TY - JOUR
T1 - A randomized controlled trial of the effects of nurse case manager and community health worker team interventions in urban African-Americans with type 2 diabetes
AU - Gary, Tiffany L.
AU - Batts-Turner, Marian
AU - Bone, Lee R.
AU - Yeh, Hsin Chieh
AU - Wang, Nae Yuh
AU - Hill-Briggs, Felicia
AU - Levine, David M.
AU - Powe, Neil R.
AU - Hill, Martha N.
AU - Saudek, Christopher
AU - Mcguire, Maura
AU - Brancati, Frederick Louis
N1 - Funding Information:
This work was funded by the National Institutes of Health (RO1-DK48117-09) and the Johns Hopkins Outpatient Department General Clinical Research Center (R00052).
Funding Information:
Project Sugar 2 is a randomized controlled trial funded by the National Institutes of Health (NIH) and set within a university-affiliated managed care organization (MCO). The MCO employs 100 primary care physicians in a staff-model practice at 19 sites, including five sites in the medically underserved areas of Baltimore City that were used for recruitment in this study. This network of community physicians provides care to 80,000 capitated patients under multiple contracts and to an additional 40,000 fee-for-service patients. One other university-affiliated primary care clinic was also included in recruitment.
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2004/2
Y1 - 2004/2
N2 - The objective of the study was to determine the effectiveness and cost-effectiveness of primary care and community-oriented interventions in managing HbA1c, blood pressure, and lipids, and reducing hospitalizations and emergency room visits over 2 years. We describe an ongoing, randomized controlled trial of 542 urban African-Americans with type 2 diabetes ages 25 years and older who are members of a university-affiliated managed-care organization in Baltimore, MD. The participants are 74% female, have a mean age of 58 years, and 35% have yearly incomes greater than US$7500. Participants were randomized to one of two intervention groups for a period of 2 years: (1) usual medical care plus minimal telephone intervention implemented by a trained lay health educator (control group) or (2) usual medical care plus intensive intervention implemented by a nurse case manager (NCM)/community health worker (CHW) team. The intensive NCM/CHW team executes individual plans of care using evidence-based algorithms that focus on traditional diabetes self-management, screening and management of diabetes-related complications, and social issues surrounding diabetes care. Face-to-face NCM visits are conducted in the clinic once per year and CHW visits are conducted in the participant's home one to three times per year, both with additional follow-up contacts as needed. Written and verbal feedback (when necessary) is provided to the participant's primary care physician. All participants are expected to attend a 24-month follow-up visit where data are collected by interviewers blinded to intervention assignment. As of May 1, 2003, recruitment is complete, interventions are being fully implemented, and 24-month follow-up visits are beginning. Baseline sociodemographic characteristics, health-care utilization, health behaviors, and clinical characteristics of the study population are reported. This study is designed to test the hypothesis that a primary-care-based NCM plus CHW team approach is an effective, practical, and economically feasible strategy for translating current knowledge about type 2 diabetes into high-quality health care for urban African-Americans.
AB - The objective of the study was to determine the effectiveness and cost-effectiveness of primary care and community-oriented interventions in managing HbA1c, blood pressure, and lipids, and reducing hospitalizations and emergency room visits over 2 years. We describe an ongoing, randomized controlled trial of 542 urban African-Americans with type 2 diabetes ages 25 years and older who are members of a university-affiliated managed-care organization in Baltimore, MD. The participants are 74% female, have a mean age of 58 years, and 35% have yearly incomes greater than US$7500. Participants were randomized to one of two intervention groups for a period of 2 years: (1) usual medical care plus minimal telephone intervention implemented by a trained lay health educator (control group) or (2) usual medical care plus intensive intervention implemented by a nurse case manager (NCM)/community health worker (CHW) team. The intensive NCM/CHW team executes individual plans of care using evidence-based algorithms that focus on traditional diabetes self-management, screening and management of diabetes-related complications, and social issues surrounding diabetes care. Face-to-face NCM visits are conducted in the clinic once per year and CHW visits are conducted in the participant's home one to three times per year, both with additional follow-up contacts as needed. Written and verbal feedback (when necessary) is provided to the participant's primary care physician. All participants are expected to attend a 24-month follow-up visit where data are collected by interviewers blinded to intervention assignment. As of May 1, 2003, recruitment is complete, interventions are being fully implemented, and 24-month follow-up visits are beginning. Baseline sociodemographic characteristics, health-care utilization, health behaviors, and clinical characteristics of the study population are reported. This study is designed to test the hypothesis that a primary-care-based NCM plus CHW team approach is an effective, practical, and economically feasible strategy for translating current knowledge about type 2 diabetes into high-quality health care for urban African-Americans.
KW - African-Americans
KW - Community health worker
KW - Interventions
KW - Nurse case manager
KW - Randomized trial
KW - Type 2 diabetes
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UR - http://www.scopus.com/inward/citedby.url?scp=10744222085&partnerID=8YFLogxK
U2 - 10.1016/j.cct.2003.10.010
DO - 10.1016/j.cct.2003.10.010
M3 - Article
C2 - 14980748
AN - SCOPUS:10744222085
SN - 0197-2456
VL - 25
SP - 53
EP - 66
JO - Controlled clinical trials
JF - Controlled clinical trials
IS - 1
ER -