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

Marcia G. Ory, Shinduk Lee, Samuel D. Towne, Starr Flores, Olga Gabriel and Matthew Lee Smith
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Marcia G. Ory: Center for Population Health and Aging, 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
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

IJERPH, 2020, vol. 17, issue 17, 1-19

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.

Keywords: chronic disease management; diabetes education; intervention; implementation and dissemination research; South Texas; health disparities; Hispanic; RE-AIM framework (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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