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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
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1 to 25 of 356 Research Studies DisplayedMcClintock HF, Edmonds SE, Bogner HR
Adherence patterns to oral hypoglycemic agents among primary care patients with type 2 diabetes.
This study’s objective was to examine patterns of adherence to oral hypoglycemic agents among primary care patients with type 2 diabetes mellitus and to assess whether these patterns were associated with baseline intervention allocation, sociodemographic characteristics, and clinical indicators. Adherence patterns for 72 participants were examined by Medication Event Monitoring System (MEMS) caps at baseline and 12 weeks. Participants were randomly allocated to a Patient Prioritized Planning (PPP) intervention or a control group. A card-sort task was used in the PPP intervention to identify health-related priorities that included social determinants of health to address medication nonadherence. Afterward, a problem-solving process was used to address unmet needs involving referral to resources. Patients were found to be either adherent, increasingly adherent, or non-adherent. Participants assigned to the PPP intervention were significantly more likely to have a pattern of improving adherence and adherence than participants assigned to the control group.
AHRQ-funded; HS023445.
Citation: McClintock HF, Edmonds SE, Bogner HR .
Adherence patterns to oral hypoglycemic agents among primary care patients with type 2 diabetes.
Prim Care Diabetes 2023 Apr;17(2):180-84. doi: 10.1016/j.pcd.2023.01.014.
Keywords: Diabetes, Patient Adherence/Compliance, Primary Care, Medication, Chronic Conditions
AA Payán, DD Brown, TT
Telehealth use, care continuity, and quality: diabetes and hypertension care in community health centers before and during the COVID-19 pandemic.
In a cohort study, researchers examined the association of care continuity with diabetes and hypertension care quality in community health centers (CHCs) before and during COVID-19, and the mediating effect of telehealth. Patients with diabetes and/or hypertension with at least 2 encounters per year during 2019 and 2020 were identified via electronic health record data from 166 CHCs; multivariable logistic regression models estimated the association of care continuity with telehealth use and care processes. The results showed that higher care continuity was associated with telehealth use and A1c testing, and lower A1c and blood pressure. The researchers concluded that care continuity might facilitate telehealth use and resilient performance on process measures.
AHRQ-funded; HS022241.
Citation: AA Payán, DD Brown, TT .
Telehealth use, care continuity, and quality: diabetes and hypertension care in community health centers before and during the COVID-19 pandemic.
Med Care 2023 Apr 1;61(Suppl 1):S62-s69. doi: 10.1097/mlr.0000000000001811.
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Diabetes, Blood Pressure, Community-Based Practice, Public Health
Gay HC, Yu J, Persell SD
Comparison of sodium-glucose cotransporter-2 inhibitor and glucagon-like peptide-1 receptor agonist prescribing in patients with diabetes mellitus with and without cardiovascular disease.
Researchers sought to describe trends in prescribing for sodium-glucose cotransporter-2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP1-RAs) to reduce cardiovascular events and mortality in adult patients with type 2 diabetes mellitus (T2DM) in diverse care settings. Their focus was on outpatient clinics in a midwestern integrated health system and small- and medium-sized community-based primary care practices and health centers in three Midwestern states. Results showed that an increase in prescription rates was greater for SGLT2is than for GLP1-RAs in a large integrated medical center and community primary care practices; overall, prescription rates for eligible patients were low, and the researchers observed racial disparities.
AHRQ-funded; HS026385; HS023921.
Citation: Gay HC, Yu J, Persell SD .
Comparison of sodium-glucose cotransporter-2 inhibitor and glucagon-like peptide-1 receptor agonist prescribing in patients with diabetes mellitus with and without cardiovascular disease.
Am J Cardiol 2023 Feb 15; 189:121-30. doi: 10.1016/j.amjcard.2022.10.041..
Keywords: Diabetes, Cardiovascular Conditions, Chronic Conditions, Medication, Primary Care
Herman WH, Bullock A, Boltri JM
The National Clinical Care Commission report to Congress: background, methods, and foundational recommendations.
