Skip to main content
Patient-Centered Outcomes Research Institute
Patient-Centered Outcomes Research Institute
  • Blog
  • Newsroom
  • Find It Fast
  • Help Center
  • Subscribe
  • Careers
  • Contact Us

PCORI

Patient-Centered Outcomes Research Institute

Search form

  • About Us
    Close mega-menu

    About Us

    • Our Programs
    • Governance
    • Financials and Reports
    • Procurement Opportunities
    • Our Staff
    • Our Vision & Mission
    • Contact Us

    Fact Sheets: Learn More About PCORI

    Download fact sheets about out work, the research we fund, and our programs and initiatives.

    Find It Fast

    Browse through an alphabetical list of frequently accessed and searched terms for information and resources.

    Subscribe to PCORI Email Alerts

    Sign up for weekly emails to stay current on the latest results of our funded projects, and more.

  • Research & Results
    Close mega-menu

    Research & Results

    • Explore Our Portfolio
    • Research Fundamentals
    • Research Results Highlights
    • Putting Evidence to Work
    • Peer Review
    • Evidence Synthesis
    • About Our Research

    Evidence Updates from PCORI-Funded Studies

    These updates capture highlights of findings from systematic reviews and our funded research studies.

    Journal Articles About Our Funded Research

    Browse through a collection of journal publications that provides insights into PCORI-funded work.

    Explore Our Portfolio of Funded Projects

    Find out about projects based on the health conditions they focus on, the state they are in, and if they have results.

  • Topics
    Close mega-menu

    Topics

    • Addressing Disparities
    • Arthritis
    • Asthma
    • Cancer
    • Cardiovascular Disease
    • Children's Health
    • Community Health Workers
    • COVID-19
    • Dementia and Cognitive Impairment
    • Diabetes
    • Kidney Disease
    • Medicaid
    • Men's Health
    • Mental and Behavioral Health
    • Minority Mental Health
    • Multiple Chronic Conditions
    • Multiple Sclerosis
    • Obesity
    • Older Adults' Health
    • Pain Care and Opioids
    • Rare Diseases
    • Rural Health
    • Shared Decision Making
    • Telehealth
    • Transitional Care
    • Veterans Health
    • Women's Health

    Featured Topic: Women's Health

    Learn more about the projects we support on conditions that specifically or more often affect women.

  • Engagement
    Close mega-menu

    Engagement

    • The Value of Engagement
    • Engagement in Health Research Literature Explorer
    • Influencing the Culture of Research
    • Engagement Awards
    • Engagement Resources
    • Engage with Us

    Engagement Tools and Resources for Research

    This searchable peer-to-peer repository includes resources that can inform future work in patient-centered outcomes research.

    Explore Engagement in Health Literature

    This tool enables searching for published articles about engagement in health research.

    Research Fundamentals: A New On-Demand Training

    It enables those new to health research or patient-centered research to learn more about the research process.

  • Funding Opportunities
    Close mega-menu

    Funding Opportunities

    • What & Who We Fund
    • What You Need to Know to Apply
    • Applicant Training
    • Merit Review
    • Awardee Resources
    • Help Center

    PCORI Funding Opportunities

    View and learn about the newly opened funding announcements and the upcoming PFAs in 2021.

    Tips for Submitting a Responsive LOI

    Find out what PCORI looks for in a letter of intent (LOI) along with other helpful tips.

    PCORI Awardee Resources

    These resources can help awardees in complying with the terms and conditions of their contract.

  • Meetings & Events
    Close mega-menu

    Meetings & Events

    • Upcoming
    • Past Events

    January 2021 Board of Governors Meeting

    The Board approved funding for a new research study relating to kidney health and a new funding allocation for PCORnet. Learn more

    Confronting COVID-19: A Webinar Series

    Learn more about the series and access recordings and summary reports of all six sessions.

    2020 PCORI Annual Meeting

    Watch recordings of all sessions, and view titles and descriptions of the posters presented at the virtual meeting.

You are here

  • Research & Results
  • Explore Our Portfolio
  • Comparing Two Approaches to Group Med...

Comparing Two Approaches to Group Medical Visits for Patients with Diabetes

Sign Up for Updates to This Study  

Project Summary  

This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.

What is the research about?

Nearly 1 in 10 Americans have diabetes. Compared with people who don’t have diabetes, people with diabetes are more likely to have other serious health problems. These problems include heart disease, stroke, kidney failure, and vision loss. They may also be at risk for early death. Exercising, eating healthy, and taking medicines as directed can help patients manage their diabetes. Group medical visits are an effective way to educate patients and help them manage their diabetes. First, patients have a short one-on-one visit with a primary care provider. Then they have a longer group session with other people with diabetes to learn about living with diabetes.

This study is comparing a uniform approach to group medical visits to an approach that allows patients to choose topics covered in the visits. The research team is examining how each approach affects the health and well-being of people with diabetes.

Who can this research help?

Clinic directors and staff can use the findings from this study when considering what type of group visits to offer patients. Patients with diabetes and their healthcare providers can use findings to understand the options for group medical visits and decide if they want to take part.

