Improving A1c Values and Type 2 Diabetes Self-management in an Underserved Community
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Date
2020-05
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Publisher
The Ohio State University
Abstract
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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Keywords
Type 2 diabetes, Diabetes self-management, Telehealth, Glycemic control, Motivational interviewing, Access to care