diabetes classes, A1C levels decreased from a mean of 8.8% to 8.3%. Among a subset of patients (35%) with poorly controlled diabetes at baseline (A1C ≥ 9), there was a 15% decrease in A1C levels. Overall improvement in A1C was observed among 219 patients seen by a diabetes educator, in either a diabetes education class or a one-on-one visit.

CONCLUSIONS

Results suggest that having a certified diabetes educator trainee as part of the primary care practice team may advance diabetes care, as evidenced by improvements in glucose control. Responses from providers and staff suggest that the certified diabetes educator trainees were well integrated into the practices and were perceived as instrumental in educating patients to better manage their diabetes.

摘要

目的

本研究旨在考察将认证糖尿病教育者培训生纳入医疗实践对患者糖尿病结局的影响。

方法

这是一项在纽约布法罗市两个高贫困社区的初级保健实践中进行的混合方法实践评估研究。该评估涉及一个由医生推荐的患者队列,对图表审查数据进行了预分析和后分析,这些数据与美国糖尿病协会的糖尿病指标相对应。在基线和 12 个月时对患者的图表进行了审查。向提供者和工作人员发放了一份简短的调查问卷,以确定认证糖尿病教育者培训生作为医疗实践团队的一部分被认为有多大用处。

结果

在参加糖尿病课程的 74 名患者中,A1C 水平从平均 8.8%降至 8.3%。在基线时(A1C≥9)糖尿病控制不佳的患者亚组(35%)中,A1C 水平下降了 15%。在接受糖尿病教育者(无论是在糖尿病教育课程中还是一对一就诊中)治疗的 219 名患者中,总体上观察到 A1C 水平的改善。

结论

结果表明,让认证糖尿病教育者培训生成为初级保健实践团队的一部分可能会促进糖尿病护理,因为葡萄糖控制得到了改善。提供者和工作人员的反应表明,认证糖尿病教育者培训生很好地融入了实践,并被认为对教育患者更好地管理糖尿病起到了重要作用。

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