Mentored implementation to initiate a diabetes program in an underserved community: a pilot study.

Area of Science:

• Diabetes Management
• Community Health
• Implementation Science

Background:

• Community clinics face barriers to research implementation.
• Mentoring is a potential strategy to overcome these barriers.
• The Telehealth-supported, Integrated Community Health Workers, Medication-access, group visit Education (TIME) program aims to improve diabetes care.

Purpose of the Study:

• To pilot an in-person and telehealth mentoring strategy for implementing the TIME program in a community clinic.
• To evaluate the impact of the TIME program on diabetes outcomes in low-income Latino(a)s.
• To assess changes in Community Health Worker (CHW) knowledge.

Main Methods:

• A two-phase, 6-month pilot study involving 55 low-income Latino(a)s with type 2 diabetes.
• Phase I: Randomized controlled trial comparing TIME intervention to usual care, with research team conducting TIME.
• Phase II: Mentorship model where clinic team implemented TIME with research team guidance for a new cohort.

Main Results:

• Intervention group showed significant improvements in HbA1c, weight, medication adherence, and American Diabetes Association (ADA) measures compared to control in Phase I.
• Phase II participants demonstrated significant reductions in HbA1c, blood pressure, BMI, weight, and medication adherence.
• CHW knowledge significantly improved from pre-test to post-tests.

Conclusions:

• A mentored approach effectively implemented the TIME program in a community clinic, leading to improved diabetes outcomes.
• The TIME program, delivered via a mentored approach, showed comparable results to research-run implementation.
• Larger, longer-duration studies are needed to confirm the potential of mentoring for community clinics.