This AHRQ-authored paper describes the background, methods, and recommendations of the National Clinical Care Commission (NCCC) focused on factors likely to improve the delivery of high-quality care to all people with diabetes. It is the first in a series of five articles describing the recommendations. The Commission made recommendations at all levels: patient, practice, health system, and health policy. This is the first paper in a series of five articles about the NCCC recommendations. The five articles include recommendations to 1) reduce diabetes-related risks, prevent type 2 diabetes, and avert diabetes complications through changes in federal policies and programs affecting the general population; 2) prevent type 2 diabetes in at-risk individuals through targeted lifestyle and medication interventions; and 3) improve the treatment of diabetes and its complications to improve the health outcomes of people with diabetes. This first article reviews the successes and limitations of previous federal efforts to combat diabetes, describes the establishment of and charge to the NCCC, and discusses the development of a hybrid conceptual model that guided the NCCC’s novel all-of-government approach to address diabetes as a societal and medical problem. The authors then review the procedures used by the NCCC to gather information from federal agencies, stakeholders, key informants, and the public and to conduct literature reviews. Finally, they review the NCCC's three foundational recommendations: 1) improve the coordination of non-health-related and health-related federal agencies to address the social and environmental conditions that are accelerating the diabetes epidemic; 2) ensure that all Americans at risk for and with diabetes have health insurance and access to health care; and 3) ensure that all federal policies and programs promote health equity in diabetes.
AHRQ-authored; AHRQ-funded.
Citation: Herman WH, Bullock A, Boltri JM .
The National Clinical Care Commission report to Congress: background, methods, and foundational recommendations.
Diabetes Care 2023 Feb; 46(2):e14-e23. doi: 10.2337/dc22-0611..
Keywords: Diabetes, Chronic Conditions, Prevention, Research Methodologies
Schillinger D, Bullock A, Powell C
The National Clinical Care Commission report to Congress: leveraging federal policies and programs for population-level diabetes prevention and control: recommendations from the National Clinical Care Commission.
The purpose of this article was to explore and consider the National Clinical Care Commission’s (NCCC) population-wide recommendations focusing on food systems; consumption of water over beverages sweetened with sugar; labeling of food and beverages; marketing and advertising; workplace, ambient, and built environments; and research to address the myriad of complex factors contributing to Type 1 and 2 diabetes. The authors’ recommendations are directed toward federal policies, agencies, departments and programs, including the Environmental Protection Agency, the Food and Drug Administration, the Department of Housing and Urban Development, and others.
AHRQ-funded.
Citation: Schillinger D, Bullock A, Powell C .
The National Clinical Care Commission report to Congress: leveraging federal policies and programs for population-level diabetes prevention and control: recommendations from the National Clinical Care Commission.
Diabetes Care 2023 Feb; 46(2):e24-e38. doi: 10.2337/dc22-0619..
Keywords: Diabetes, Chronic Conditions, Policy, Prevention
Greenlee MC, Bolen S, Chong W
The National Clinical Care Commission report to Congress: leveraging federal policies and programs to improve diabetes treatment and reduce complications.
This paper is the fourth in a series of five articles describing the recommendations of the National Clinician Care Commission (NCCC) on diabetes care. This paper focused on the recommendations of the Treatment and Complications subcommittee of the National Clinical Care Commission. The Commission made recommendations at all levels: patient, practice, health system, and health policy. They also identified several areas that need additional research, such as studying the barriers to uptake of diabetes self-management education and support, exploring methods to implement team-based care, and evaluating the importance of digital connectivity as a social determinant of health.
AHRQ-funded.
Citation: Greenlee MC, Bolen S, Chong W .
The National Clinical Care Commission report to Congress: leveraging federal policies and programs to improve diabetes treatment and reduce complications.
Diabetes Care 2023 Feb; 46(2):e51-e59. doi: 10.2337/dc22-0621..
