Intervention IP-113: Implementing Diabetes Group Visits in Midwestern Community Health Centers to Improve Diabetes Outcomes among Disadvantaged Patients

Improve diabetes processes of care; knowledge, attitudes, and skills for diabetes self-management; clinical outcomes; and health care utilization for patients participating in the diabetes group visit program.

The diabetes group visit program is available for dissemination among and use by health centers and health care providers at the local, state, and national levels.

The five-year cluster randomized trial was conducted to test the impact of diabetes group visits on patient outcomes in community health centers in the Midwest. The academic team from University of Chicago partnered with the Midwest Clinicians' Network (MWCN). The cluster randomized controlled study recruited adults with diabetes mellitus with glycosylated hemoglobin, A1C greater than or equal to eight percent: 75 intervention and 120 usual care. Group visit patients completed a six-month program. Primary outcome wasA1C change from baseline to 12 months. Participants improved their A1C by 0.38%–0.40% with no difference across arms (p=.63). Group visit patients improved their diabetes social support, knowledge, and distress and were more likely to receive guideline-based care compared with control. Group visit patients with anxiety or depression were more likely to have a visit with behavioral health compared with usual care (p=.02).

Compared baseline characteristics between the intervention and usual care groups using generalized estimating equations (GEE) using the identity link function for continuous variables and the log/log/cumulative logit link function for binary/ordinal/multinomial variables, respectively. We also used linear mixed models (LMMs) and generalized linear mixed models (GLMMs) to model repeated measures over time and to test effects of time, intervention, and interaction between time and intervention.