J Health Care Poor Underserved. 2022;33(1):374-384. doi: 10.1353/hpu.2022.0028.
Diabetes self-management education and support (DSMES) is an evidence-based intervention to improve diabetes-related outcomes. Access to DSMES is limited for diverse and low-income groups, despite greater need for services to address health disparities. Providing DSMES in federally qualified health centers (FQHCs) may increase reach for priority populations, and further study is needed to evaluate this delivery model. This report examines program effectiveness, including outcomes by race/ethnicity and Medicaid status, among 1,247 enrollees in FQHC-based DSMES. There was substantial glycated hemoglobin (A1c) improvement overall (-0.98%) among a diverse, majority-Medicaid population. However, Medicaid beneficiaries were approximately half as likely to attend as other enrollees (p<.001), while Latinx and non-Latinx Black participants attended fewer sessions (p=.008 and p=.040, respectively). Additionally, Medicaid beneficiaries experienced less A1c improvement than others (p=.040). Findings are promising that FQHC-based delivery can increase access to high-quality DSMES, although further effort appears needed to ensure optimal outcomes for all.
糖尿病自我管理教育和支持（DSMES）是一种基于证据的干预措施，可改善与糖尿病相关的结果。尽管需要更多的服务来解决健康差距，但获得 DSMES 的机会仍然有限，尤其是在多样化和低收入群体中。在联邦合格的健康中心（FQHC）中提供 DSMES 可能会增加优先人群的服务覆盖范围，需要进一步研究来评估这种交付模式。本报告考察了 FQHC 为基础的 DSMES 项目的有效性，包括按种族/族裔和医疗补助状况划分的结果。在一个多样化的、以医疗补助为主的人群中，糖化血红蛋白（A1c）总体上有显著改善（-0.98%）。然而，医疗补助受益人的参与率大约只有其他参与者的一半（p<.001），而拉丁裔和非拉丁裔黑人参与者的参与次数较少（p=.008 和 p=.040，分别）。此外，医疗补助受益人的 A1c 改善程度低于其他人（p=.040）。这些发现表明，基于 FQHC 的服务交付可以增加高质量 DSMES 的可及性，但似乎需要进一步努力，以确保所有人都能获得最佳结果。
