Kwan Bethany M, Jortberg Bonnie, Warman Meredith K, Kane Ilima, Wearner Robyn, Koren Romona, Carrigan Thomas, Martinez Vincent, Nease Donald E
Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
Colorado Foundation for Public Health and the Environment, Denver, CO, USA and.
Fam Pract. 2017 Jun 1;34(3):358-363. doi: 10.1093/fampra/cmw127.
Self-management support (SMS) for patients with diabetes can improve adherence to treatment, mitigate disease-related distress, and improve health outcomes. Translating this evidence into real-world practice is needed, as it is not clear which SMS models are acceptable to patients, and feasible and sustainable for primary care practices.
To use the Boot Camp Translation (BCT) method to engage patient, practice, community resource and research stakeholders in translation of evidence about SMS and diabetes distress into mutually acceptable care models and to inform patient-centred outcomes research (PCOR).
Twenty-seven diabetes care stakeholders, including patients and providers from a local network of federally qualified health centres participated.
Stakeholders met in-person and by conference call over the course of 8 months. Subject matter experts provided education on the diabetes SMS evidence. Facilitators engaged the group in discussions about barriers to self-management and opportunities for improving delivery of SMS.
BCT participants identified lack of social support, personal resources, trust, knowledge and confidence as barriers to diabetes self-management. Intervention opportunities emphasized peer support, use of multidisciplinary care teams and centralized systems for sharing information about community and practice resources. BCT informed new services and a PCOR study proposal.
Patients and family engaged in diabetes care research value peer support, group visits, and multidisciplinary care teams as key features of SMS models. SMS should be tailored to an individual patient's health literacy. BCT can be used to engage multiple stakeholders in translation of evidence into practice and to inform PCOR.
对糖尿病患者的自我管理支持（SMS）可以提高治疗依从性，减轻与疾病相关的痛苦，并改善健康结局。需要将这一证据转化为实际应用，因为尚不清楚哪些SMS模式为患者所接受，以及对初级保健机构而言是可行且可持续的。
运用新兵训练营转化（BCT）方法，让患者、医疗机构、社区资源和研究利益相关者参与将有关SMS和糖尿病痛苦的证据转化为相互认可的照护模式，并为以患者为中心的结局研究（PCOR）提供信息。
27名糖尿病照护利益相关者参与其中，包括来自当地联邦合格健康中心网络的患者和提供者。
利益相关者在8个月的时间里进行了面对面会议和电话会议。主题专家提供了有关糖尿病SMS证据的教育。协调人引导小组讨论自我管理的障碍以及改善SMS提供的机会。
BCT参与者确定缺乏社会支持、个人资源、信任、知识和信心是糖尿病自我管理的障碍。干预机会强调同伴支持、多学科照护团队的使用以及用于共享社区和医疗机构资源信息的集中系统。BCT为新服务和一项PCOR研究提案提供了信息。
参与糖尿病照护研究的患者和家庭重视同伴支持、小组就诊和多学科照护团队，将其视为SMS模式的关键特征。SMS应根据个体患者的健康素养进行调整。BCT可用于让多个利益相关者参与将证据转化为实践，并为PCOR提供信息。