Keywords: Diabetes, Chronic Conditions, Policy, Prevention, Quality of Life
Boltri JM, Tracer H, Strogatz D
The National Clinical Care Commission report to Congress: leveraging federal policies and programs to prevent diabetes in people with prediabetes.
This article described the recommendations of a National Clinical Care Commission subcommittee focused primarily on the prevention of type 2 diabetes in people with prediabetes. The goal of these recommendations is to improve current Federal diabetes prevention activities by increasing awareness of and diagnosis of prediabetes on a population basis, facilitating FDA review and approval of metformin for diabetes prevention, and supporting research to enhance the effectiveness of diabetes prevention. The recommendations also highlight the importance of research to advance understanding of the etiology of and opportunities for prevention of type 1 diabetes.
AHRQ-authored; AHRQ-funded.
Citation: Boltri JM, Tracer H, Strogatz D .
The National Clinical Care Commission report to Congress: leveraging federal policies and programs to prevent diabetes in people with prediabetes.
Diabetes Care 2023 Feb; 46(2):e39-e50. doi: 10.2337/dc22-0620..
Keywords: Diabetes, Prevention, Chronic Conditions
Herman WH, Schillinger D, Bolen S
The National Clinical Care Commission report to Congress: recommendations to better leverage federal policies and programs to prevent and control diabetes.
This AHRQ-authored article is an overview paper of the recommendations of the National Clinical Care Commission (NCCC) Report to Congress to better leverage federal policies and programs to prevent and control diabetes. The NCCC surveyed federal agencies and conducted follow-up meetings with representatives from 10 health-related and 11 non-health-related federal agencies. They held 12 public meetings, solicited comments, met with numerous interested parties and key informants, and performed comprehensive literature reviews. The final report was transmitted to Congress in January 2022 and contained 39 specific recommendations, including 3 foundational recommendations that addressed the necessity of an all-of-government approach to diabetes, health equity, and access to health care. Recommendations were made at the general population level and the individual level to strengthen federal policies and programs to increase awareness of prediabetes and remove barriers to proven effective treatments for diabetes and its complications.
AHRQ-authored; AHRQ-funded.
Citation: Herman WH, Schillinger D, Bolen S .
The National Clinical Care Commission report to Congress: recommendations to better leverage federal policies and programs to prevent and control diabetes.
Diabetes Care 2023 Feb; 46(2):255-61. doi: 10.2337/dc22-1587..
Keywords: Diabetes, Chronic Conditions, Policy, Prevention
Conlin PR, Boltri JM, Bullock A
The National Clinical Care Commission report to Congress: summary and next steps.
This article summarized recommendations of the National Clinical Care Commission (NCCC) to prevent and control diabetes and its complications more effectively. The NCCC has determined that diabetes should not be considered solely as a medical problem but must also as a societal problem. Its recommendations cover policies and programs of both non-health-related and health-related federal agencies, including three recommendations that: non-health-related and health-related federal agencies coordinate their activities to better address diabetes; all federal agencies and departments ensure health equity as a guiding principle for their policies and programs that impact diabetes; all Americans have access to comprehensive and affordable health care. The NCCC also recommends that a coordinating Office of National Diabetes Policy be established.
AHRQ-authored; AHRQ-funded.
Citation: Conlin PR, Boltri JM, Bullock A .
The National Clinical Care Commission report to Congress: summary and next steps.
Diabetes Care 2023 Feb; 46(2):e60-e63. doi: 10.2337/dc22-0622..
Keywords: Diabetes, Chronic Conditions, Policy, Prevention
Weiner M, Adeoye P, Boeh MJ
Continuous glucose monitoring and other wearable devices to assess hypoglycemia among older adult outpatients with diabetes mellitus.
The purpose of this study was to assess whether vulnerable older adults could use wearable devices, and explore Hypoglycemia frequency over a two week period. The researchers recruited 10 participants with diabetes mellitus to pilot test a continuous glucometer, physical activity monitor, electronic medication bottles, and smartphones which that provided prompts about medications, behaviors, and symptoms. A sample of 70 then wore glucometers and activity monitors and used the smartphone and bottles for a duration of 2 weeks and provided feedback. The study found that patients were interested in assistance with the interpretation of graphs, had challenges with keeping the glucometers attached. Nearly 23% of respondents indicated that they never check their blood sugars. In two weeks of monitoring, 73% had HG and 42% had serious, clinically significant HG.
