Andress Lauri, Scalise Danny, Wright Jessica G, Moore Stephanie E
Department of Health Policy, Management & Leadership, West Virginia University Robert C. Byrd Health Sciences Center, School of Public Health, United States.
West Virginia Medical State Association, 4307 MacCorkle Avenue, Chaleston, WV 25304, United States.
Prev Med Rep. 2018 Jun 2;11:216-220. doi: 10.1016/j.pmedr.2018.06.002. eCollection 2018 Sep.
This study used a focus group in August 2017 (n = 9) to explore the perceptions of rural physicians to a state request to incorporate diabetes prevention screening into their West Virginia medical practice. Analysis of the data revealed that the participants did not think private physicians were equipped to incorporate diabetes prevention programming into their practice. Three categories emerged from the data analysis to explain the reasoning of the health practitioners on the incorporation of pre-diabetes screening and management into their practice.⁎The practice of medicine⁎Prevention is a mismatch⁎Social determinants of health In the end, the study revealed that a request for physicians to identify and refer at risk patients to a diabetes prevention program is problematic due to conceptual and structural issues. Based on the findings it does not appear at this time that private physicians in rural settings can incorporate diabetes prevention into their existing practice. To address conceptual and structural barriers the invitation to rural physicians must: 1) present evidence on how physicians may be effective in a diabetes management team; 2) include a model that demonstrates a limited, specific role and duties for the physician within a team setting; and last, 3) integrate physicians into an existing community-based network of social and human service providers set up to provide diabetes prevention services.
本研究于2017年8月采用焦点小组法（n = 9），以探讨乡村医生对该州要求将糖尿病预防筛查纳入其西弗吉尼亚州医疗实践的看法。数据分析显示，参与者认为私人医生没有能力将糖尿病预防项目纳入其医疗实践。数据分析得出了三类内容，用以解释医疗从业者将糖尿病前期筛查及管理纳入其实践的理由。⁎医学实践⁎预防存在不匹配⁎健康的社会决定因素 最后，该研究表明，要求医生识别有风险的患者并将其转介至糖尿病预防项目存在概念和结构问题。基于这些发现，目前看来乡村地区的私人医生无法将糖尿病预防纳入其现有医疗实践。为解决概念和结构障碍，向乡村医生发出的邀请必须：1）提供关于医生如何在糖尿病管理团队中发挥有效作用的证据；2）包含一个模型，展示医生在团队环境中的有限、特定角色和职责；最后，3）将医生纳入现有的基于社区的社会和人类服务提供者网络，该网络旨在提供糖尿病预防服务。
