Management Intervention Program Research Articles

Development of a nurse navigation program for cancer pain

ObjectiveCancer pain significantly impacts the overall quality of life of cancer patients, necessitating proactive management. The manifestations of cancer pain vary individually and require tailored interventions to address each patient's unique characteristics. Therefore, this study aims to develop a nurse navigation program for cancer pain (NNP-CP) tailored to the needs of cancer patients requiring pain control, aiming to establish evidence-based clinical nursing practices and promote effective cancer pain management. MethodsThis study is a methodological research into developing a pain management program led by nurses for cancer patients requiring pain control, based on a professional navigation framework. The development of the program relied on three out of the five stages of the ADDIE (Analysis, Design, Development, Implementation, Evaluation) model. ResultsA literature review was conducted to select the content and rationale to be included in the intervention program. Publications within the last 10 years in English or Korean were identified and screened based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 literature selection flow, 17 articles were included. Standardized information regarding cancer pain control was based on the 7th edition of 'Cancer Pain Management Guidelines'. The initial draft of the pain management intervention program was developed by organizing and structuring the derived content based on the professional navigation framework. Subsequently, the final intervention program was confirmed through the review by six clinical experts specializing in cancer pain. ConclusionsCancer pain is a significant factor that profoundly influences the quality of life and survival duration of cancer patients. While appropriate management methods offer the prospect of control, insufficient intervention is the current reality. Through the pain management intervention program based on the expert navigation framework that promotes continuity of care and empowers the recipients, this study anticipates not only pain reduction in cancer patients but also an enhancement in their quality of life.

The correlation of ABC goal attainment with insulin resistance/sensitivity in Syrian type 2 diabetes patients

BackgroundThe rising prevalence of type 2 diabetes (T2D) in Syria emphasizes the urgent requirement for effective management approaches. The ABC goals, which include maintaining glycated hemoglobin levels below 7 %, blood pressure below 140/90 mmHg, and low-density lipoprotein cholesterol levels below 100 mg/dl, serve as crucial benchmarks for managing T2D and its associated comorbidities. MethodsIn this cross-sectional study, the achievement of ABC goals was retrospectively examined among 681 clinically diagnosed T2D patients (not on Insulin) who participated in a six-year online lifestyle intervention program for diabetes management at the Freedom from Diabetes Clinic in Syria between January 2016 and December 2022. ResultsOut of the participants, 152 (22.3 %) successfully achieved all three ABC goals, while 306 (45.0 %) and 183 (26.9 %) achieved two or one goal(s) respectively. The factors influencing the attainment of all three ABC goals revealed a significant association with older age (>50 years), lower body mass index (<25 kg/m2), and lower insulin resistance (Homeostatic Model Assessment of Insulin Resistance < 2.5). Furthermore, patients who successfully achieved all three ABC goals exhibited lower insulin resistance, improved lipid profiles, and higher insulin sensitivity and beta cell function. ConclusionThis study offers new insights into the relationship between insulin resistance/sensitivity and the achievement of ABC goals in the Syrian population with T2D, underscoring the necessity for tailored strategies to enhance comprehensive diabetes management.

Interplay Between the American Diabetes Association's ABC Targets for Diabetes, Insulin Resistance Indices, and Dyslipidemia in Indian Type 2 Diabetes Patients.