AHRQ-funded; HS024384.
Citation: Weiner M, Adeoye P, Boeh MJ .
Continuous glucose monitoring and other wearable devices to assess hypoglycemia among older adult outpatients with diabetes mellitus.
Appl Clin Inform 2023 Jan; 14(1):37-44. doi: 10.1055/a-1975-4136..
Keywords: Elderly, Diabetes, Chronic Conditions, Ambulatory Care and Surgery, Patient Self-Management, Medical Devices
Fareed N, Swoboda C, Singh P
Developing and testing an integrated patient mHealth and provider dashboard application system for type 2 diabetes management among Medicaid-enrolled pregnant individuals based on a user-centered approach: mixed-methods study.
The objective of this study was to develop user specifications for a tailored and integrated technology, patient application (mHealth) and provider dashboard, that provides a complete view of Medicaid-enrolled patients with type 2 diabetes (T2D) during pregnancy and to develop prototypes based on users’ needs. Participating patients and providers stated a core set of expectations for the mHealth and dashboard applications. Participants then provided feedback to improve these applications. The authors concluded that digital health tools could transform health care among Medicaid-enrolled patients with T2D during pregnancy, with the goal of managing their blood glucose levels. Refining the stated needs and preferences of patients and providers to develop applications holds potential for tackling complicated health care issues.
AHRQ-funded; HS028822.
Citation: Fareed N, Swoboda C, Singh P .
Developing and testing an integrated patient mHealth and provider dashboard application system for type 2 diabetes management among Medicaid-enrolled pregnant individuals based on a user-centered approach: mixed-methods study.
Digit Health 2023 Jan-Dec; 9:20552076221144181. doi: 10.1177/20552076221144181..
Keywords: Patient-Centered Healthcare, Telehealth, Diabetes, Pregnancy, Chronic Conditions, Women, Health Information Technology (HIT)
Rodriguez HP, Ciemins EL, Rubio K
Health systems and telemedicine adoption for diabetes and hypertension care.
This study examined differences in telemedicine use for adults with diabetes and/or hypertension across 10 health systems and analyzed practice and patient characteristics associated with greater use. Encounter-level data from the AMGA Optum Data Warehouse for March 13, 2020 to December 31, 2020 were analyzed. This included 3,016,761 clinical encounters from 764,521 adults with diabetes and/or hypertension attributed to 1 of 1207 practice sites with at least 50 system-attributed patients. Telemedicine use time was divided into adoption (weeks 0-4), de-adoption (weeks 5-12), and maintenance (weeks 13-42) periods. Telemedicine use peaked after 4 weeks at 11-42% of weekly encounters. Small practices had lower telemedicine use for adults with diabetes during the maintenance period compared with larger practices, with ownership showing no association with telemedicine use. Practices with higher proportions of Black patients continued their expansion of telemedicine use during the de-adoption and maintenance periods.
Citation: Rodriguez HP, Ciemins EL, Rubio K .
Health systems and telemedicine adoption for diabetes and hypertension care.
Am J Manag Care 2023 Jan; 29(1):42-49. doi: 10.37765/ajmc.2023.89302..
Keywords: Telehealth, Health Information Technology (HIT), Diabetes, Blood Pressure, Chronic Conditions
Mills J, Barnhart H
Screening for prediabetes and type 2 diabetes in children and adolescents.
This Putting Prevention into Practice case study is used to increase understanding of the USPSTF final recommendation on screening for prediabetes and type 2 diabetes in children and adolescents. A case study was presented using a 12-year-old-patient with no specific concerns but had gained 18 pounds since their last wellness visit and lives a sedentary lifestyle. The patient’s family history of type 2 diabetes mellitus in maternal and paternal grandparents is described. Three multiple-choice questions are presented regarding harms and benefits of screening for prediabetes and type 2 diabetes for that patient.
