Article Figures & Data
Figures
- Figure 1.
Study design flow chart. EMR, electronic medical record; PVA, previsit assessment; SES, self-efficacy scale.
Tables
HOW MOTIVATED ARE YOU IN GETTING BETTER CONTROL OF YOUR DIABETES? 1 2 3 4 5 6 7 8 9 10 NOT READY SOMEWHAT READY VERY READY HOW LONG HAVE YOU HAD DIABETES? PHARMACIST/PHYSICIAN: Do you have a blood sugar meter to check your blood sugar? And the supplies that go with the meter? Do you know how to check your blood sugar? When does the doctor want you to check your blood sugar? How many times a day do you actually check your blood sugar? Has it been hard for you to check your blood sugar? Are you able to get your diabetic medications from the pharmacy every month? Do you have trouble taking any of your diabetic medications or injecting insulin? Do any of your diabetic medications make you sick? SOCIAL WORK: Do you ever not have access to enough food to eat 3 meals a day? Is it hard for you to make it to your doctor appointments? NUTRITION: Who prepares your meals? How many meals do you eat daily? And what are they? Do you eat snacks during the day? Between which meals? What kinds of snacks? BEHAVIORAL HEALTH: Who helps you manage your diabetes? How does having diabetes make you feel? PATIENT STATED GOAL: NOT AT ALL CONFIDENT TOTALLY CONFIDENT 1. HOW CONFIDENT DO YOU FEEL THAT YOU CAN EAT YOUR MEALS EVERY 4 TO 5 HOURS EVERY DAY, INCLUDING BREAKFAST EVERY DAY? 1 2 3 4 5 6 7 8 9 10 2. HOW CONFIDENT DO YOU FEEL THAT YOU CAN FOLLOW YOUR DIET WHEN YOU HAVE TO PREPARE OR SHARE FOOD WITH OTHER PEOPLE WHO DO NOT HAVE DIABETES? 1 2 3 4 5 6 7 8 9 10 3. HOW CONFIDENT DO YOU FEEL THAT YOU CAN CHOOSE THE APPROPRIATE FOODS TO EAT WHEN YOU ARE HUNGRY (FOR EXAMPLE, SNACKS)? 1 2 3 4 5 6 7 8 9 10 4. HOW CONFIDENT DO YOU FEEL THAT YOU CAN EXERCISE 15 TO 30 MINUTES, 4 TO 5 TIMES A WEEK? 1 2 3 4 5 6 7 8 9 10 5. HOW CONFIDENT DO YOU FEEL THAT YOU CAN DO SOMETHING TO PREVENT YOUR BLOOD SUGAR LEVEL FROM DROPPING WHEN YOU EXERCISE? 1 2 3 4 5 6 7 8 9 10 6. HOW CONFIDENT DO YOU FEEL THAT YOU KNOW WHAT TO DO WHEN YOUR BLOOD SUGAR LEVEL GOES HIGHER OR LOWER THAN IT SHOULD BE? 1 2 3 4 5 6 7 8 9 10 7. HOW CONFIDENT DO YOU FEEL THAT YOU CAN JUDGE WHEN THE CHANGES IN YOUR ILLNESS MEAN YOU SHOULD VISIT THE DOCTOR? 1 2 3 4 5 6 7 8 9 10 8. HOW CONFIDENT DO YOU FEEL THAT YOU CAN CONTROL YOUR DIABETES SO THAT IT DOES NOT INTERFERE WITH THE THINGS YOU WANT TO DO? 1 2 3 4 5 6 7 8 9 10 9. IN GENERAL, WOULD YOU SAY YOUR HEALTH IS: Excellent | Very Good | Good | Fair | Poor 10. HOW LIKELY ARE YOU TO RECOMMEND ELIZABETH FAMILY MEDICINE TO YOUR FRIENDS AND FAMILY WHO HAVE DIABETES? Very Likely | Somewhat Likely | Neither Likely or Unlikely | Somewhat Unlikely | Very Unlikely 11. WHAT COULD WE HAVE DONE BETTER WHEN PROVIDING DIABETES CARE? 12. WHICH OF THE FOLLOWING BEST DESCRIBES YOUR RACE OR THE RACE WITH WHICH YOU BEST IDENTIFY? American Indian or Alaska Native | Asian | Black or African American | Native Hawaiian or Other Pacific Islander | Caucasian | Other 13. WHAT DO YOU CONSIDER TO BE YOUR ETHNICITY? Hispanic or Latino | Non-Hispanic or Latino | Unknown 14. WHAT IS YOUR HIGHEST LEVEL OF EDUCATION? Less than high school | HS graduate/GED | Some college | Associate's degree | Bachelor's degree | Master's degree | Professional degree | Doctorate degree Intervention Group (n = 36) Control Group (n = 38) P Value Age, mean (SD) 55.4 (9.7) 54.6 (11.9) 0.75 Age, n (%) 0.75 18 to 44 4 (11.1) 7 (18.4) 45 to 64 25 (69.4) 23 (60.5) 65+ 7 (19.4) 8 (21.1) Gender, n (%) 0.24 Male 12 (33.3) 14 (36.8) Female 24 (66.7) 24 (63.2) Ethnicity, n (%) 0.24 Hispanic or Latino 0 (0.0) 3 (7.9) Non-Hispanic or Latino 36 (100.0) 35 (92.1) Race, n (%) 0.42 African American 32 (88.9) 35 (92.1) Caucasian 4 (11.1) 2 (5.3) Other 0 (0.0) 1 (2.6) Education, n (%) 0.14 < High school 6 (16.6) 11 (29.0) High school graduate/GED 13 (36.1) 6 (15.8) Some college 8 (22.2) 15 (39.5) Associate's cegree 3 (8.3) 2 (5.3) College graduate or higher 6 (16.6) 4 (10.5) BMI, n (%) 0.13 Underweight < 18.5 0 (0.0) 0 (0.0) Normal 18.5 to 24.9 0 (0.0) 1 (2.6) Overweight 25.0 to 29.9 6 (16.7) 11 (29.0) Obese ≥30 25 (69.4) 26 (68.4) Baseline smoking status (within last year) 0.10 Smoker 4 (11.8) 10 (27.8) Nonsmoker 30 (88.2) 25 (69.4) BMI, body mass index; SD, standard deviation.
- Table 4.
Comparison of Clinical and Behavioral Outcomes at Baseline and 6-Month Visit Among Patients Enrolled in Diabetes Clinic Study
Intervention Group (n = 36) Control Group (n = 38) P Value for Between-Group Comparison of Baseline to 6-Month Change† Baseline 6 Months P Value* Baseline 6 Months P Value* Weight, mean (SD) 219.3 (56.4) 217.0 (56.0) 0.73 230.6 (61.1) 226.0 (52.5) 0.51 1.0 A1c, mean (SD) 10.6 (1.4) 8.2 (1.7) <0.01 10.2 (1.8) 9.1 (2.0) <0.01 0.02 SBP, mean (SD) 129.8 (14.1) 128.6 (19.3) 0.84 134.1 (20.6) 128.5 (22.3) 0.06 0.49 PHQ-9, n (%) 1.0 0.08 0.17 ≤15 29 (96.7%) 28 (96.6%) 31 (83.8%) 31 (93.9%) >15 1 (3.3%) 1 (3.4%) 6 (16.2%) 2 (6.1%) Self-efficacy,‡ mean (SD) 7.2 (1.6) 8.0 (1.5) 0.01 7.0 (1.8) 7.3 (1.5) 0.26 0.05 Self-rated health, n (%) 0.11 0.08 0.49 Excellent/Very Good 7 (19.4%) 10 (31.3%) 3 (7.9%) 9 (25.0%) Good 15 (41.7%) 13 (40.6%) 16 (42.1%) 9 (25.0%) Fair 9 (25.0%) 7 (21.9%) 17 (44.7%) 15 (41.7%) Poor 5 (13.9%) 2 (6.3%) 2 (5.3%) 3 (8.3%) ↵* Within-group change from baseline to 6 months was analyzed using the paired t-test for weight, A1c, SBP, and self-efficacy; McNemar's test for PHQ-9 (binary); and the Wilcoxon signed-rank test for self-rated health.
↵† For weight, A1c, systolic blood pressure (SBP), self-efficacy, and self-rated health, between-group comparisons of baseline to 6-month change were performed using generalized linear models with the 6-month measure as the dependent variable, group (intervention, control) as the primary independent variable, and the baseline measure as a covariate. For PHQ-9 (binary), the Breslow-Day test was used for this purpose.
↵‡ The self-efficacy composite score was calculated as the average of items 1-8.22
PHQ-9, 9-item Patient Health Questionnaire; SD, standard deviation.
- Table 5.
Comparison of A1c at Baseline and 12-Month Visit Among Patients Enrolled in Diabetes Clinic Study
Intervention Group Control Group P Value for Between-Group Comparison of Baseline to 12-Month Change Baseline (n = 36) 12 Months (n = 27) P Value Baseline (n = 38) 12 Months (n = 28) P Value A1c, mean (SD) 10.6 (1.4) 7.7 (1.2) <0.01 10.2 (1.8) 9.0 (2.1) <0.01 <0.01 SD, standard deviation.
