University of Chicago

Improving Diabetes Care and Outcomes on the

South Side of Chicago

www.alliancefordiabetes.org
Improving Diabetes Care and Outcomes
on the South Side of Chicago
      Alliance to Reduce Disparities in Diabetes
Diabetes


Mellitus Death
Rates (per
100,000) -by
Community Area

Community Areas with the Lowest Median Household Income

PSA: 8 of 10
8 of Chicago’s 10
lowest income
communities are in
UCH’s primary
service area.

At least 33% below the citywide average
  
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


 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



 Intervention

 Six health centers 
 2 academic clinics
 4 FQHCs


 Patient activation/ communication training


 Provider communication training


 Clinic Redesign


 Community Connections
  
 Intervention

 Six health centers 
 2 academic clinics
 4 FQHCs


 Patient activation/ communication training


 Provider communication training


 Clinic Redesign


 Community Connections
  
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 
Changes in Self-Efficacy

Survey Question Number of Patients (n =21)

Baseline Post-Intervention P-value

I feel confident in my ability to  3.9 4.5 0.04
manage my diabetes 

I feel capable of handling my  3.8 4.5 0.01

diabetes 

I am able to do my own routine  3.9 4.6 0.02

diabetes care now 

I am able to meet the challenge  3.9 4.2 0.28

of controlling my diabetes
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  3.9 4.4 0.04
manage my diabetes 

I feel capable of handling my  3.8 4.6 0.02

diabetes 

I am able to do my own routine  3.9 4.6 0.02

diabetes care now 

I am able to meet the challenge  3.9 4.4 0.16

of controlling my diabetes
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

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

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


 Results: User Experience

Strongly Agree Moderately or Disagree

Slightly Agree
It was easy to receive and read the text  94 6 0
messages from the research team.
It was easy to send text messages to  72 28 0
the research team.
I found the text message reminders to be 89 11 0
helpful at decreasing the number of pills
I missed.
I found the text message reminders to be 89 11 0
helpful at increasing the number of times 
I checked my feet.
I found the text message reminders to be 87 13 0
helpful at decreasing the number of 
doctor visits that I missed.
I would be willing to use a cell phone  78 22 0
reminder system in the future to help me 
manage my diabetes.
I would recommend a cell phone 94 6 0
reminder system to my friends/family that 
have diabetes.
Changes in Self-Efficacy

P<0.01

P<0.01
 Intervention

Provider communication training


 Shared Decision-Making


Clinic Redesign


 Community Health Workers
 Peer educators
 Group visits


Community Connections


 Education
 Resources
  
 Our Project Team
• Marshall Chin • Deborah Burnet
• Monica Peek • Karen Kim
• Abigail Wilkes • Dawnavan Davis
• Tonya Roberson • Thomas Fisher
• Kristine Bordenave • Quin Golden
• Michael Quinn • Eric Whitaker
• Doriane Miller • Asim Mishra
• Lisa Vinci • Laura Derks
• Andrew Davis • Mickey Eder
• Elbert Huang • Peggy Hasenauer
• Jonathan Birnberg • Louis Philipson
• Keisha Bishop • Rick Kittles
• Jonathan Dick • Marla Soloman
• Shantanu Nundy • Rebecca Lipton
• Melinda Drum • Tiffany White
• Hui Tang • Donald Goens
 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