Medicine and Health Sciences Commons^™

Improving Outpatient Diabetes Care, Susan Kirsh, Michael Hein, Leonard Pogach, Gordon Schectman, Lauren Stevenson, Sharon Watts, Archana Radhakrishnan, John Chardos, David Aron

Public Health Resources

More than 20% of patients in the Veterans Health Administration (VHA) have diabetes; therefore, disseminating “best practices” in outpatient diabetes care is paramount. The authors’ goal was to identify such practices and the factors associated with their development. First, a national VHA diabetes registry with 2008 data identified clinical performance based on the percentage of patients with an A1c >9%. Facilities (n = 140) and community-based outpatient clinics (n = 582) were included and stratified into high, mid, and low performers. Semistructured telephone interviews (31) and site visits (5) were conducted. Low performers cited lack of teamwork between physicians and …

One-Year Changes In Glucose And Heart Disease Risk Factors Among Participants In The Wisewoman Programme, Jc Will, O Khavjou, Ea Finkelstein, Rk Loo, Ky Gregory-Mercado

Public Health Resources

Background: WISEWOMAN provides chronic disease risk factor screening, referrals and lifestyle interventions to low-income, uninsured women, to reduce their heart disease and stroke risk. Participants learn behaviour-changing skills tailored to low-income populations, such as collaborative goal setting, the need to take small steps and other empowerment techniques.

Aim: To quantify the baseline prevalence of pre-diabetes (fasting blood glucose 5.5–6.9 mmol/l) and diabetes among WISEWOMAN participants and assess one year changes in glucose levels and other diabetes risk factors.

Methods: We used 1998–2005 baseline and one-year follow-up data from WISEWOMAN participants. Using a multilevel regression model, we assessed …