Background The increasing incidence of type 2 diabetes (T2D) in India underscores the pressing need for effective management strategies. Meeting the American Diabetes Association (ADA) ABC targets for diabetes (glycated hemoglobin (HbA1c), blood pressure, and serum low-density lipoprotein cholesterol (LDL-C)) is crucial for effectively managing T2D, as it reflects the optimal control of key metabolic parameters. Insulin resistance (IR) and impaired beta cell function (BCF) have been found to have a significant impact on glycemic control, lipid metabolism, and hypertension, contributing to the complex cardiovascular risk profile of patients with T2D. This study aimed to explore the association between ABC targets for diabetes, IR, BCF, and dyslipidemia in a cross-sectional cohort of T2D patients. Methods This retrospective study examined data from 681 T2D patients with comorbid hypertension and dyslipidemia. The patients were part of a one-year online lifestyle intervention program for diabetes management at the Freedom from Diabetes Clinic in Pune, India, between January 2021 and December 2022. Baseline data (at the time of enrollment in the program) on medical history and anthropometric and biochemical parameters were retrospectively extracted from medical records and used to assess ABC targets and other clinical parameters. The ABC targets for diabetes include three goals: an HbA1c level of less than 7.0%, a blood pressure level of less than 140/90 mmHg, and an LDL-C level of less than 100 mg/dL. Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), Homeostatic Model Assessment of Beta Cell Function (HOMA-B), and Quantitative Insulin Sensitivity Check Index (QUICKI) were calculated using standard formulas. Results Cross-sectional analysis at baseline showed that 152 (22.3%) participants met all three ABC targets, 306 (45.0%) and 183 (26.8%) participants met two or one targets, respectively, and 40 (5.9%) did not meet any of the ABC targets. Participants meeting all three targets showed significantly lower IR, higher sensitivity (HOMA-IR, median 2.1; QUICKI, median 0.34), higher BCF (HOMA-B, median 62.9), and healthier lipid profiles (mg/dL) (total cholesterol, median 126; triglycerides, median 114; and non-high-density lipoprotein (HDL), median 84) than those who did not meet any of the ABC targets (HOMA-IR, median 3.4; QUICKI, median 0.31; HOMA-B, median 31.7; total cholesterol, median 221; triglycerides, median 187; and non-HDL, median 182) (p < 0.01). A significant association was observed between lower BMI (< 25 kg/m2), lower IR (HOMA-IR <2.5), and meeting all three ABC targets (p < 0.01). No significant association was observed between the duration of diabetes and ABC target status (p > 0.1). Lower IR was identified as a predictor of achievement of all three ABC targets (p < 0.01). Conclusion This study highlights the significance of meeting ABC targets for diabetes in relation to not only a better lipid profile but also lower IR and higher BCF. These preliminary findings provide novel insights into the interplay between IR, BCF, dyslipidemia, and meeting ABC targets in an Indian T2D population. These findings highlight the need for effective diabetes management strategies and improved patient outcomes, considering factors such as BMI and IR indices.

What features of drug treatment programs help, or not, with access? a qualitative study of the perspectives of family members and community-based organization staff in Atlantic Canada

BackgroundWithdrawal management and opioid agonist treatment (OAT) programs help to reduce some of the harms experienced by people who use substances (PWUS). There is literature on how features of drug treatment programs (e.g., policies and practices) are helpful, or not helpful, to PWUS when seeking access to, or in, treatment. There is, however, relatively little literature based on the perspectives of family members/family of choice of PWUS and community-based organization staff within the context of Atlantic Canada. This paper explored the perspectives of these two groups on what was helpful, or not, about drug treatment programs in Atlantic Canada in terms of supporting access to, and retention in, treatment.MethodsOne-on-one qualitative telephone interviews were conducted in 2020 with the two groups. Interviews focused on government-funded withdrawal management and OAT programs. Data were coded using a qualitative data management program (ATLAS.ti) and analyzed inductively for key themes/subthemes using grounded theory techniques.ResultsFifteen family members/family of choice and 16 community-based organization staff members participated (n = 31). Participants spoke about features of drug treatment programs in various places, and noted features that were perceived as helpful (e.g., quick access), as well as not helpful (e.g., wait times, programs located far from where PWUS live). Some participants provided their perceptions of how PWUS felt when seeking or accessing treatment. A number of participants reported taking various actions to help support access to treatment, including providing transportation to programs. A few participants also provided suggestions for change to help support access and retention such as better alignment of mental health and addiction systems.ConclusionsParticipants highlighted several helpful and not helpful features of drug treatment programs in terms of supporting treatment access and retention. Previous studies with PWUS and in other places have reported similar features, some of which (e.g., wait times) have been reported for many years. Changes are needed to reduce barriers to access and retention including the changes recommended by study participants. It is critical that the voices of key groups, (including PWUS) are heard to ensure treatment programs in all places support access and retention.

