Opportunities and challenges for diabetes prevention at two community health centers
Department of Medicine, Division of Preventive and Behavioral Medicine
Adult; *Community Health Centers; Delivery of Health Care; Diabetes Mellitus; Diabetes Mellitus, Type 2; Documentation; Health Knowledge, Attitudes, Practice; *Health Promotion; Humans; Interviews as Topic; Language; Medical Audit; Medical Records; Patient Education as Topic; Patient Selection; Teaching
Behavioral Disciplines and Activities | Community Health and Preventive Medicine | Life Sciences | Medicine and Health Sciences
OBJECTIVE: Translating evidence-based diabetes prevention interventions to disadvantaged groups is a public health priority that poses unique challenges. Community health centers (CHCs) provide unequaled opportunities to prevent diabetes among poor and minority high-risk groups. This formative study sought to assess structural, processes-of-care (health care quality domains), and patient factors that need to be considered for diabetes prevention at CHCs.
RESEARCH DESIGN AND METHODS: A multimethod approach was implemented to assess system-, provider-, and patient-level factors at two large CHCs serving diverse urban communities.
RESULTS: Medical chart audits (n = 303) showed limited documentation of risks. Provider surveys (n = 74) evidenced knowledge gaps regarding factors associated with increased diabetes risk, efficacy of pharmacological interventions, and low perceived efficacy in promoting patient behavior change. Patient focus groups (two groups) with at-risk Hispanics and African Americans suggested mixed knowledge regarding whether diabetes can be prevented, some knowledge gaps regarding factors related to risk, and multiple challenges for lifestyle change.
CONCLUSIONS: Multiple and multilevel challenges to translating diabetes prevention interventions for the benefit of at-risk populations who seek care at CHCs were observed.
DOI of Published Version
Diabetes Care. 2008 Feb;31(2):247-54. Epub 2007 Nov 5. Link to article on publisher's site
Rosal MC, Benjamin EM, Pekow PS, Lemon SC, von Goeler DS. (2008). Opportunities and challenges for diabetes prevention at two community health centers. Open Access Publications by UMMS Authors. https://doi.org/10.2337/dc07-0746. Retrieved from https://escholarship.umassmed.edu/oapubs/1253