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Topic: Diabetes / Insulin Resistance
Title: Systems Approach to Diabetes Prevention and Management
Status: Completed
Funding Source: Connecticut Health Foundation
Funding Period: 2007-2010
Study Design: N/A
Purpose: To enhance both access and quality of diabetes care in underserved communities and to ameliorate health-related disparities. The PRC directed and conducted an overall evaluation of initiatives based in 4 community health centers: Community Health Center, Inc. of Meriden, CT; Community Health Services, Inc. of Hartford, CT; Fair Haven Community Health Center, Inc. of New Haven, CT; and Staywell Health Care, Inc. of Waterbury, CT.
Further Study Details:

This study represents a first step in obtaining practice-based evidence for the efficacy for the efficacy of systems change to inform programs and policies at community health centers within the region and at a national level. Participating community health centers submitted proposals to introduce discrete systems change in their practices based on the Chronic Care Model (CCM). The funding enhanced ongoing work to assess the feasibility and efficacy of innovative systems changes targeting populations that carry a disproportionate burden of diabetes.

The proposals focused on:

  • improving the quality of diabetes care;
  • expanding and improving access to diabetes preventive and treatment services;
  • contributing to the understanding of diabetes disparities and effective interventions through research, best practices, and evaluation;
  • and increasing and improving racial and ethnic diabetes data collection and analysis
Findings: The four participating health centers implemented diabetes-focused interventions that appropriately relied on the Chronic Care Model. The extent to which elements of the CCM were incorporated into the programs varied from center to center, with a minimum of two elements included at each center. Community Health Center, Inc. had results contrary to expectations: improvements in total cholesterol and hemoglobin A1c (a measure of blood glucose control) in the control group, compared to an increase in total cholesterol and a more modest decrease in hemoglobin A1C in the intervention group. Staywell Health Center, Inc. reported non-significant improvements in diastolic blood pressure and total cholesterol and no changes in other measures from baseline as a result of its intervention (there was no control group). Fair Haven Community Health Center, Inc. reported high numbers of individuals reached, high program participation rates, and successful weight loss and maintenance of weight loss among participants. Community Health Services, Inc. found significant improvements in diastolic blood pressure, diet, and diabetes empowerment, and near significant improvements in other measures. These results suggest that the Chronic Care Model can be used effectively by community health centers to prevent clinical measures predictive of diabetes and diabetesrelated complications, but success is likely highly dependent upon the focus and intensity of the interventions.
Eligibility: N/A

Changed at: 1/18/2011 7:19 AM Changed by: Judy Treu
Created at: 8/31/2010 10:55 AM Created by: Griffin Hospital