140-LB: Improving Translation of Diabetes Management Practices in Community Primary Care

Abstract

Objective: To evaluate the feasibility of using an innovative workforce development model, Project ECHO (Extension for Community Health Outcomes), to improve knowledge and self-efficacy around diabetes management practices among PCPs serving urban, under-resourced communities in the Chicago area. Methods: The Project ECHO model was applied to the management of medically and socially complex diabetes. For this series, a multidisciplinary subject matter expert team met with 30 PCPs from 12 health centers across the Chicago area for 17 weekly videoconferencing telementoring sessions. PCPs completed knowledge tests and self-efficacy surveys prior to the first session. During each hourly session, after a short didactic, PCPs presented de-identified patient cases for discussion and received evidence-based guidance and mentorship with a focus on individualized care. After series completion, PCPs repeated surveys. Post-program semi-structured interviews were conducted. Results: Increase in self-efficacy for treating complex diabetes reached the goal of 10% (p=.0007); the percentage of knowledge questions answered correctly increased from 39% to 62% (p<.0001). Participants reported increased comfort with and use of newer therapeutic agents. Participants reported taking the complicated psychosocial contexts of patients more in mind and adapting treatment regimens accordingly. One participant noted: “I was able to pick up pointers on how to talk to patients and how to motivate them asking the right questions about what is challenging for you, what can we do, and offer treatment, offer support accordingly.” Conclusion: Among PCPs serving under-resourced communities in the Chicago area, ECHO-Chicago: Complex Diabetes improved confidence and knowledge in complex diabetes management. Interviews demonstrate changes in clinical practices. Continued application of the ECHO model to medically and socially complex diabetes care is likely to be useful in under-resourced communities. Disclosure C. C. Thomas: None. M. E. Peek: None. C. Paul: None. M. Allison: None. A. Heilbrun: None. S. Tilmon: None. R. Thompson: None. D. P. Thomas: None. D. C. Johnson: None. Funding Chicago Center for Diabetes Translation Research