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Novel, culturally sensitive, shared medical appointment model for Hispanic pediatric type 1 diabetes patients
Author(s) -
Pascual Andrea B.,
Pyle Laura,
Nieto Jazmin,
Klingensmith Georgeanna J.,
Gonzalez Andrea Gerard
Publication year - 2019
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/pedi.12852
Subject(s) - medicine , culturally sensitive , sma* , culturally appropriate , type 1 diabetes , type 2 diabetes , diabetes mellitus , pediatrics , family medicine , psychology , social psychology , mathematics , combinatorics , endocrinology
Background/Objective Latino patients with type 1 diabetes (T1D) face cultural and language barriers leading to poor outcomes. Shared medical appointments (SMAs) are recognized as effective models of care. Our aim is to develop a culturally sensitive, cost effective SMA program for Latino T1D. Subjects Spanish speaking Latinos 1 to 20 years with T1D ( n = 88) and their families. Methods Routine care alternating with SMAs that included group education was provided. Teens, ages >11 received the SMA separate from parents. Younger children were seen together. Hemoglobin A1c (HbA1c), behavioral questionnaires, and use of diabetes technology were measured at baseline and every 3 to 6 months. Results 57.7% of children and 77.27% of teens completed the 2 years of the Program. There was a significant association between age and change in HbA1c from baseline to year 1 ( P = .001) and baseline to year 2 ( P = <.0001). For participants <12 years, there was a significant improvement in HbA1c from baseline to year 1 ( P = .0146) and from year 1 to year 2 ( P = .0069). Participants ≥12 years, had an increase in HbA1c from year 1 to year 2 ( P = .0082). Technology use increased significantly from baseline to year 2 for participants <12 years of age (19%‐60%, P = .0455) and for participants who were ≥12 years of age (10%‐23%, P = .0027). Participants reported a 98% satisfaction rate. Conclusions The culturally sensitive SMA proved to be an appreciated, feasible, and effective alternative to care for Latinos with T1D.