AHRQ-authored.
Citation: Mills J, Barnhart H .
Screening for prediabetes and type 2 diabetes in children and adolescents.
Am Fam Physician 2023 Jan; 107(1):79-80..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Diabetes, Screening, Evidence-Based Practice, Guidelines, Prevention, Chronic Conditions, Case Study
Lock LJ, Channa R, Brennan MB
Effect of health system on the association of rurality and level of disadvantage with receipt of diabetic eye screening.
The goal of this retrospective cohort study was to determine the role of level of disadvantage in diabetic eye screening to explain the effect of health systems on rural and urban disparities. Researchers used an all-payer, statewide claims database to include adult Wisconsin residents with diabetes who had claims billed throughout the baseline and measurement years. Results indicated that patients from urban underserved clinics were more likely to receive screening than those from rural underserved clinics; similar findings emerged for both Medicare and non-Medicare subgroups. The researchers concluded that health systems, especially those that serve urban underserved populations, have an opportunity to increase screening rates by leveraging health system-level interventions and supporting patients in overcoming barriers.
AHRQ-funded; HS026279.
Citation: Lock LJ, Channa R, Brennan MB .
Effect of health system on the association of rurality and level of disadvantage with receipt of diabetic eye screening.
BMJ Open Diabetes Res Care 2022 Dec;10(6):e003174. doi: 10.1136/bmjdrc-2022-003174..
Keywords: Rural Health, Access to Care, Screening, Diabetes, Eye Disease and Health, Disparities, Chronic Conditions, Health Systems
Sneed NM, Azuero A, Morrison SA
Prediabetes awareness is not associated with lower consumption of self-reported added sugar in U.S. adults.
This study examined whether prediabetes awareness is associated with lower consumption of self-reported added sugar in US adults 20 years and older. Cross-sectional data for 3314 adults with prediabetes were analyzed from 2013-2018 National Health and Nutrition Examination Survey data. Among 3314 adults, 528 reported being aware and 2786 were unaware of their condition. Prediabetes awareness was not significantly associated with added sugar consumption with no differences for age, sex, or race/Hispanic origin.
AHRQ-funded; HS026122.
Citation: Sneed NM, Azuero A, Morrison SA .
Prediabetes awareness is not associated with lower consumption of self-reported added sugar in U.S. adults.
Ann Epidemiol 2022 Nov;75:21-24. doi: 10.1016/j.annepidem.2022.08.039..
Keywords: Diabetes, Chronic Conditions, Education: Patient and Caregiver, Nutrition, Health Promotion
Glynn A, Hernandez I, Roberts ET
Consequences of forgoing prescription drug subsidies among low-income Medicare beneficiaries with diabetes.
This study’s objective was to estimate the take-up of the Medicare Part D Low-Income Subsidy (LIS) among Medicare beneficiaries with diabetes and examine differences in out-of-pocket costs and prescription drug use between LIS enrollees and LIS-eligible non-enrollees. Data from the Health and Retirement Study linked to Medicare administrative data from 2008 to 2016 was used. The authors first estimated LIS take-up stratified by income (≤100% of the Federal Poverty Level [FPL] and >100% to ≤150% of FPL). Second, to assess the consequences of forgoing the LIS among near-poor beneficiaries (incomes >100% to ≤150% of FPL), they conducted propensity score-weighted regression analyses to compare out-of-pocket costs, prescription drug use, and cost-related medication non-adherence among LIS enrollees and LIS-eligible non-enrollees. Among Medicare beneficiaries with diabetes, 68.1% of those considered near-poor (incomes >100% to ≤150% of FPL) received the LIS, compared to 90.3% of those with incomes ≤100% of FPL. Among near-poor beneficiaries, LIS-eligible non-enrollees incurred higher annual out-of-pocket drug spending ($518], filled 7.3 fewer prescriptions for diabetes, hypertension, and hyperlipidemia drugs, and were 8.9 percentage points more likely to report skipping drugs due to cost. all compared to LIS enrollees.
