CoMac Communication System—A Feasibility Implementation of Language-Centered Intervention for T2DM

Abstract

The CoMac Communication System is a scientifically tested set of tools to individualize Diabetes Self-Management Education and Support (DSMES), by speaking to persons with type 2 diabetes (T2DM) using their own language and worldviews. In this quasi experimental study, conducted in a Midwestern diabetes care clinic with an accredited DSMES, a tablet was provided for patients to complete the CoMac segmentation survey. Altogether 72 patients took the survey and received the tailored communication. An unplanned control group of 48 patients emerged, due to occasional unavailability of the tablet/survey. These patients received the clinic’s standard DSMES, without the use of the CoMac tools. A1C levels from the first visit to the follow-up visit for each group were compared. Interviews with the healthcare providers (HCPs), conducted during the six-month study, provided evidence about the success of the implementation. Individual psychosocial profiles and language recommendations helped HCPs better align their language. “Words matter” led to more efficient and effective behavioral goal settings with the patients. The A1Cs of the intervention group decreased from 8.9 to 7.3, the control group’s from 8.3 to 7.6. A multiple regression analysis with the A1C level change as the dependent variable showed that the independent variables of age, gender, and starting weight were not significant predictors of A1C reduction. Statistically significant were the starting value of A1C and the CoMac intervention. Patients with higher initial A1Cs showed a greater decline in A1Cs. The key variable of interest, treated with the CoMac intervention, had a t-value of -1.81, with a prob value of 0.037. Although a cause-and-effect relationship cannot be proven without random assignment, the significantly improved A1Cs of the intervention group are highly encouraging. As diabetes care teams and delivery models expand, person-centered language tools are an innovation in effective management of DSMES. Disclosure U.M. Connor: Other Relationship; Self; CoMac Analytics, Inc..R. Sandy: None. M. de Groot: Consultant; Self; Johnson & Johnson Diabetes Institute, LLC., Eli Lilly and Company. R.S. MacNeill: Other Relationship; Self; comAc analytics inc.