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

Elizabeth M Vaughan1, Aanand D Naik2,3,4, Amber B Amspoker3,4

  • 1Department of Medicine, Baylor College of Medicine, Houston, Texas, USA elizabeth.vaughan@bcm.edu.

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Summary

A mentored approach successfully implemented the Telehealth-supported, Integrated Community Health Workers, Medication-access, group visit Education (TIME) program in a community clinic, improving diabetes outcomes for low-income Latino(a)s.

Keywords:
community medicinehealth services researchmedication adherencetelemedicine

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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.