AHRQ-funded; HS026727.
Citation: Glynn A, Hernandez I, Roberts ET .
Consequences of forgoing prescription drug subsidies among low-income Medicare beneficiaries with diabetes.
Health Serv Res 2022 Oct;57(5):1136-44. doi: 10.1111/1475-6773.13990..
Keywords: Medication, Diabetes, Chronic Conditions, Low-Income, Medicare, Healthcare Costs
Jonas DE, Vander Schaaf EB, Riley S
Screening for prediabetes and type 2 diabetes in children and adolescents: evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this study was to explore the evidence on the benefits and harms of screening children and adolescents for prediabetes and type 2 diabetes to inform the US Preventive Services Task Force (USPSTF). The researchers utilized references; experts; literature surveillance, and PubMed/MEDLINE, Cochrane Library, and trial registries. The final review included 8 publications with 856 participants with a mean age of 14 years. The researchers found that none of the eligible studies directly assessed the benefits or harms of preventive screening. The limited eligible clinical trials reported few health outcomes and found no difference between groups.
AHRQ-funded; 290201500007I.
Citation: Jonas DE, Vander Schaaf EB, Riley S .
Screening for prediabetes and type 2 diabetes in children and adolescents: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Sep 13;328(10):968-79. doi: 10.1001/jama.2022.7957..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Diabetes, Screening, Prevention, Evidence-Based Practice, Guidelines
Grauer A, Duran AT, Liyanage-Don NA
Association between telemedicine use and diabetes risk factor assessment and control in a primary care network.
The purpose of this retrospective cohort study was to explore whether there is a relationship between telemedicine use in primary care and risk factor assessment and control for patients with diabetes mellitus. The study included patients with diabetes mellitus ages 18-75 with a telemedicine visit in a primary care network between February 2020 and December 2020. Researchers evaluated whether low-density lipoprotein cholesterol (LDL-C), blood pressure (BP), and hemoglobin A1c (HbA1c) and were assessed for each patient. The study identified 1,824 patients with diabetes during the study period and found that telemedicine use was associated with a lower proportion of patients with all three risk factors assessed. The researchers concluded that telemedicine use was related with gaps in risk factor assessment for patients with diabetes during the COVID-19 pandemic.
AHRQ-funded; HS026121; HS024262.
Citation: Grauer A, Duran AT, Liyanage-Don NA .
Association between telemedicine use and diabetes risk factor assessment and control in a primary care network.
J Endocrinol Invest 2022 Sep;45(9):1749-56. doi: 10.1007/s40618-022-01814-6..
Keywords: Diabetes, Chronic Conditions, Telehealth, Health Information Technology (HIT), Primary Care, Risk
Roddy MK, Mayberry LS, Nair D
Exploring mHealth potential to improve kidney function: secondary analysis of a randomized trial of diabetes self-care in diverse adults.
This study examined whether REACH, a text message-delivered self-management support intervention, which focuses on medication adherence, diet, and exercise can significantly improve glycemic control in 506 chronic kidney disease (CKD) patients with Type 2 Diabetes (T2D). The authors used data from the trial to explore the intervention’s effect on change in estimated glomerular filtration rate (eGR) at 12 months in a subsample of 271 patients. Patients with proteinuria at baseline who received REACH had less worsening of eGFR.
AHRQ-funded; HS026395.
Citation: Roddy MK, Mayberry LS, Nair D .
Exploring mHealth potential to improve kidney function: secondary analysis of a randomized trial of diabetes self-care in diverse adults.
BMC Nephrol 2022 Aug 10;23(1):280. doi: 10.1186/s12882-022-02885-6..
Keywords: Telehealth, Health Information Technology (HIT), Patient Self-Management, Diabetes, Chronic Conditions, Kidney Disease and Health, Patient Adherence/Compliance
Wallace DD, Barrington C, Albrecht S
The role of stress responses on engagement in dietary and physical activity behaviors among Latino adults living with prediabetes.
