Using a Community-Based Collaborative Care Model as a Platform for Successful Interprofessional Education

Using a Community-Based Collaborative Care Model as a Platform for Successful Interprofessional Education

Jannette Berkley-Patton (University of Missouri-Kansas City, USA), Carole Bowe Thompson (University of Missouri-Kansas City, USA), Katherine G. Ervie (University of Missouri-Kansas City, USA), Miranda Huffman (Meharry Medical College, USA) and Nia R. Johnson (Saint Louis University, USA)
Copyright: © 2020 |Pages: 26
DOI: 10.4018/978-1-7998-3066-5.ch009

Abstract

Diabetes is a growing public health epidemic in the U.S. African Americans are particularly at-risk for diabetes with rates twice as high as whites. Health professionals are recommended to encourage their at-risk patients to participate in evidence-based lifestyle change programs, such as CDC's National Diabetes Prevention Program (DPP) and support their weight loss efforts. This chapter describes feasibility/outcomes of a community-based collaborative care model used to implement a weekly-group DPP facilitated by interprofessional teams of medical school students with three African American churches (N=72 participants; 93% overweight/obese). At 12-weeks, 30% of participants had lost at least 5 lbs.; among those attending at least nine sessions, 55% achieved at least 3% weight loss. Findings suggest interprofessional student teams can feasibly partner with churches to deliver the DPP and achieve weight-loss outcomes associated with reducing diabetes risk. Future research is needed to determine scalability/costs of using community-based collaborative care student models to address diabetes.
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Introduction

Diabetes continues to be a major national health threat. National efforts to prevent diabetes have yielded lifestyle change programs (LCPs) that aim to reduce primary risks, including overweight/obesity (Ackermann & Marrero, 2007; Diabetes Prevention Research Group, 2002; 2004). The Diabetes Prevention Program (DPP) is a rigorously evaluated lifestyle intervention that has been proven to reduce or delay diabetes onset by up to 50 to 60% with diet changes, physical activity, and modest weight loss among at-risk individuals (Diabetes Prevention Research Group, 2002). National health organizations are making widespread attempts to disseminate evidence-based LCPs like the DPP to curb growing diabetes rates (e.g., CDC, 2018b). These dissemination efforts include educating health professionals on the importance of patient screening and referral to LCPs and partnering with patients in discussing their lifestyle change behaviors and outcomes. They also call for culturally-appropriate lifestyle change programs for high risk minority populations in community settings, recognizing most health settings do not provide these programs and offering LCPs in community settings may be less costly and more accessible (American Medical Association, 2019; CDC, 2018b). Accessibility of evidence-based LCPs could particularly be beneficial to African Americans communities where rates of diabetes tend to be disproportionately high and availability of LCPs are limited or nonexistent (CDC, 2017). Moreover, although reports on engaging health profession students to assist with diabetes prevention are rare (e.g., Gorrindo, Alon & Ladner, 2014), students’ participation as health coaches in community-based LCPs could greatly assist national DPP dissemination efforts. This approach could also provide students with interprofessional opportunities to learn culturally competent ways to collaborate with underserved communities and partner with patients, particularly African Americans on their lifestyle change goals.

This chapter describes the planning, implementation, and outcomes of a pilot study used to test a community-based collaborative care model to disseminate the DPP using interprofessional teams of medical school students in partnership with the African American faith community. Specifically, the objectives of this chapter are first to provide background contextual information a multilevel religiously-tailored diabetes risk reduction intervention study (named Project Faith Influencing Transformation [FIT]) that included a weekly group-DPP component and was originally disseminated and tested in urban Kansas City (KC), Missouri African American churches. The second objective is to highlight the community-student engagement approach that was used to refine the Project FIT group DPP component for feasible implementation and impact as Project FIT 2.0 – a pilot study delivered by interprofessional teams of students serving as health coaches and paired with African American church health workers. The third objective is to describe how student teams and church health workers were trained and how they jointly implemented Project FIT 2.0 as a community-based collaborative care model in urban KC African American churches with volunteering adult participants. The fourth objective is to report on the feasibility and participant weight loss outcomes of the Project FIT 2.0 collaborative care model. The last objective is to provide a discussion of the findings in light of previous DPP research conducted in African American communities. The discussion also highlights future research and practice needed to further understand the impact, scalability, and sustainability of community-based collaborative care models to reduce the growing rates of diabetes.

Key Terms in this Chapter

Interprofessional Student Teams: A group of students from different professional backgrounds that come together to provide care or supportive services to patients, clients, or communities.

National Diabetes Prevention Program (DPP): A CDC evidence-based program that has been proven to significantly reduce risk for onset of diabetes through modest weight loss and physical activity.

Community-Based Participatory Research: An approach to conducting health science research that starts with the community identifying the priority health issues to be addressed and engages the community in all phases of research from conceptualizing the research agenda to research planning, implementation, evaluation and dissemination of findings, with the ultimate goal to reduce health disparities.

Collaborative Care: A strategy used to provide health care services and support in partnership directly with patients and/or with community and health organizations that are providing services and care with the patient.

Lifestyle Change Programs: Programs that provide information, skills, and support to help persons engage in health promotion behaviors including physical activity, healthy nutritional intake, stress management, and connecting with others to reduce risk for and/or manage chronic diseases and increase longevity.

Cultural Competence: The ability to understand patient needs and provide quality care in a manner acceptable to the patient regardless of their ethnicity, race, gender, religious and/or other personal characteristics or beliefs.

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