![Page 1: Improving Diabetes Care and Outcomes on the South Side of Chicago](https://reader033.vdocuments.us/reader033/viewer/2022052316/55855cfcd8b42a54608b5330/html5/thumbnails/1.jpg)
www.alliancefordiabetes.org
University of Chicago
Improving Diabetes Care and Outcomes on the South
Side of Chicago
![Page 2: Improving Diabetes Care and Outcomes on the South Side of Chicago](https://reader033.vdocuments.us/reader033/viewer/2022052316/55855cfcd8b42a54608b5330/html5/thumbnails/2.jpg)
Improving Diabetes Care and Outcomes
on the South Side of Chicago
![Page 3: Improving Diabetes Care and Outcomes on the South Side of Chicago](https://reader033.vdocuments.us/reader033/viewer/2022052316/55855cfcd8b42a54608b5330/html5/thumbnails/3.jpg)
Alliance to Reduce Disparities in Diabetes
![Page 4: Improving Diabetes Care and Outcomes on the South Side of Chicago](https://reader033.vdocuments.us/reader033/viewer/2022052316/55855cfcd8b42a54608b5330/html5/thumbnails/4.jpg)
Diabetes Mellitus Death Rates (per 100,000) -by Community Area
![Page 5: Improving Diabetes Care and Outcomes on the South Side of Chicago](https://reader033.vdocuments.us/reader033/viewer/2022052316/55855cfcd8b42a54608b5330/html5/thumbnails/5.jpg)
Community Areas with the Lowest Median Household Income
At least 33% below the citywide average
PSA: 8 of 10
8 of Chicago’s 10
lowest income
communities are in
UCH’s primary
service area. Community Location
Median Household
Income
Oakland PSA $10,739
Riverdale PSA $13,178
Grand Boulevard PSA $14,178
Washington Park PSA $15,160
Woodlawn PSA $18,266
North Lawndale Other $18,342
Fuller Park PSA $18,412
Englewood PSA $18,955
Armour Square PSA $22,756
West Garfield Park Other $23,121
East Garfield Park Other $24,216
Douglas PSA $24,835
New City PSA $25,647
$38,625
$46,435
Chicago Average
Illinois Average
H
![Page 6: Improving Diabetes Care and Outcomes on the South Side of Chicago](https://reader033.vdocuments.us/reader033/viewer/2022052316/55855cfcd8b42a54608b5330/html5/thumbnails/6.jpg)
Project Goals
• Short-term goals:
– Improve access to care
– Improve quality of care
– Improve clinical outcomes
• Long-term goals:
– Strengthen partnerships among HCs, CBOs and University of
Chicago
– Empower communities to address diabetes
– Be sustainable
![Page 7: Improving Diabetes Care and Outcomes on the South Side of Chicago](https://reader033.vdocuments.us/reader033/viewer/2022052316/55855cfcd8b42a54608b5330/html5/thumbnails/7.jpg)
6 Participating Health Centers
– ACCESS Booker Family Health Center
– ACCESS Grand Boulevard Health Center
– Chicago Family Health Center
– Friend Family Health Center
– University of Chicago Kovler Diabetes Center
– University of Chicago Primary Care Group
![Page 8: Improving Diabetes Care and Outcomes on the South Side of Chicago](https://reader033.vdocuments.us/reader033/viewer/2022052316/55855cfcd8b42a54608b5330/html5/thumbnails/8.jpg)
Intervention
• Six health centers – 2 academic clinics
– 4 FQHCs
• Patient activation/ communication training
• Provider communication training
• Clinic Redesign
• Community Connections
![Page 9: Improving Diabetes Care and Outcomes on the South Side of Chicago](https://reader033.vdocuments.us/reader033/viewer/2022052316/55855cfcd8b42a54608b5330/html5/thumbnails/9.jpg)
Intervention
• Six health centers – 2 academic clinics
– 4 FQHCs
• Patient activation/ communication training
• Provider communication training
• Clinic Redesign
• Community Connections
![Page 10: Improving Diabetes Care and Outcomes on the South Side of Chicago](https://reader033.vdocuments.us/reader033/viewer/2022052316/55855cfcd8b42a54608b5330/html5/thumbnails/10.jpg)
Patient Intervention
• Patient communication training – Patient empowerment
– Culturally tailored diabetes education
– Shared decision-making
• Discuss (Information-Sharing)
• Debate (Deliberation)
• Decide (Decision-Making)
• 2-3 hr classes x 10 weeks
• Pilot (n=21):
– 86% attended > 70% classes
– Improved self-efficacy, self-mgnt
![Page 11: Improving Diabetes Care and Outcomes on the South Side of Chicago](https://reader033.vdocuments.us/reader033/viewer/2022052316/55855cfcd8b42a54608b5330/html5/thumbnails/11.jpg)
Changes in Self-Efficacy
Survey Question Number of Patients (n =21)
Baseline Post-Intervention P-value
I feel confident in my ability to
manage my diabetes
3.9 4.5 0.04
I feel capable of handling my
diabetes
3.8 4.5 0.01
I am able to do my own routine
diabetes care now
3.9 4.6 0.02
I am able to meet the challenge
of controlling my diabetes
3.9 4.2 0.28
