Racial/ethnic and socioeconomic disparities in the quality of care and outcomes of patients with diabetes have been widely documented, yet relatively little is known about how to reduce these differences. In particular, innovative, sustainable models to improve regional diabetes care are desperately needed that take into account the cultural, racial, organizational, and economic realities of the urban health setting. Previously the investigators have systematically identified gaps in the literature regarding effective interventions to reduce diabetes disparities. This proposal seeks to address these knowledge gaps in an innovative, sustainable way that can be replicated in other areas of the country. The primary goal is to test whether a multi-factorial intervention can improve the quality of care and outcomes of diabetes patients living in predominantly low- income African-American communities, through collaboration between community health centers, an academic medical center, and community-based organizations.
The Specific Aims are: 1) To test the effectiveness of a collaborative model program implemented within six clinics on the South Side of Chicago on the quality of diabetes care and outcomes. This multi-factorial intervention incorporates culturally tailored patient activation, cultural competency and communication training for clinicians, and clinic redesign with patient advocates, a quality improvement collaborative, care management, and enhanced community partnerships. The intervention also seeks to increase the number of persons with diabetes from underserved populations who access comprehensive care in safety net health centers through patient advocates and partnerships with community- based organizations. 2) To identify the costs of intervention implementation from the business case perspective of the outpatient clinics and from a societal perspective. 3) To determine the major barriers and solutions to successfully implementing this regional intervention. The study team has expertise in outcomes research, culturally tailored behavioral change, cultural competency training, regional quality improvement collaboratives, race studies, economic analyses, organizational theory, and community-based participatory research.

Public Health Relevance

Innovative, sustainable models to improve regional diabetes care are desperately needed that take into account the cultural, racial, organizational, and economic realities of the urban health setting. This proposal seeks to address acknowledged gaps in an innovative, sustainable way that can be replicated in other areas of the country. The primary goal is to test whether a multi-factorial intervention can improve the quality of care and outcomes of diabetes patients living in predominantly low-income African-American communities, through collaboration between community health centers, an academic medical center, and community-based organizations.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Demonstration and Dissemination Projects (R18)
Project #
5R18DK083946-03
Application #
8322161
Study Section
Special Emphasis Panel (ZDK1-GRB-1 (M1))
Program Officer
Hunter, Christine
Project Start
2010-08-05
Project End
2015-07-31
Budget Start
2012-08-01
Budget End
2013-07-31
Support Year
3
Fiscal Year
2012
Total Cost
$503,198
Indirect Cost
$180,635
Name
University of Chicago
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
005421136
City
Chicago
State
IL
Country
United States
Zip Code
60637
Raffel, Katie E; Goddu, Anna P; Peek, Monica E (2014) "I Kept Coming for the Love": Enhancing the Retention of Urban African Americans in Diabetes Education. Diabetes Educ 40:351-360
Chin, Marshall H; Goddu, Anna P; Ferguson, Molly J et al. (2014) Expanding and sustaining integrated health care-community efforts to reduce diabetes disparities. Health Promot Pract 15:29S-39S
Peek, Monica E; Ferguson, Molly J; Roberson, Tonya P et al. (2014) Putting theory into practice: a case study of diabetes-related behavioral change interventions on Chicago's South Side. Health Promot Pract 15:40S-50S
Nundy, Shantanu; Mishra, Anjuli; Hogan, Patrick et al. (2014) How do mobile phone diabetes programs drive behavior change? Evidence from a mixed methods observational cohort study. Diabetes Educ 40:806-19
Peek, Monica E; Ferguson, Molly; Bergeron, Nyahne et al. (2014) Integrated community-healthcare diabetes interventions to reduce disparities. Curr Diab Rep 14:467
Nundy, Shantanu; Lu, Chen-Yuan E; Hogan, Patrick et al. (2014) Using Patient-Generated Health Data From Mobile Technologies for Diabetes Self-Management Support: Provider Perspectives From an Academic Medical Center. J Diabetes Sci Technol 8:74-82
Nundy, Shantanu; Dick, Jonathan J; Chou, Chia-Hung et al. (2014) Mobile phone diabetes project led to improved glycemic control and net savings for Chicago plan participants. Health Aff (Millwood) 33:265-72
Nundy, Shantanu; Dick, Jonathan J; Solomon, Marla C et al. (2013) Developing a behavioral model for mobile phone-based diabetes interventions. Patient Educ Couns 90:125-32
Peek, Monica E; Wilkes, Abigail E; Roberson, Tonya S et al. (2012) Early lessons from an initiative on Chicago's South Side to reduce disparities in diabetes care and outcomes. Health Aff (Millwood) 31:177-86