Implementing Diabetes Group Visits and Text Messaging in Community Health Centers to Improve Outcomes Among Disadvantaged Patients

In a recent pilot study, “Implementing Diabetes Group Visits in Community Health Centers,” researchers from CCDTR and Midwest Clinicians’ Network (MWCN) tested an innovative way to care for patients with diabetes through group visits and a text messaging program. The purpose of the pilot was to develop and evaluate a staff training program, identify barriers and facilitators to implementation, measure staff and patient satisfaction, and assess the patient outcomes and effects of diabetes group visits. The pilot also tested the feasibility and acceptability of using text messaging as a supplement to diabetes group visits. As part of the Partnerships to Achieve Health Equity program, the U.S. Department of Health and Human Services Office of Minority Health is funding a 5-year cluster randomized clinical trial of a diabetes group visit and text messaging intervention designed to improve diabetes care for low-income and racial and ethnic minority patients at community health centers.

Purpose
The main goal of this study is to implement, at the regional level, a replicable diabetes group visit program to improve outcomes among persons with diabetes. Through in-person and web-based training and peer learning facilitated by the University of Chicago and MWCN, community health center staff and providers will gain the requisite knowledge, skills, and motivation to implement a diabetes group visit and text messaging program at their sites. In collaboration with the health center teams, the University of Chicago and MWCN will evaluate the effects of the program on patient knowledge, self-care behaviors, quality of life, clinical outcomes, processes of care, and health care utilization. Results of the study will be used to develop a training curriculum and group visit implementation toolkit that could be used by health centers and providers nationally.

Overview of research
In collaboration with MWCN, researchers from the University of Chicago will train staff from 20 health centers across the Midwest to implement group visits for patients with diabetes. Health center teams will attend two in-person learning sessions and monthly webinars over the course of about 18 months. Teams will recruit patients with uncontrolled diabetes to attend their group visit programs. Each monthly group visit session will include a medical exam for each patient, group education, activities, goal setting, and social support. The University of Chicago team will also partner with CareMessage, a non-profit that helps health care organizations use mobile technology, to assist health centers in implementing a diabetes text messaging program. Patients will receive 3-5 text messages per week with diabetes-related tips, reminders, and questions. The study will enroll health centers from urban, rural, and migrant health settings that serve diverse patient populations, including African American, American Indian, Latino, and White patients. Survey, interview, and electronic health record data will be used to evaluate the program.

A request for applications from interested health centers will be sent out in February 2018. If you have questions about the study, please contact the project manager, Erin Staab, at estaab@medicine.bsd.uchicago.edu.

Principal Investigator: Arshiya A. Baig, MD, MPH
Research Team:
Erin Staab, MPH
Jasmine Solola, MA
Michael T. Quinn, PhD
Sandra Ham, MS
Wen Wan, PhD
Amanda Campbell, Midwest Clinicians’ Network
Cynthia T. Schaefer, RN, PhD, Midwest Clinicians’ Network, University of Evansville

Funding Source:
US. Department of Health and Human Services, Office of Minority Health