title: Effectiveness of nurse practitioner coordinated team group visits for type 2 diabetes in medically underserved Appalachia.
abstract: OBJECTIVE
  To study the effectiveness of multidisciplinary nurse practitioner coordinated team (NPCT) group visits in medically underserved Appalachia on the health, knowledge, and self-efficacy of patients with type 2 diabetes (DM). The study also identified perceived barriers to participating in the diabetes programs.
  
  
  METHODS
  A researcher-developed tool was used to assess demographic data, clinical data, and barriers to care. The participants completed the Diabetes Knowledge Tests and the Diabetes Empowerment Scales. Two groups were assessed. One group participated in the diabetes intervention, and the other received usual care. Both groups completed the instruments prior to the intervention and after the intervention was completed.
  
  
  CONCLUSIONS
  The group that participated in the intervention had better clinical outcomes (blood glucose and A1Cs), greater knowledge, and better self-efficacy following the intervention than the usual care groups. This suggests that the intervention was important in improving outcomes of patients with type 2 DM. Barriers to care included fuel, time, family, work, and transportation. Barriers need to be addressed in order to have more patients participate in such programs.
  
  
  CONCLUSIONS
  NPCT group visits may represent an effective means of integrating diabetes self-management education and medical management in a family practice clinic in medically underserved areas.
authors.affiliation: C-Health, PC, Lebanon, Virginia 24266, USA. bjessee@c-healthonline.com
authors.forename: Brenda Thomas
authors.initials: BT
authors.lastname: Jessee
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Rutledge
mesh_terms: D001061:Appalachian Region; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008507:Medically Underserved Area; D008875:Middle Aged; D009722:Nurse Practitioners; D010342:Patient Acceptance of Health Care; D010348:Patient Care Team / Q000458:organization & administration*; D011209:Power, Psychological; D011446:Prospective Studies; D019035:Rural Health Services / Q000458:organization & administration*; D020377:Self Efficacy; D016896:Treatment Outcome