Frequent Use of Contingency Management and Opioid Treatment Programs that Provide Treatment for More than Only Opioid Use Disorder

Contingency management is an effective behavioral intervention for treating substance use disorders that provides patients with incentives for objective verification of completed targeted recovery behaviors including abstinence from substances, attending treatment, and medication adherence. Accredited/licensed opioid treatment programs provide effective, medications for opioid use disorder. This study evaluated the prevalence of frequent contingency management use among a national sample of opioid treatment programs in the U.S. ( N = 672). A binary logistic regression model examined factors associated with providing contingency management, including state-level fatal overdoses, number of pharmacotherapies, outpatient treatment, facility ownership, and residential treatment. Most evaluated facilities provided contingency management ( n = 440; 65.5%). Facilities that prescribed more pharmacotherapies, were located in states with high drug overdose death rates, and for-profit (compared to nonprofit) providers were more likely to offer contingency management. Because contingency management effectively treats substance use disorders, contingency management should be offered more broadly across opioid treatment programs.

Education Management Intervention in Managing School Problems

This study was carried out with the intention of developing a complete management intervention program for the purpose of managing issues that arise in schools. For the purpose of this study, the descriptive documentary-developmental research approach was executed. The study investigated the behavioral and academic issues of students attending public high schools in relation to their academic performance in English and Mathematics. As a result, the descriptive approach was chosen to conduct the evaluation. As stated by Travers (1978), the primary objectives of conducting descriptive research are to offer a description of the nature of a situation as it is at the time of the study and to investigate the factors that contribute to certain events. The behavior problems of public high school students are greatly affected by their social environment like home; students were troubled in school and presently encountering a lot of problems in school work. Those student-respondents of public secondary schools were having difficulty in terms of finances.

Social Network Analysis as a Tool in the Care and Wellbeing of Zoo Animals: A Case Study of a Family Group of Black Lemurs (Eulemur macaco).

Social network analysis (SNA) is an increasingly utilised technique in the literature examining the social structures and organisation of animals and understanding the bonds between groups and individuals. Using a case study as an illustration, the applications of SNA are explored, including the identification of dominance hierarchies and detection of sources of social pressure, with a particular focus on the applications of SNA to holistic assessments of animal welfare alongside other methods. Based on the examination of social dynamics in a family group of four black lemurs (Eulemur macaco), a primate whose social organisation is characterised by patterns of female dominance, it is demonstrated that SNA can be used to examine the affiliative and agonistic interactions between individuals living in human care. SNA showed species-typical forms of female dominance that were largely directed towards the two males, characterised by the initiation of aggressive interactions and male submission. More intricate relationships and consistent social roles across networks were revealed through the examination of SNA. It is concluded that SNA has wide-ranging benefits in the assessment of effects of environmental changes, such as informing social management decisions, developing enrichment and intervention programs, and guiding overall improvements to the housing and care of individual animals. SNA, as part of an animal welfare toolbox, could, therefore, be a pivotal technique for modern animal welfare assessment that considers individual animals and their social lives. By sharing a case study of the technique in use, it is hoped that animal collections may adopt similar modern and evidence-based assessment methods.

The Evolution of Diversity Management in Business Practice

Diversity and inclusion are among the most essential issues for modern labour, with millennials emerging as the largest group in the workforce. Through the definition of diversity management and the use of examples, this paper demonstrates the function of diversity management in contemporary business environments. This paper explores, through case studies and critical analysis, the benefits and drawbacks of diversity management in corporate practise. This essay uses the examples of IBM and McDonald's to demonstrate how diversity management may be used effectively. This essay makes the case that in order to accomplish varied management and practise, any organisation must identify workable solutions that are appropriate for its size and manner of operation. In order to implement diversity management intervention programmes, human resource departments can use this paper as a guide.

