Details:

Alternative Title:
Prev Chronic Dis
Personal Author:
Trevisi, Letizia ; Orav, John E. ; Atwood, Sidney ; Brown, Christian ; Curley, Cameron ; ... More +
Trevisi, Letizia ; Orav, John E. ; Atwood, Sidney ; Brown, Christian ; Curley, Cameron ; King, Caroline ; Muskett, Olivia ; Sehn, Hannah ; Nelson, Adrianne Katrina ; Begay, Mae-Gilene ; Shin, Sonya S. Less -
Description:
Introduction

The Community Outreach and Patient Empowerment (COPE) intervention provides integrated outreach through community health representatives (CHRs) to people living with diabetes in Navajo Nation. The aim of this study was to identify groups for whom the intervention had the greatest effect on glycated hemoglobin A1c (HbA1c).

Methods

We analyzed de-identified data extracted from routine health records dated from December 1, 2010, through August 31, 2014, to compare net change in HbA1c among COPE patients and non-COPE patients. We used linear mixed models to assess whether the intervention was modified by age, sex, preferred language, having a primary care provider, baseline HbA1c, or having a mental health condition.

Results

Age, having a primary care provider, and baseline HbA1c significantly modified HbA1c levels. Among patients aged 64 or younger, COPE participation was associated with a net decrease in HbA1c of 0.77%; among patients aged 65 or older, the net decrease was 0.49% (P = .03). COPE participation was associated with a steeper decrease in HbA1c among patients without a primary care physician (net decrease, 0.99%) than among patients with a primary care provider (net decrease, 0.57%) (P = .03). COPE patients with a baseline HbA1c >9% had a net decrease of 0.70%, while those with a baseline HbA1c ≤9% had a net decrease of 0.34% (P = .01). We found no significant differences based on sex, preferred language, or having a mental health condition.

Conclusion

Findings suggest that the COPE intervention was robust and equitable, benefiting all groups living with diabetes in Navajo Nation, but conferring the greatest benefit on the most vulnerable.


Subjects:
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Original Research
Source:
Prev Chronic Dis. 2020; 17
Pubmed ID:
32701432
Pubmed Central ID:
PMC7380292
Document Type:
Journal Article
Collection(s):
Preventing Chronic Disease
Main Document Checksum:
[+]
urn:sha256:725ff733b0e089aa08e5d9549b1929e832e0bef6a755543e8cf300b67d804c13
Download URL:
https://stacks.cdc.gov/view/cdc/91693/cdc_91693_DS1.pdf
File Type:

Supporting Files

• PCD-17-E68.nxml

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