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Research ArticleOriginal Research

The Psychosocial Needs of Patients Participating in Diabetes Shared Medical Appointments

Andrea L. Nederveld, Dennis Gurfinkel, Patrick Hosokawa, R. Mark Gritz, L. Miriam Dickinson, Phoutdavone Phimphasone-Brady, Jeanette A. Waxmonsky and Bethany M. Kwan
The Journal of the American Board of Family Medicine December 2022, 35 (6) 1103-1114; DOI: https://doi.org/10.3122/jabfm.2022.220062R1
Andrea L. Nederveld
From Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO (ALN, JAW, BMK); Adult & Child Consortium for Health Outcomes Research & Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO (DG, PH, RMG, LMD, JAW, BMK); Eugene S. Farley, Jr. Health Policy Center, University of Colorado Anschutz Medical Campus, Aurora, CO (RMG); Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO (PPB).
MD, MPH
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Dennis Gurfinkel
From Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO (ALN, JAW, BMK); Adult & Child Consortium for Health Outcomes Research & Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO (DG, PH, RMG, LMD, JAW, BMK); Eugene S. Farley, Jr. Health Policy Center, University of Colorado Anschutz Medical Campus, Aurora, CO (RMG); Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO (PPB).
MPH
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Patrick Hosokawa
From Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO (ALN, JAW, BMK); Adult & Child Consortium for Health Outcomes Research & Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO (DG, PH, RMG, LMD, JAW, BMK); Eugene S. Farley, Jr. Health Policy Center, University of Colorado Anschutz Medical Campus, Aurora, CO (RMG); Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO (PPB).
MS
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R. Mark Gritz
From Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO (ALN, JAW, BMK); Adult & Child Consortium for Health Outcomes Research & Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO (DG, PH, RMG, LMD, JAW, BMK); Eugene S. Farley, Jr. Health Policy Center, University of Colorado Anschutz Medical Campus, Aurora, CO (RMG); Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO (PPB).
PhD
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L. Miriam Dickinson
From Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO (ALN, JAW, BMK); Adult & Child Consortium for Health Outcomes Research & Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO (DG, PH, RMG, LMD, JAW, BMK); Eugene S. Farley, Jr. Health Policy Center, University of Colorado Anschutz Medical Campus, Aurora, CO (RMG); Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO (PPB).
PhD
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Phoutdavone Phimphasone-Brady
From Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO (ALN, JAW, BMK); Adult & Child Consortium for Health Outcomes Research & Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO (DG, PH, RMG, LMD, JAW, BMK); Eugene S. Farley, Jr. Health Policy Center, University of Colorado Anschutz Medical Campus, Aurora, CO (RMG); Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO (PPB).
PhD
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Jeanette A. Waxmonsky
From Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO (ALN, JAW, BMK); Adult & Child Consortium for Health Outcomes Research & Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO (DG, PH, RMG, LMD, JAW, BMK); Eugene S. Farley, Jr. Health Policy Center, University of Colorado Anschutz Medical Campus, Aurora, CO (RMG); Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO (PPB).
PhD, LP
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Bethany M. Kwan
From Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO (ALN, JAW, BMK); Adult & Child Consortium for Health Outcomes Research & Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO (DG, PH, RMG, LMD, JAW, BMK); Eugene S. Farley, Jr. Health Policy Center, University of Colorado Anschutz Medical Campus, Aurora, CO (RMG); Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO (PPB).
PhD, MSPH
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Abstract

Background: Patient reported outcomes (PROs) for diabetes are self-reported and often give insight into outcomes important to people with diabetes. Federally Qualified Health Centers (FQHCs) see patients who may have higher levels of diabetes distress and lower levels of self-care behaviors.

Methods: The Invested in Diabetes study is a comparative effectiveness trial of diabetes Shared Medical Appointments (SMAs) in FQHCs and non-FQHC settings. PROs measure outcomes including validated measures on diabetes distress.

Setting and Participants: 616 people from 22 practices completed PROs prior to SMAs. At FQHCs, participants were younger (average 57.7 years vs 66.9 years, p < 0.0001), more likely to be female (36.8% vs 46.1%, p = 0.02), and fewer spoke English (72.7% vs 99.6%, p < 0.0001).

Results: At FQHCs, diabetes distress was higher (2.1 vs 1.8, P = .02), more people were current smokers (14.3% vs 4.7%, P = .0002), on insulin (48.9% vs 22.3%, P < .0001) and reported food insecurity (52.7% vs 26.2%, P < .0001). After controlling for sociodemographic factors, these differences were nonsignificant.

Conclusions: Higher numbers of patients at FQHCs report diabetes distress and food insecurity compared with patients in non-FQHC settings, indicating that patient social circumstances need to be considered as part of program implementation.

  • Patient-Centered Care
  • Patient Reported Outcome Measures
  • Self-Report
  • Shared Medical Appointments
  • Social Determinants of Health
  • Type 2 Diabetes
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The Journal of the American Board of Family Medicine: 35 (6)
The Journal of the American Board of Family Medicine
Vol. 35, Issue 6
November/December 2022
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The Psychosocial Needs of Patients Participating in Diabetes Shared Medical Appointments
Andrea L. Nederveld, Dennis Gurfinkel, Patrick Hosokawa, R. Mark Gritz, L. Miriam Dickinson, Phoutdavone Phimphasone-Brady, Jeanette A. Waxmonsky, Bethany M. Kwan
The Journal of the American Board of Family Medicine Dec 2022, 35 (6) 1103-1114; DOI: 10.3122/jabfm.2022.220062R1

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The Psychosocial Needs of Patients Participating in Diabetes Shared Medical Appointments
Andrea L. Nederveld, Dennis Gurfinkel, Patrick Hosokawa, R. Mark Gritz, L. Miriam Dickinson, Phoutdavone Phimphasone-Brady, Jeanette A. Waxmonsky, Bethany M. Kwan
The Journal of the American Board of Family Medicine Dec 2022, 35 (6) 1103-1114; DOI: 10.3122/jabfm.2022.220062R1
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Keywords

  • Patient-Centered Care
  • Patient Reported Outcome Measures
  • Self-Report
  • Shared Medical Appointments
  • Social Determinants of Health
  • Type 2 Diabetes

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