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从安全网医疗服务环境中启动远程同行指导中获得的真实世界见解。

Real-world insights from launching remote peer-to-peer mentoring in a safety net healthcare delivery setting.

机构信息

Department of Medicine, University of California, San Francisco, California, USA.

Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA.

出版信息

J Am Med Inform Assoc. 2021 Feb 15;28(2):365-370. doi: 10.1093/jamia/ocaa251.

Abstract

Peer mentors have been proven to improve diabetes outcomes, especially among diverse patients. Delivering peer mentoring via remote strategies (phone, text, mobile applications) is critical, especially in light of the recent pandemic. We conducted a real-world evaluation of a remote diabetes intervention in a safety-net delivery system in New York. We summarized the uptake, content, and pre-post clinical effectiveness for English- and Spanish-speaking participants. Of patients who could be reached, 71% (n = 690/974) were enrolled, and 90% of those (n = 618/690) participated in coaching. Patients and mentors had a mean of 32 check-ins, and each patient set an average of 10 goals. 29% of the participants accessed the program via the smartphone application. Among participants with complete hemoglobin A1c data (n = 179), there was an absolute 1.71% reduction (P < .01). There are multiple lessons for successful implementation of remote peer coaching into settings serving diverse patients, including meaningful patient-mentor matching and addressing social determinants.

摘要

同伴导师已被证明可以改善糖尿病的治疗效果,尤其是在不同种族的患者中。通过远程策略(电话、短信、移动应用程序)提供同伴指导至关重要,尤其是在最近的大流行背景下。我们对纽约一个保障系统中的远程糖尿病干预措施进行了真实世界的评估。我们总结了英语和西班牙语参与者的参与率、内容和前后临床效果。在可以联系到的患者中,71%(n=690/974)入组,其中 90%(n=618/690)参与了辅导。患者和导师平均进行了 32 次检查,每位患者平均设定了 10 个目标。29%的参与者通过智能手机应用程序访问该项目。在完成糖化血红蛋白数据(n=179)的参与者中,绝对降低了 1.71%(P<.01)。对于成功将远程同伴指导融入服务不同患者的环境,有多个经验教训,包括有意义的医患匹配和解决社会决定因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bc4/7883966/d2a0d7499164/ocaa251f1.jpg

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