Abstract

A Mixed Methods Approach to Identifying Local Variations in Diabetes Care

Kyle Shaak, MPH1, Michael Topmiller, PhD2, Autumn Kieber-Emmons, MD1, Beth Careyva, MD1 and Melanie Johnson, MPA1
(1)Lehigh Valley Health Network, Allentown, PA, (2)American Academy of Family Physicians, Cincinnati, OH

APHA's 2019 Annual Meeting and Expo (Nov. 2 - Nov. 6)

Context: The prevalence of Type 2 Diabetes in the United States has been increasing since the middle of the 20th century, and is expected to continue to rise. The connection between health and the communities patients live in is well documented. Identifying and locating geographic regions with pockets of patients most in need of intervention may provide insight into how to improve health care disparities in our community. Objective: To identify local regions with increased diabetes prevalence and rates of poor diabetes control and explore the underlying barriers and facilitators causing those disparities. Design: Patient level data, including addresses, demographics, diabetic status, and diabetes care metrics, were retrieved from the Electronic Medical Record. Data was aggregated to the 5-digit zip code level, and a geospatial analysis was conducted. Focus groups will be conducted in regions identified as outliers to explore local barriers and facilitators to receiving appropriate diabetes care. Results: Geospatial analysis identified several zip codes with high rates of diabetes prevalence and high rates of poor diabetes control. Additional zip codes experiencing high rate of good diabetes control were identified. After the conclusion of focus groups in these regions, a qualitative analysis will be conducted to identify the social determinants of health in each region that have the largest impact on diabetes care being received. Conclusion: Qualitative data provides context to clinical data that would not be possible without having conversations with community members. This context may help public health professionals design interventions that account for where people live and what resources they have available.

Assessment of individual and community needs for health education