Improving A1c Values and Type 2 Diabetes Self-management in an Underserved Community
Keywords:Type 2 diabetes
Access to care
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Publisher:The Ohio State University
Series/Report no.:The Ohio State University. College of Nursing Doctor of Nursing Practice Final Document Projects
The purpose of this project was to utilize telehealth to reinforce educational and behavioral interventions with adult individuals with type 2 diabetes (T2DM) at a medically-underserved health center to improve glycemic control and diabetes self-management. The project design was a pre-test/post-test quality improvement initiative that utilized motivational interviewing and SMART goal-setting in five telephone follow-up sessions over the course of 3 months. The Diabetes Self-Management Questionnaire (DSMQ) was utilized to measure self-management scores pre and post project implementation. The setting for this project was at a Federally Qualified Health Center (FQHC) that is situated within a medically underserved rural community. The project measured A1c, Diabetes Self-Management Questionnaire (DSMQ) scores, weight, Body Mass Index (BMI), blood pressure (BP), and patient satisfaction pre and post intervention. Post-intervention data as compared to pre-intervention data show that participants had a statistically significant difference in their A1C scores at 3 months. Diabetes self-management scores in glucose management and overall self-care scores were also statistically improved. Patient satisfaction was also measured at the end of the DSMQ post-intervention and most participants found it very helpful in their diabetes self-management. There were 8 participants that started the project with a systolic BP greater than 130. Of these eight participants, six improved their systolic BP post-intervention. There was no significant difference in weight or BMI data. In sum, use of telehealth for reinforcement of educational and behavioral interventions is effective in improving glycemic control and self-management in T2DM.
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