TY - JOUR
T1 - Implementing a diabetes education program to reduce health disparities in south texas
T2 - Application of the re-aim framework for planning and evaluation
AU - Ory, Marcia G.
AU - Lee, Shinduk
AU - Towne, Samuel D.
AU - Flores, Starr
AU - Gabriel, Olga
AU - Smith, Matthew Lee
N1 - Funding Information:
This research is supported in part by the State of Texas’s legislative action to establish and support the Healthy South Texas initiative. Funds were administered through Texas A&M University Health Science Center grant number 23-183000. Acknowledgments: The authors would like to thank the Healthy South Texas team within the Texas A&M Health Science Center for their work to deliver and evaluate this program. A special thanks is given to the Diabetes Education Program trainers, educators, and staff in Corpus Christi and McAllen who are continually dedicated to improving lives in South Texas. Additionally, the authors would like to thank Carrie L. Byington, former Senior Vice President of the Texas A&M University Health Science Center and Vice Chancellor for Health Services of the Texas A&M University System (currently Executive Vice President and Head of UC Health at the University of California) and Susan Ballabina, Deputy Vice Chancellor for Texas A&M AgriLife for their leadership role in the Healthy South Texas initiative during the study period.
Funding Information:
Funding: This research is supported in part by the State of Texas’s legislative action to establish and support the Healthy South Texas initiative. Funds were administered through Texas A&M University Health Science Center grant number 23-183000.
Publisher Copyright:
© 2020 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2020/9/1
Y1 - 2020/9/1
N2 - Health disparities in diabetes management and control are well-documented. The objective of this study is to describe one diabetes education program delivered in the United States in terms of the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) Planning and Evaluation Framework. Questionnaires, clinical data, and administrative records were analyzed from 8664 adults with diabetes living in South Texas, an area characterized by high health disparities. The Diabetes Education Program delivered was a professionally led 12-month program involving 8 h of in-person workshop education followed by quarterly follow-up sessions. Changes in average blood glucose levels over the past 3 months (e.g., A1c levels) were the primary clinical outcome. Descriptive and multiple generalized linear mixed models were performed. This community-based initiative reached a large and diverse population, and statistically significant reductions in A1c levels (p < 0.01) were observed among participants with Type 2 diabetes at 3 months. These reductions in A1c levels were sustained at 6-, 9-, and 12-month follow-up assessments (p < 0.01). However, considerable attrition over time at follow-up sessions indicate the need for more robust strategies to keep participants engaged. For this diabetes education program, the RE-AIM model was a useful framework to present study processes and outcomes.
AB - Health disparities in diabetes management and control are well-documented. The objective of this study is to describe one diabetes education program delivered in the United States in terms of the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) Planning and Evaluation Framework. Questionnaires, clinical data, and administrative records were analyzed from 8664 adults with diabetes living in South Texas, an area characterized by high health disparities. The Diabetes Education Program delivered was a professionally led 12-month program involving 8 h of in-person workshop education followed by quarterly follow-up sessions. Changes in average blood glucose levels over the past 3 months (e.g., A1c levels) were the primary clinical outcome. Descriptive and multiple generalized linear mixed models were performed. This community-based initiative reached a large and diverse population, and statistically significant reductions in A1c levels (p < 0.01) were observed among participants with Type 2 diabetes at 3 months. These reductions in A1c levels were sustained at 6-, 9-, and 12-month follow-up assessments (p < 0.01). However, considerable attrition over time at follow-up sessions indicate the need for more robust strategies to keep participants engaged. For this diabetes education program, the RE-AIM model was a useful framework to present study processes and outcomes.
KW - Chronic disease management
KW - Diabetes education
KW - Health disparities
KW - Hispanic
KW - Implementation and dissemination research
KW - Intervention
KW - RE-AIM framework
KW - South Texas
UR - http://www.scopus.com/inward/record.url?scp=85090025309&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85090025309&partnerID=8YFLogxK
U2 - 10.3390/ijerph17176312
DO - 10.3390/ijerph17176312
M3 - Article
C2 - 32872662
AN - SCOPUS:85090025309
SN - 1661-7827
VL - 17
SP - 1
EP - 19
JO - International journal of environmental research and public health
JF - International journal of environmental research and public health
IS - 17
M1 - 6312
ER -