Objective: We assessed factors associated with engagement in lifestyle wellness programs for patients with prediabetes.
Methods: This mixed-methods study, conducted between March 2018 and April of 2021, combined a retrospective cohort study and semi-structured interviews in a Northern California cohort of patients from a randomized controlled pragmatic clinical trial aged 18-75 with body mass index 25 and at least one HbA1c between 5.7-6.
Background: Population-level tracking of hospital use patterns with integrated care organizations in patients experiencing homelessness has been difficult. A California law implemented in 2019 (Senate Bill 1152) aimed to ensure safety for this population after discharge from the hospital by requiring additional documentation for patients experiencing homelessness, which provides an opportunity to evaluate hospital use by this population.
Methods: In a large integrated health system in California, patients experiencing homelessness were identified through documentation change requirements associated with this law and compared with a matched group from the general population.
Introduction Homelessness contributes to worsening health and increased health care costs. There is little published research that leverages rich electronic health record (EHR) data to predict future homelessness risk and inform interventions to address it. The authors' objective was to develop a model for predicting future homelessness using individual EHR and geographic data covariates.
View Article and Find Full Text PDFThe ronarus isease 20 (COVID-19) pandemic has resulted in significant lifestyle changes due to shelter-in-place confinement orders. The study's purpose was to assess if the COVID-19 pandemic affected self-reported diabetes prevention behaviors among American adults with prediabetes. As part of a randomized clinical trial among adults with prediabetes and overweight/obesity, questions were added to existing study surveys to assess the effect of the COVID-19 pandemic on diabetes prevention behaviors and stress.
View Article and Find Full Text PDFPsychosocial factors such as self-efficacy may be important in helping high-risk adults prevent diabetes. We aimed to describe psychosocial and diabetes risk factors in adults with prediabetes and evaluate if these varied by demographic characteristics. Cross-sectional data came from baseline surveys and electronic health records (2018-2021) of adults with prediabetes enrolled in a randomized study of peer support for diabetes prevention at Kaiser Permanente Northern California and Michigan Medicine.
View Article and Find Full Text PDFThe projected three-fold increase in diabetes burden by 2060 in the United States will affect certain race and gender groups disproportionately. The objective of this mixed-methods study was to assess differences in prediabetes screening and clinician response to prediabetes by patient race and gender. We utilized data from 18,742 patients seen between 11/1/15 and 4/30/17 who met criteria for blood glucose screening by the 2015 US Preventive Service Task Force recommendation and had at least one visit to a primary care practice within a large, academic health system located in North Carolina.
View Article and Find Full Text PDFBackground: In 2015, the US Preventive Services Task Force (USPSTF) revised clinical recommendations to more broadly recommend abnormal blood glucose screening and more clearly recommend referral to behavioral interventions for adults with prediabetes.
Objective: To assess the effects of the 2015 USPSTF recommendation changes on abnormal blood glucose screening and referral to behavioral interventions, and to examine physicians' perceptions of the revised recommendation.
Design: We utilized a sequential, dependent mixed-methods triangulation design.
Background: In the United States, people of color face disparities in access to health care, the quality of care received, and health outcomes. The attitudes and behaviors of health care providers have been identified as one of many factors that contribute to health disparities. Implicit attitudes are thoughts and feelings that often exist outside of conscious awareness, and thus are difficult to consciously acknowledge and control.
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