Disseminating Evidence to Promote Patient-Centered Diabetes Self-Management Strategies

Background: The Southeast Regional Clinicians Network is a practice-based research network (PBRN) of Federally Qualified Health Centers (FQHCs) in eight southeastern states. FQHCs provide comprehensive services to a disproportionately poor and medically underserved population. Our stakeholders prioritize chronic disease self-management as key areas of need and are primed to understand new evidence related to diabetes self-management. Evidence from The Monitor Trial is pertinent to our stakeholders because FQHC patients have high rates of diabetes and face financial and coverage barriers to obtaining glucose testing supplies.

Proposed Solution to the Problem: We propose a multimodal approach to disseminate evidence from The Monitor Trial to three key stakeholder groups: primary care clinicians (PCCs), patients with non-insulin dependent diabetes mellitus (NIDD), and FQHC quality improvement (QI) staff. This project will be successful because (1) it is in line with the self-identified needs and priorities of a broad group of stakeholders in our network; and (2) it leverages our robust engagement infrastructure of state Primary Care Association (PCA) leaders, FQHCs, and patient stakeholders across our regional network footprint.

Objectives: The long-term objective of this project is to improve the uptake of patient-centered diabetes self-management strategies in our regional PBRN of FQHCs. The primary objective of this proposal is to effectively disseminate evidence that shows glucose self-monitoring has no clear benefit for diabetic control or quality of life for patients with NIDD to PCCs, patients with NIDD, and QI staff in our PBRN.

Activities:

• Tailor dissemination strategies to engage the three targeted stakeholder groups.
• Deploy tailored dissemination strategies to each of the three key stakeholder groups via widespread (presentations at statewide conferences) and intensive dissemination initiatives (deployment of tailored dissemination products to patients, PCCs, and QI staff in 16 FQHCs).
• Evaluate the reach and impact of the dissemination strategy.

Outcomes: Widespread dissemination initiative attendees will include 200 QI staff and 1,800 PCCs across eight states. The intensive dissemination initiative will focus on QI staff (25), PCCs (80), and patients with NIDD (8,000) at 16 FQHCs across eight states. Potential results of this dissemination initiative for patients with NIDD include reduced discomfort and financial burden and increased time for effective self-management counseling. We will create a stakeholder dissemination blueprint for our research network based on the lessons learned from this initiative.

Patient and Stakeholder Engagement Plan: The evidence for dissemination was selected unanimously by our steering committee and stakeholder leaders representing all eight states in our network. We will engage our steering committee and patient advisory board members to tailor the dissemination strategies and products for this project. We will engage patients in interviews to understand the impact of this dissemination initiative on their health care and quality of life.

Project Collaborators: Project collaborators will include the PCAs in the eight states in our network, which support FQHCs in each state through training, advocacy, and technical assistance. Our partners at the PCAs will facilitate widespread dissemination of evidence at statewide conferences and facilitate recruitment of 16 FQHCs that will engage in the intensive dissemination initiative.