The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #64092

Somer Goad, MPH¹, Danielle O'Connor, BS¹, Karen M. Perrin, PhD, MPH, RN², Howard Jacobson, MD², Robert J McDermott, PhD, FAAHB³, Claire Shippey, MA², Gary Walby, MS, MSPH⁴, Seraphine Pitt, MPH, CHES⁵, and Melinda S Forthofer, PhD⁴. (1) Dept. of Community and Family Health, University of South Florida, College of Public Health, 13201 Bruce B. Downs Blvd., MDC-56, Tampa, FL 33612, (2) Dept of Community and Family Health, University of South Florida, College of Public Health, 13201 Bruce B. Downs Blvd., MDC-56, Tampa, FL 33612, 813 974 6704, kperrin@hsc.usf.edu, (3) Department of Community and Family Health, University of South Florida College of Public Health, 13201 Bruce B. Downs Blvd, MDC 56, Tampa, FL 33612, (4) College of Public Health, University of South Florida, 13201 Bruce B. Downs, Blvd., MDC 56, Tampa, FL 33612, (5) Department of Community and Family Health, University of South Florida, College of Public Health, 13201 Bruce B. Downs Boulevard, Tampa, FL 33612

Background: Pfizer Inc., the University of South Florida College of Public Health, and the Florida Agency for Health Care Administration collaborated to address the needs of low literacy patients receiving chronic disease management services at 27 Florida Community Health Care Centers (CHCCs). Purpose: Medication and behavioral regimen compliance was examined among patients with Type 2 diabetes and/or hypertension provided with cost-free medication and exposed to For Your Health, an English/Spanish intervention designed to enhance patient understanding of chronic disease management. Methods: For Your Health consists of incentives, group classes, waiting room posters, brochures, workbooks, and 3-month and 6-month patient evaluations. Bilingual health educator field notes pertinent to patients and the clinic environment were formally analyzed for themes with Ethnograph 5.0. Results: Field notes provided insights for recruitment and retention of patients and motivation of skeptical physicians and clinic staff initially unreceptive to the paperwork and protocols associated with research. As the initial phase of the study winds down, early clinical results include: (1) patient weight loss; (2) more favorable clinical values; (3) reduced depression; and (4) improved family support. Staff turnover, administrative uncertainty, facility limitations, and other factors present ongoing programmatic challenges. Conclusions: With For Your Health active in 14 Florida CHCCs, motivated health educators, receptive clinic staff, and continuity of care contribute to patient compliance and health literacy improvement. Removal of compliance barriers such as pharmacologic costs and low health literacy should contribute to improved patient outcomes.

Learning Objectives:

• At the end of the session, the participants will be able to:
• 1. Describe the implementation process used for the Florida Health Literacy Study.
• 2. Discuss ways that the health educators were successful in motivating the clinic staff and patients to increase recruitment and retention.
• 3. Describe how some barriers to the implementation process were successfully overcome by the health educators.

Keywords: Diabetes, Disease Management

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.