This study used qualitative methods to understand how Latinos with prediabetes attempted to modify their diet and physical activity behaviors to slow type-2 diabetes progression and how stress affected their engagement in these behaviors. Findings showed that stress affected behavioral and cognitive progresses that adversely altered primarily dietary behaviors.
AHRQ-funded; HS000032.
Citation: Wallace DD, Barrington C, Albrecht S .
The role of stress responses on engagement in dietary and physical activity behaviors among Latino adults living with prediabetes.
Ethn Health 2022 Aug;27(6):1395-409. doi: 10.1080/13557858.2021.1880549..
Keywords: Stress, Nutrition, Lifestyle Changes, Racial and Ethnic Minorities, Diabetes, Chronic Conditions
Brown SD, Hedderson MM, Gordon N
Reach, acceptability, and perceived success of a telehealth diabetes prevention program among racially and ethnically diverse patients with gestational diabetes: the gem cluster-randomized trial.
The purpose of this study was to describe overall and race/ethnicity-specific reach, acceptability, and perceived success from an effective telehealth diabetes prevention lifestyle program for patients with gestational diabetes mellitus, implemented in the Gestational Diabetes Effects on Moms (GEM) cluster-randomized controlled trial. An intervention of 13 telephone sessions and behavior change techniques (BCTs) in a healthcare system were tested by GEM. Survey respondents largely rated BCTs as very helpful. Black and White respondents reported more limited success reaching a healthy weight than Asian/Pacific Islander, Hispanic, and multiracial/other women. The researchers concluded that a telehealth diabetes prevention lifestyle program showed both reach and acceptability across racial/ethnic groups, and that similar interventions could encourage preventive care access and help reduce disparities in the risk for diabetes.
AHRQ-funded; HS019367.
Citation: Brown SD, Hedderson MM, Gordon N .
Reach, acceptability, and perceived success of a telehealth diabetes prevention program among racially and ethnically diverse patients with gestational diabetes: the gem cluster-randomized trial.
Transl Behav Med 2022 Jul 18;12(7):793-99. doi: 10.1093/tbm/ibac019..
Keywords: Diabetes, Chronic Conditions, Telehealth, Health Information Technology (HIT), Prevention, Lifestyle Changes
Patil SJ, Tallon E, Wang Y
Effect of Stanford Youth Diabetes Coaches' Program on youth and adults in diverse communities.
This study’s objective was to assess the effects of the Stanford Youth Diabetes Coaches’ Program (SYDCP) on youth and adults from a rural and urban underserved high school community. The program trains high school students to become diabetes coaches for friends and adult family members. The authors used the Patient-Reported Outcomes Measurement Information System (PROMIS) measure Pediatric Sense of Meaning and Purpose. Coached adults were surveyed using measures from PROMIS Adult Global Health and Self-Efficacy. Twenty-five students participated in the study, with 15 having coached adults with diabetes or prediabetes. Postintervention results included significant improvement in students’ sense of meaning and purpose. Youth and adult-relatedness also led to improved health behaviors.
AHRQ-funded; HS022140.
Citation: Patil SJ, Tallon E, Wang Y .
Effect of Stanford Youth Diabetes Coaches' Program on youth and adults in diverse communities.
Fam Community Health 2022 Jul-Sep;45(3):178-86. doi: 10.1097/fch.0000000000000323..
Keywords: Children/Adolescents, Diabetes, Health Promotion, Lifestyle Changes
Campbell JI, Dubois MM, Savage TJ
Comorbidities associated with hospitalization and progression among adolescents with symptomatic coronavirus disease 2019.
