Article Figures & Data
Figures
- Figure 1.
IDEALL project overview. ATDM, an interactive telephone dictates self-management support system. The telephone diabetes management program queries patients with automated questions weekly, and includes nurse call-backs for out of range responses to touch tone responses.
Tables
- Table 1.
Description of Research Strategies Used to Increase Generalizability in the IDEALL Study
Recommended Strategy Anticipated Impact on Generalizability IDEALL Strategy Challenges and Trade-offs Patient sample reflects population diversity Minimize exclusions Results apply to broad range of patients since a broad range was included in the study Few clinical exclusion criteria applied and intervention offered in 3 languages IRB restrictions for direct patient contact led to a change in study design and recruitment strategy Some exclusion criteria, such as requiring patients to come to the clinic or to be in the area for 12 months may have restricted diversity Recruit patients from diverse clinic settings Results apply to broad range of patients irrespective of practice level conditions that may affect the delivery or quality of care Inclusion of as many CHNSF clinics as possible using a targeted recruitment of clinics with the largest number of eligible patients Logistics: needing to recruit patients over a short time period and setting up GMV at each clinic limited the number of clinics to 4 Balance of neighborhood and hospital-based clinics Interventions are relevant across patient groups and across settings Develop interventions that reflect primary care realities Implementation and adoption likely smoother and higher overall at the patient, clinician, and health care systems level Include patient, clinician, and clinic level input into the nature and design of interventions Adjunctive care model does not address the importance of having clinics independently integrate patient self-management supports into primary care settings and may not be sustainable Adjunctive care model chosen to provide extra care to patients without burdening clinics Compare clinically relevant alternatives Randomized design did not allow patients to select interventions, affecting acceptability to patients and clinics
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