![Page 12: Improving Diabetes Care and Outcomes on the South Side of Chicago](https://reader033.vdocuments.us/reader033/viewer/2022052316/55855cfcd8b42a54608b5330/html5/thumbnails/12.jpg)
Changes in Self-Efficacy: 3-month follow-up
Survey Question Number of Patients (n =21)
Baseline Post-Intervention P-value
I feel confident in my ability to
manage my diabetes
3.9 4.4 0.04
I feel capable of handling my
diabetes
3.8 4.6 0.02
I am able to do my own routine
diabetes care now
3.9 4.6 0.02
I am able to meet the challenge
of controlling my diabetes
3.9 4.4 0.16
![Page 13: Improving Diabetes Care and Outcomes on the South Side of Chicago](https://reader033.vdocuments.us/reader033/viewer/2022052316/55855cfcd8b42a54608b5330/html5/thumbnails/13.jpg)
Changes in Self-Care Behaviors
Survey Question Number of Patients (n =21)
Baseline Post-Intervention P-value
Healthful eating plan
3.4 5.1 0.002
Self-Foot Care 4.1 6.0 0.001
Self-Glucose Monitoring 4.4
6.2 0.04
Exercise 2.9 3.1 0.09
![Page 14: Improving Diabetes Care and Outcomes on the South Side of Chicago](https://reader033.vdocuments.us/reader033/viewer/2022052316/55855cfcd8b42a54608b5330/html5/thumbnails/14.jpg)
Changes in Self-Care Behaviors (3 mo f/u)
Survey Question Number of Patients (n =21)
Baseline Post-Intervention P-value
Healthful eating plan
5.9 5.9 0.08
Self-Foot Care 4.1 6.2 0.51
Self-Glucose Monitoring 4.4
5.6 0.28
Exercise 2.9 2.9 0.13
![Page 15: Improving Diabetes Care and Outcomes on the South Side of Chicago](https://reader033.vdocuments.us/reader033/viewer/2022052316/55855cfcd8b42a54608b5330/html5/thumbnails/15.jpg)
Patient Intervention: Mobile Phone Pilot
• 4 week pilot at PCG (n=18)
• Text message reminders re:
diabetes self-management
• Improvements in:
– Diabetes self-efficacy
– Self-foot examinations
– Medication adherence
![Page 16: Improving Diabetes Care and Outcomes on the South Side of Chicago](https://reader033.vdocuments.us/reader033/viewer/2022052316/55855cfcd8b42a54608b5330/html5/thumbnails/16.jpg)
Results: User Experience
Strongly Agree Moderately or
Slightly Agree
Disagree
It was easy to receive and read the
text messages from the research team.
94 6 0
It was easy to send text messages to
the research team.
72 28 0
I found the text message reminders to
be helpful at decreasing the number of
pills I missed.
89 11 0
I found the text message reminders to
be helpful at increasing the number of
times I checked my feet.
89 11 0
I found the text message reminders to
be helpful at decreasing the number of
doctor visits that I missed.
87 13 0
I would be willing to use a cell phone
reminder system in the future to help
me manage my diabetes.
78 22 0
I would recommend a cell phone
reminder system to my friends/family
that have diabetes.
94 6 0
![Page 17: Improving Diabetes Care and Outcomes on the South Side of Chicago](https://reader033.vdocuments.us/reader033/viewer/2022052316/55855cfcd8b42a54608b5330/html5/thumbnails/17.jpg)
Changes in Self-Efficacy
Pre During Post
Series1 14.0 18.8 17.8
0.0
5.0
10.0
15.0
20.0
P<0.01
P<0.01
![Page 18: Improving Diabetes Care and Outcomes on the South Side of Chicago](https://reader033.vdocuments.us/reader033/viewer/2022052316/55855cfcd8b42a54608b5330/html5/thumbnails/18.jpg)
Intervention
• Provider communication training – Shared Decision-Making
• Clinic Redesign – Community Health Workers
– Peer educators
– Group visits
• Community Connections – Education
– Resources
![Page 19: Improving Diabetes Care and Outcomes on the South Side of Chicago](https://reader033.vdocuments.us/reader033/viewer/2022052316/55855cfcd8b42a54608b5330/html5/thumbnails/19.jpg)
Our Project Team
• Marshall Chin
• Monica Peek
• Abigail Wilkes
• Tonya Roberson
• Kristine Bordenave
• Michael Quinn
• Doriane Miller
• Lisa Vinci
• Andrew Davis
• Elbert Huang
• Jonathan Birnberg
• Keisha Bishop
• Jonathan Dick
• Shantanu Nundy
• Melinda Drum
• Hui Tang
• Shannon Wilson
• Deborah Burnet
• Karen Kim
• Dawnavan Davis
• Thomas Fisher
• Quin Golden
• Eric Whitaker
• Asim Mishra
• Laura Derks
• Mickey Eder
• Peggy Hasenauer
• Louis Philipson
• Rick Kittles
• Marla Soloman
• Rebecca Lipton
• Tiffany White
• Donald Goens
• Melishia Bansa
![Page 20: Improving Diabetes Care and Outcomes on the South Side of Chicago](https://reader033.vdocuments.us/reader033/viewer/2022052316/55855cfcd8b42a54608b5330/html5/thumbnails/20.jpg)
Funding/ Support
• Merck Company Foundation
• NIDDK R18 DK083946-01A1
• NIDDK P60 DK20595 (DRTC)
• NIDDK K23 DK075006
• NIDDK K24 DK071933
• University of Chicago CTSA Pilot and Collaborative
Translational and Clinical Studies Award