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Implementing a Diabetes Education Program to Reduce Health Disparities in South Texas: Application of the RE-AIM Framework for Planning and Evaluation

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  • Marcia G. Ory

    (Center for Population Health and Aging, Texas A&M University, College Station, TX 77843, USA
    Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX 77843, USA)

  • Shinduk Lee

    (Center for Population Health and Aging, Texas A&M University, College Station, TX 77843, USA)

  • Samuel D. Towne

    (Center for Population Health and Aging, Texas A&M University, College Station, TX 77843, USA
    Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX 77843, USA
    Department of Health Management and Informatics, University of Central Florida, Orlando, FL 32816, USA
    Disability, Aging, and Technology Cluster, University of Central Florida, Orlando, FL 32816, USA)

  • Starr Flores

    (Coastal Bend Health Education Center, School of Public Health, Texas A&M University, Corpus Christi, TX 78403, USA)

  • Olga Gabriel

    (Texas A&M South Texas Center-McAllen Campus, School of Public Health, Texas A&M University, McAllen, TX 78503, USA)

  • Matthew Lee Smith

    (Center for Population Health and Aging, Texas A&M University, College Station, TX 77843, USA
    Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX 77843, USA)

Abstract

Health disparities in diabetes management and control are well-documented. The objective of this study is to describe one diabetes education program delivered in the United States in terms of the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) Planning and Evaluation Framework. Questionnaires, clinical data, and administrative records were analyzed from 8664 adults with diabetes living in South Texas, an area characterized by high health disparities. The Diabetes Education Program delivered was a professionally led 12-month program involving 8 h of in-person workshop education followed by quarterly follow-up sessions. Changes in average blood glucose levels over the past 3 months (e.g., A1c levels) were the primary clinical outcome. Descriptive and multiple generalized linear mixed models were performed. This community-based initiative reached a large and diverse population, and statistically significant reductions in A1c levels ( p < 0.01) were observed among participants with Type 2 diabetes at 3 months. These reductions in A1c levels were sustained at 6-, 9-, and 12-month follow-up assessments ( p < 0.01). However, considerable attrition over time at follow-up sessions indicate the need for more robust strategies to keep participants engaged. For this diabetes education program, the RE-AIM model was a useful framework to present study processes and outcomes.

Suggested Citation

  • Marcia G. Ory & Shinduk Lee & Samuel D. Towne & Starr Flores & Olga Gabriel & Matthew Lee Smith, 2020. "Implementing a Diabetes Education Program to Reduce Health Disparities in South Texas: Application of the RE-AIM Framework for Planning and Evaluation," IJERPH, MDPI, vol. 17(17), pages 1-19, August.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:17:p:6312-:d:406262
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    References listed on IDEAS

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    1. Megha Bansal & Mona Shah & Brian Reilly & Susan Willman & Max Gill & Francine R. Kaufman, 2018. "Impact of Reducing Glycated Hemoglobin on Healthcare Costs Among a Population with Uncontrolled Diabetes," Applied Health Economics and Health Policy, Springer, vol. 16(5), pages 675-684, October.
    2. Gaglio, B. & Shoup, J.A. & Glasgow, R.E., 2013. "The RE-AIM framework: A systematic review of use over time," American Journal of Public Health, American Public Health Association, vol. 103(6), pages 38-46.
    3. Alexandra C. H. Nowakowski & Jihyung Shin & Henry J. Carretta, 2019. "Regional Risk: Mapping Single and Multiple Chronic Conditions in the United States," SAGE Open, , vol. 9(1), pages 21582440188, January.
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