title: Primary care-public health linkages: Older primary care patients with prediabetes & type 2 diabetes encouraged to attend community-based senior centers.
abstract: The Institute of Medicine (IOM) suggests that primary care-public health integration can improve health outcomes for vulnerable patients, but the extent to which formal linkages may enhance patients' use of community resources, or the factors that may influence providers to encourage their patients to use these resources, remain unclear. We conducted baseline assessments in 2014-2015 with 149 older adults with prediabetes or diabetes who had recently joined three senior centers linked to a network of primary care clinics in San Antonio, Texas. In addition to collecting sociodemographic and clinical characteristics, we asked members to identify their source of primary care and whether a health care provider had encouraged them to go to the senior center. We also asked members why they had joined the senior centers and which programs interested them the most. Members' source of primary care was not associated with being encouraged to attend the senior centers by a health care professional. Multivariable analysis indicated that participants with total annual household incomes of $20,000 or less [OR = 2.78; 95% CI = (1.05, 7.14)] and those reporting 12 years of education or less [OR = 3.57; 95% CI = (1.11, 11.11)] were significantly more likely to report being encouraged to attend the senior center by a health care provider. Providers who are aware of community-based resources to support patient self-management may be just as likely to encourage their socioeconomically vulnerable patients with prediabetes or diabetes to use them as providers who have a more formal partnership with the senior centers.
authors.affiliation: UT Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, United States; South Texas Veterans Health Care System, 7400 Merton Minter Blvd, San Antonio, TX 78229, United States.
authors.forename: Polly H
authors.initials: PH
authors.lastname: Noël
authors.affiliation: MacColl Center for Healthcare Innovation, Group Health Research Institute, Group Health Cooperative, 1730 Minor Avenue, Suite 1600, Seattle, WA 98101, United States.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Parchman
authors.affiliation: UT Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, United States; South Texas Veterans Health Care System, 7400 Merton Minter Blvd, San Antonio, TX 78229, United States.
authors.forename: Erin P
authors.initials: EP
authors.lastname: Finley
authors.affiliation: UT Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, United States; South Texas Veterans Health Care System, 7400 Merton Minter Blvd, San Antonio, TX 78229, United States.
authors.forename: Chen-Pin
authors.initials: CP
authors.lastname: Wang
authors.affiliation: UT Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, United States; South Texas Veterans Health Care System, 7400 Merton Minter Blvd, San Antonio, TX 78229, United States.
authors.forename: Mary
authors.initials: M
authors.lastname: Bollinger
authors.affiliation: UT Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, United States; South Texas Veterans Health Care System, 7400 Merton Minter Blvd, San Antonio, TX 78229, United States.
authors.forename: Sara E
authors.initials: SE
authors.lastname: Espinoza
authors.affiliation: UT Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, United States.
authors.forename: Helen P
authors.initials: HP
authors.lastname: Hazuda
keywords: Diabetes; Health promotion; Older adults; Primary health care; Public health; Senior centers; Socioeconomic status