title: Measuring the Implementation and Effects of a Coordinated Care Model Featuring Diabetes Self-management Education Within Four Patient-Centered Medical Homes.
abstract: The purpose of this study is to measure the implementation and effects of a multisite coordinated care approach that delivered diabetes self-management education (DSME) and diabetes self-management support (DSMS) for disadvantaged patients within 4 patient-centered medical homes (PCMH).
  
  
  
  A total of 173 patients (69.9% African American, 26.0% Caucasian, and 4.1% other) experienced elements of the intervention, which featured DSME and coordinated care. Key informant interviews with PCMH site staff were used to capture, code, and characterize activities related to implementation and sustainability of the intervention. Outcome measures collected at baseline and at 6 months included clinical health indicators, A1C, body mass index (BMI), blood pressure, and lipids, as well as the AADE7 Behaviors.
  
  
  
  A statistically significant decrease occurred in A1C and BMI within 6 months for participants within 1 PCMH. This improvement among clinical health outcomes was associated with the frequency of services provided (eg, DSME, patient support).
  
  
  
  Integrating and delivering DSME and DSMS within coordinated care settings have the potential to improve PCMH practice and associated clinical health outcomes for populations experiencing health disparities.
authors: University of Kansas Work Group for Community Health and Development, Lawrence, Kansas (Mr Sepers, Dr Fawcett, Dr Schultz, Dr Collie-Akers)
authors: Charles E
authors: CE
authors: Sepers
authors: University of Kansas Work Group for Community Health and Development, Lawrence, Kansas (Mr Sepers, Dr Fawcett, Dr Schultz, Dr Collie-Akers)
authors: Stephen B
authors: SB
authors: Fawcett
authors: American Association of Diabetes Educators, Chicago, Illinois (Dr Lipman)
authors: Ruth
authors: R
authors: Lipman
authors: University of Kansas Work Group for Community Health and Development, Lawrence, Kansas (Mr Sepers, Dr Fawcett, Dr Schultz, Dr Collie-Akers)
authors: Jerry
authors: J
authors: Schultz
authors: University of Kansas Work Group for Community Health and Development, Lawrence, Kansas (Mr Sepers, Dr Fawcett, Dr Schultz, Dr Collie-Akers)
authors: Vicki
authors: V
authors: Colie-Akers
authors: Nova Southeastern University College of Pharmacy, Davie, Florida (Dr Perez)
authors: Alexandra
authors: A
authors: Perez
mesh_terms: D000368:Aged; D001794:Blood Pressure; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000523:psychology*; D005260:Female; D005431:Florida; D006442:Glycated Hemoglobin / Q000032:analysis; D006284:Health Plan Implementation / Q000706:statistics & numerical data*; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D009820:Ohio; D009825:Oklahoma; D010353:Patient Education as Topic / Q000379:methods*; D018802:Patient-Centered Care; D015397:Program Evaluation / Q000706:statistics & numerical data*; D012648:Self Care / Q000379:methods* / Q000523:psychology; D013714:Tennessee
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human