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    Opportunities and challenges for diabetes prevention at two community health centers

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    Authors
    Rosal, Milagros C.
    Benjamin, Evan M.
    Pekow, Penelope S.
    Lemon, Stephenie C.
    von Goeler, Dorothea S.
    UMass Chan Affiliations
    Department of Medicine, Division of Preventive and Behavioral Medicine
    Document Type
    Journal Article
    Publication Date
    2008-02-09
    Keywords
    Adult
    *Community Health Centers
    Delivery of Health Care
    Diabetes Mellitus
    Diabetes Mellitus, Type 2
    Documentation
    Health Knowledge, Attitudes, Practice
    *Health Promotion
    Humans
    Interviews as Topic
    Language
    Medical Audit
    Medical Records
    Patient Education as Topic
    Patient Selection
    Teaching
    Behavioral Disciplines and Activities
    Community Health and Preventive Medicine
    Life Sciences
    Medicine and Health Sciences
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    Link to Full Text
    http://dx.doi.org/10.2337/dc07-0746
    Abstract
    OBJECTIVE: Translating evidence-based diabetes prevention interventions to disadvantaged groups is a public health priority that poses unique challenges. Community health centers (CHCs) provide unequaled opportunities to prevent diabetes among poor and minority high-risk groups. This formative study sought to assess structural, processes-of-care (health care quality domains), and patient factors that need to be considered for diabetes prevention at CHCs. RESEARCH DESIGN AND METHODS: A multimethod approach was implemented to assess system-, provider-, and patient-level factors at two large CHCs serving diverse urban communities. RESULTS: Medical chart audits (n = 303) showed limited documentation of risks. Provider surveys (n = 74) evidenced knowledge gaps regarding factors associated with increased diabetes risk, efficacy of pharmacological interventions, and low perceived efficacy in promoting patient behavior change. Patient focus groups (two groups) with at-risk Hispanics and African Americans suggested mixed knowledge regarding whether diabetes can be prevented, some knowledge gaps regarding factors related to risk, and multiple challenges for lifestyle change. CONCLUSIONS: Multiple and multilevel challenges to translating diabetes prevention interventions for the benefit of at-risk populations who seek care at CHCs were observed.
    Source
    Diabetes Care. 2008 Feb;31(2):247-54. Epub 2007 Nov 5. Link to article on publisher's site
    DOI
    10.2337/dc07-0746
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/38388
    PubMed ID
    17989311
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.2337/dc07-0746
    Scopus Count
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