Chambers Earle C, Rehm Colin D, Correra Jordan, Garcia Lydia Elena, Marquez Melinda E, Wylie-Rosett Judith, Parsons Amanda
Albert Einstein College of Medicine, Department of Family and Social Medicine, 1300 Morris Park Ave, Block 408, Bronx, NY 10461. Email:
Office of Community and Population Health, Montefiore Health System, Bronx, New York.
Prev Chronic Dis. 2017 Mar 30;14:E28. doi: 10.5888/pcd14.160486.
The reach of the New York State YMCA's Diabetes Prevention Program (DPP) to at-risk populations may be increased through integration with primary care settings. Although considerable effort has been made in the referral and retention of patients, little is known about the factors associated with the placement of potential participants into YMCA's DPP.
Among Montefiore Health System (MHS) patients referred to YMCA's DPP (n = 1,249) from July 10, 2010, through November 11, 2015, we identified demographic factors (eg, age, preferred language) and primary care practice-level factors (eg, time between referral and start of session, session season) associated with placement into a session and subsequent drop-out. We also evaluated factors associated with weight loss.
Patients were predominantly female (71%) and aged 45 years or older (71%). Patients preferring sessions in Spanish were less often placed in sessions. Patients aged 18 to 44 years were less often placed (P = .01) and enrolled (P = .001) than patients aged 60 years or older. Sessions conducted in the summer and spring had higher enrollment than fall and winter months. Patients who started the YMCA's DPP within 2 months of their referral date were more often enrolled (54.4%) than patients who waited 4 or more months (21.6%) to start their sessions. Patients aged 45 to 59 years lost marginally less weight than those aged 60 years or older (-3.1% vs -3.8%; P = .07).
Although this evaluation gives some insight into the barriers to placement and enrollment in YMCA's DPP, challenges remain. Efforts are under way to increase referral of patients to community-based DPPs.
通过与初级保健机构整合,纽约州基督教青年会糖尿病预防计划(DPP)覆盖高危人群的范围可能会扩大。尽管在患者转诊和留存方面已付出巨大努力,但对于潜在参与者进入基督教青年会DPP的相关因素却知之甚少。
在2010年7月10日至2015年11月11日转诊至基督教青年会DPP的蒙特菲奥里医疗系统(MHS)患者(n = 1249)中,我们确定了与参加课程及后续退出相关的人口统计学因素(如年龄、首选语言)和初级保健机构层面的因素(如转诊至课程开始的时间、课程季节)。我们还评估了与体重减轻相关的因素。
患者以女性为主(71%),年龄在45岁及以上(71%)。更喜欢西班牙语课程的患者较少能参加课程。18至44岁的患者比60岁及以上的患者更难参加课程(P = 0.01)和注册入组(P = 0.001)。夏季和春季开展的课程注册率高于秋季和冬季月份。在转诊日期后2个月内开始参加基督教青年会DPP的患者比等待4个月或更长时间才开始课程的患者更常注册入组(54.4%对21.6%)。45至59岁的患者体重减轻幅度略低于60岁及以上的患者(-3.1%对-3.8%;P = 0.07)。
尽管该评估对基督教青年会DPP的参加和注册障碍有一定了解,但挑战依然存在。目前正在努力增加将患者转诊至社区DPP的数量。