Recorded presentation

Yvette Roubideaux, MD MPH¹, Carolyn Noonan, MS², Jack Goldberg, PhD³, Lorraine Prucha, MPH⁴, S. Lorraine Valdez, RN, CDE⁵, and Kelly J. Acton, MD, MPH⁵. (1) Mel and Enid Zuckerman Arizona College of Public Health, University of Arizona, 500 N. Tucson Blvd, #110, Tucson, AZ 85716, 520-318-7280, yvetter@u.arizona.edu, (2) Center for Clinical and Epidemiological Research, University of Washington, 613 9th Ave, Box 359780, Seattle, WA 98104, (3) Department of Medicine, University of Washington, 325 Ninth Ave, Box 359780, Harborview Medical Center, Seattle, WA 98104, (4) College of Public Health, University of Arizona, 500 N. Tucson Blvd, #110, Tucson, AZ 85716, (5) National Headquarters Diabetes Program, Indian Health Service, 5300 Homestead Rd NE, Albuquerque, NM 87110

Research Objective: The purpose of this study is to examine the relationship between the level of diabetes education program services and the quality of diabetes care. Study Design: Cross-sectional study of the quality of diabetes care among patients in the Indian Health Service. Diabetes programs were invited to participate in the IHS Integrated Diabetes Education and Care Recognition Program and rank the level of comprehensiveness of their services into one of three groups ranging from the lowest (developmental) to the highest (integrated). The quality of care was determined using the 2001 IHS Diabetes Care and Outcomes Audit. The quality indicators included recommended yearly examinations, education, and laboratory tests. Results were compared among programs of differing comprehensiveness of services. Principle Findings: In the 86 participating programs, the majority of programs were classified at or below the developmental level of program comprehensiveness and only 9 programs (10%) were at the higher program levels (educational and integrated). After adjustment for patient characteristics, program factors and clustering of data within programs, more comprehensive programs were associated with greater completion rates of diet education, yearly cholesterol tests, and a1c tests (p< 0.05). Other quality of care indicators such as yearly foot and eye exams, routine laboratory tests and immunizations showed better outcomes for the higher level programs but these differences were not statistically significant. Conclusions: System-wide improvements in diabetes education are associated with better diabetes care outcomes. The results of this study could help inform development of diabetes education programs in minority and non-minority populations.

Learning Objectives:

• Learn about the IHS Integrated Diabetes Education Recognition Program
• Learn how many Indian health diabetes education programs rank in each level of the recongition program
• Learn whether higher level programs are associated with better diabetes care outcomes

Keywords: Diabetes, American Indians

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.

Recorded presentation