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Improving Care for Spanish-Speaking ...

Ismail, Mohamed Hani.

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Improving Care for Spanish-Speaking People with Diabetes in a Free Clinic Setting.

Record Type:	Electronic resources : Monograph/item
Title/Author:	Improving Care for Spanish-Speaking People with Diabetes in a Free Clinic Setting./
Author:	Ismail, Mohamed Hani.
Published:	Ann Arbor : ProQuest Dissertations & Theses, : 2019,
Description:	102 p.
Notes:	Source: Dissertations Abstracts International, Volume: 81-07, Section: A.
Contained By:	Dissertations Abstracts International81-07A.
Subject:	Public health. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=27546484
ISBN:	9781392744390

Improving Care for Spanish-Speaking People with Diabetes in a Free Clinic Setting.
Ismail, Mohamed Hani.

Improving Care for Spanish-Speaking People with Diabetes in a Free Clinic Setting. - Ann Arbor : ProQuest Dissertations & Theses, 2019 - 102 p.

Source: Dissertations Abstracts International, Volume: 81-07, Section: A.

Thesis (Dr.P.H.)--The University of North Carolina at Chapel Hill, 2019.

This item must not be sold to any third party vendors.

Background: The risk for diabetic complications is especially high for those with socioeconomic, health-insurance, and language barriers. Spanish-speaking patients receiving care in free clinic settings experience all these barriers and thus require tailored interventions to meet their diabetic-care goals. A literature review of interventions for Latinos in free clinics found that pharmacist-led education; health education taught by other individual educators; and team-based education improved glycemic control. Potential challenges to the implementation and sustainment of such interventions have also been described.Objective: My goal was to identify and assess the determinants of implementation and sustainment of health education interventions for Spanish-speaking diabetics getting care at a free clinic. I planned to use these results to develop a plan for change to improve diabetic care at this clinic.Methods: I conducted focus groups and interviews with patients, providers, board members, a donor, and a peer clinic director based on the Consolidated Framework for Implementation Research (CFIR). I then developed a plan for change based on the Exploration, Preparation, Implementation, Sustainment (EPIS) framework, including the selection of an intervention and preparation of the clinic for its implementation.Results: Key determinants of an intervention's potential implementation were: an unmet need for inclusive, comprehensive, group health education taught by individual educators; poor staff communication and the lack of a patient registry; and a lack of awareness of patient needs and a lack of implementation leadership from the providers and board. The key determinants of sustainment were the clinic's networking with external organizations and grant management.Plan for change: I identified two no-cost, diabetes self-management programs in the community to sustainably meet patient and clinic needs. I recommend educating providers about these programs and using existing funding for site preparation (including an improved communication network and an electronic patient registry). To lead these efforts, I recommended the establishment of an implementation team.

ISBN: 9781392744390Subjects--Topical Terms:

534748
Public health.
Subjects--Index Terms:

Diabetes

Improving Care for Spanish-Speaking People with Diabetes in a Free Clinic Setting.
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300 $a 102 p.
500 $a Source: Dissertations Abstracts International, Volume: 81-07, Section: A.
500 $a Advisor: Birken, Sarah.
502 $a Thesis (Dr.P.H.)--The University of North Carolina at Chapel Hill, 2019.
506 $a This item must not be sold to any third party vendors.
520 $a Background: The risk for diabetic complications is especially high for those with socioeconomic, health-insurance, and language barriers. Spanish-speaking patients receiving care in free clinic settings experience all these barriers and thus require tailored interventions to meet their diabetic-care goals. A literature review of interventions for Latinos in free clinics found that pharmacist-led education; health education taught by other individual educators; and team-based education improved glycemic control. Potential challenges to the implementation and sustainment of such interventions have also been described.Objective: My goal was to identify and assess the determinants of implementation and sustainment of health education interventions for Spanish-speaking diabetics getting care at a free clinic. I planned to use these results to develop a plan for change to improve diabetic care at this clinic.Methods: I conducted focus groups and interviews with patients, providers, board members, a donor, and a peer clinic director based on the Consolidated Framework for Implementation Research (CFIR). I then developed a plan for change based on the Exploration, Preparation, Implementation, Sustainment (EPIS) framework, including the selection of an intervention and preparation of the clinic for its implementation.Results: Key determinants of an intervention's potential implementation were: an unmet need for inclusive, comprehensive, group health education taught by individual educators; poor staff communication and the lack of a patient registry; and a lack of awareness of patient needs and a lack of implementation leadership from the providers and board. The key determinants of sustainment were the clinic's networking with external organizations and grant management.Plan for change: I identified two no-cost, diabetes self-management programs in the community to sustainably meet patient and clinic needs. I recommend educating providers about these programs and using existing funding for site preparation (including an improved communication network and an electronic patient registry). To lead these efforts, I recommended the establishment of an implementation team.
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