This study’s objective was to identify subgroups likely to benefit from monoclonal antibody and antiviral therapy to treat COVID-19 by evaluating the relationship between comorbidities and hospitalization among US adolescents aged 12-17 with symptomatic coronavirus disease 2019 (COVID-19). The authors used the Pediatric COVID-19 US registry to identify patients who met their inclusion criteria of comorbidities including obesity, chronic kidney disease (CKD), diabetes, immunosuppressive disease or treatment, sickle cell disease (SCD), heart disease, neurologic disease/neurodevelopmental disorders, and pulmonary disease (excluding patients with mild asthma). Out of 1877 total patients included 284 (15%) were hospitalized within 28 days of their COVID-19 diagnosis. The following comorbidities were associated with increased odds of hospitalization: SCD, immunocompromising condition, obesity, diabetes, neurologic disease, and pulmonary disease (excluding mild asthma).
AHRQ-funded; HS000063.
Citation: Campbell JI, Dubois MM, Savage TJ .
Comorbidities associated with hospitalization and progression among adolescents with symptomatic coronavirus disease 2019.
J Pediatr 2022 Jun;245:102-10.e2. doi: 10.1016/j.jpeds.2022.02.048..
Keywords: Children/Adolescents, Diabetes, Asthma, Kidney Disease and Health, Hospitalization
McQueen A, Kreuter MW, Herrick CJ
Associations among social needs, health and healthcare utilization, and desire for navigation services among US Medicaid beneficiaries with type 2 diabetes.
The purpose of this study was to determine the number and types of social needs experienced by Medicaid beneficiaries with type 2 diabetes and how these social needs are associated with key health indicators. Findings showed that having more social needs was associated with a wide range of indicators of poor health and well-being. Study participants with the greatest social need burden were most open to intervention.
AHRQ-funded; HS019455.
Citation: McQueen A, Kreuter MW, Herrick CJ .
Associations among social needs, health and healthcare utilization, and desire for navigation services among US Medicaid beneficiaries with type 2 diabetes.
Health Soc Care Community 2022 May;30(3):1035-44. doi: 10.1111/hsc.13296..
Keywords: Diabetes, Chronic Conditions, Medicaid, Social Determinants of Health
Brennan MB, Powell WR, Kaiksow F
Association of race, ethnicity, and rurality with major leg amputation or death among Medicare beneficiaries hospitalized with diabetic foot ulcers.
The authors report that diabetic foot ulcer patients self-identifying as Black and also those living in disadvantaged and rural neighborhoods are at an increased risk of above-ankle amputations. The purpose of the study was to evaluate Medicare beneficiaries hospitalized with diabetic foot ulcers to assess whether intersecting identities of Black race, ethnicity, and living in a disadvantaged neighborhood or rural residence were associated with a higher risk of major leg amputation or death. The retrospective study looked at 2013-2014 data from the US National Medicare Claims Data Database of patients hospitalized with a diabetic foot ulcer. The study focused on major leg amputation or death during hospitalization or within 30 days of discharge from the hospital. The study cohort included 124,487 patients with a mean age of 71.5 years. Of those, 71,286 were men (57.3%), 21,649 (17.4%) identified as Black, and 13,100 (10.5%) were rural. Major leg amputations or death were experienced by 17.6% of the cohort, 18.3% of rural patients, and 21.9% patients who identified as Black. The proportion of those experiencing major leg amputations or death among the 1239 rural patients identifying as Black was 28%, which exceeded by more than 2-fold the expected excess for rural patients plus those identifying as Black, reflecting a significant interaction between race and rural residence. The study concluded that rural patients identifying as Black had a more than 10% increased risk of major leg amputation or death when compared with the full cohort, and that when investigating disparities in major leg amputations and death in patients with diabetic foot ulcers, a perspective of intersectionality should be considered.
AHRQ-funded; HS026279.
Citation: Brennan MB, Powell WR, Kaiksow F .
Association of race, ethnicity, and rurality with major leg amputation or death among Medicare beneficiaries hospitalized with diabetic foot ulcers.
JAMA Netw Open 2022 Apr;5(4):e228399. doi: 10.1001/jamanetworkopen.2022.8399..
Keywords: Diabetes, Chronic Conditions, Racial and Ethnic Minorities