What is the research team doing?

The research team is working with 20 primary care and community mental health centers in Colorado. Each site is enrolling 72 patients with diabetes into group visits. Patients attend a six-session group visit program called Targeted Training for Illness Management, or TTIM. Each session covers topics such as exercise, healthy eating, taking medicine, coping with diabetes, and social support. Half of the clinics provide uniform group visits. The other half follow a patient-driven approach. All patients within a practice receive the same type of group visit.

In the patient-driven approach, patients choose the time spent on each topic. They also choose the order of the topics. A diabetes peer educator co-leads the sessions with a team that includes a health educator, a medical provider, and a mental health provider. In groups using the uniform version of TTIM, patients receive sessions on preset topics in a fixed order. A health educator leads the sessions alone.

Before the program starts and after it ends, the research team is using a survey to measure the stress and anxiety patients feel because of their diabetes. The team is also tracking patients’ ability to manage their diabetes, blood sugar, blood pressure, and weight. They are also looking at how engaged patients are in their care. Using another survey, the team is asking staff members at each clinic how the group visits work as part of regular care for people with diabetes.

Patients, caregivers, researchers, and representatives from healthcare practices and health plans are working with the research team to design the study, examine findings, and share results.

Research methods at a glance

Design Elements Description
Design Cluster-randomized pragmatic trial
Population 1,440 adults 18 years of age or older with type 2 diabetes receiving care at a participating clinic who are not pregnant or planning on becoming pregnant in the next year, terminally ill, or planning on moving in the next year
Interventions/
Comparators
  • Targeted Training for Illness Management (TTIM) curriculum led by a health educator and delivered in a uniform order
  • TTIM curriculum co-led by a health educator and diabetes peer mentor; patients choose the time spent on topics and the order of sessions; may include sessions led by a team that includes a medical provider or behavioral health provider
Outcomes

Primary: diabetes distress

Secondary: autonomy support, diabetes self-management behaviors, hemoglobin A1c, blood pressure, body mass index, patient engagement, and practice-level value and sustainability

Timeframe 9-month follow-up for primary outcome

Related Articles

Journal of the American Board of Family Medicine

Adapting Diabetes Shared Medical Appointments to Fit Context for Practice-Based Research (PBR)

Trials

The Invested in Diabetes Study Protocol: a cluster randomized pragmatic trial comparing standardized and patient-driven diabetes shared medical appointments

Project Details

Principal Investigator
Bethany Matthews Kwan, PhD, MSPH
Other Principal Investigator
Jeanette Waxmonsky, PhD
Project Status
In progress; Recruiting
Project Title
Comparing Patient-Centered Outcomes of Standardized vs Patient-Driven Diabetes Shared Medical Appointments
Board Approval Date
August 2017
Project End Date
April 2023
Organization
University of Colorado Denver
Year Awarded
2017
State
Colorado
Project Type
Research Project
Health Conditions  
Mental/Behavioral Health
Depression
Schizophrenia and Psychotic Disorders
Anxiety
Bipolar Disorder
Nutritional and Metabolic Disorders
Diabetes
Multiple/Comorbid Chronic Conditions
Intervention Strategies
Care Coordination
Other Health Services Interventions
Training and Education Interventions
Populations
Racial/Ethnic Minorities
Low Health Literacy/Numeracy
Project Budget
$4,760,078
Study Registration Information
HSRP20181592
NCT03590041
Page Last Updated: 
February 20, 2020

Research & Results

  • Explore Our Portfolio
  • Research Fundamentals
  • Research Results Highlights
  • Putting Evidence to Work
  • Peer Review
  • Evidence Synthesis
  • About Our Research

About Us

  • Our Programs
  • Governance
  • Financials and Reports
  • Procurement Opportunities
  • Our Staff
  • Our Vision & Mission
  • Contact Us

Research & Results

  • Explore Our Portfolio
  • Research Fundamentals
  • Research Results Highlights
  • Putting Evidence to Work
  • Peer Review
  • Evidence Synthesis
  • About Our Research

Engagement

  • The Value of Engagement
  • Engagement in Health Research Literature Explorer
  • Influencing the Culture of Research
  • Engagement Awards
  • Engagement Resources
  • Engage with Us

Funding Opportunities

  • What & Who We Fund
  • What You Need to Know to Apply
  • Applicant Training
  • Merit Review
  • Awardee Resources
  • Help Center

Meetings & Events

January 21
Cycle 1 2021 Broad PFA Applicant Town Hall
February 2
PCORI 2021 and Beyond: Opportunities for Funding and Involvement in Patient-Centered Research
February 9
Board of Governors Meeting: February 9, 2021

PCORI

Footer contact address

Patient-Centered Outcomes
Research Institute

1828 L Street, NW, Suite 900
Washington, DC 20036
Phone: (202) 827-7700 | Fax: (202) 355-9558
[email protected]

Subscribe to Newsletter

Twitter Facebook LinkedIn Vimeo

© 2011-2021 Patient-Centered Outcomes Research Institute. All Rights Reserved.

Privacy Policy | Terms of Use | Trademark Usage Guidelines | Credits | Help Center