Academic career management intervention at a South African university: A modified Delphi study

Orientation: Understanding the components for an academic career management intervention programme, to enable the development of the required academic pipeline to achieve the strategic objectives of higher education institutions.Research purpose: A consensus view across subject experts for a career management intervention programme to enable the progression of academic careers.Motivation for the study: While academic career literature captures an array of normative designs of career management programmes to cultivate the required academic talent consortium, literature indicates a lack of a comprehensive and systematic approach for career management to provide a framework for successfully managing academic careers.Research design, approach and method: A modified Delphi technique was employed, by presenting an expert panel with the findings of a broader research project to initiate the consensus-seeking methodology - a systematic approach to obtain concordance on the experts’ opinions through two rounds of structured questionnaires.Main findings: The identified components are structured and presented in five main themes (categories), including: (1) institutional, (2) individual, (3) overlapping, (4) cultural and (5) external. The results show a strong agreement among the experts on the first four categories. The fifth (external) offers the lowest level of agreement, reminding that the higher education system is part of a broader contextual system; it should be understood within its operational context and time.Practical/managerial implications: Offering talent management practitioners and higher education leaders expert observations of the factors to consider while planning and implementing career management intervention programmes to enable academic career progression.Contribution/value-add: A comprehensive and systematic approach for career management, providing a framework for successfully managing academic careers across the various career stages.

Anger and Stress Management Techniques for Successful Educational Leadership

This study aimed to investigate the effectiveness of an anger and stress management intervention program on school leaders' burnout, stress, anger, and leadership skills. The study utilized a pre-test, post-test, and follow-up design and collected quantitative data using standardized measures. The study also collected qualitative data through focus group discussions with school leaders at the end of the intervention phase. The data were analyzed using descriptive statistics, paired-sample t-tests, repeated-measures ANOVA, and thematic analysis. The quantitative results showed significant improvements in burnout, stress, anger, and leadership skills among the school leaders who participated in the intervention program. The qualitative findings revealed four main themes: increased self-awareness and emotional regulation, improved communication and conflict resolution skills, enhanced problem-solving and decision-making skills, and improved work-life balance and well-being. The study suggests that anger and stress management interventions can be effective in improving school leaders' well-being and leadership skills. These findings have practical implications for educational institutions and policymakers to implement anger and stress management interventions to support the well-being of school leaders and improve the quality of education

Prevalence and factors associated with hypertension among peoples living with HIV in East Africa, a systematic review and meta-analysis

BackgroundIn recent years, improved access to effective antiretroviral therapy has meant that people living with human immune virus are living longer than before. The burden of non-communicable diseases particularly, hypertension parallels with the increase in age. Although hypertension screening is thought to be an effective indicator of overall health status and paves the way for early interventions in peoples living with human immune virus, the exact prevalence of hypertension in this population remained unknown. We aimed to report the prevalence of hypertension and examine the factors associated with hypertension among people living with human immune virus in East Africa.MethodsIn this systematic review and meta-analysis, we searched PubMed, Science Direct, Scopus, Cochrane library, and Google Scholar databases for studies published until January 1, 2023. The search period was from January 10/2023, to February 10/ 2023. Random-effect models were used to calculate the pooled prevalence of hypertension. Subgroup analyses were conducted to explore potential heterogeneity. The Funnel plot and Egger’s test were used to assess publication bias.ResultA total of 15 studies with 10,916 individuals were included in the present meta-analysis. The pooled prevalence of hypertension among people living with human immune virus was19.75% (95% CI, 16.07%-23.42%)),). The prevalence of hypertension was not differed between studies conducted 2014- 2019 and, studies conducted 2020–2022. The prevalence of hypertension was lowest in Ethiopia (16.13%) and highest in Tanzania (26.76%). Alcohol consumption (Adjusted Odds Ratio (AOR): 3.39, 95% CI: 2.35–4.43), diabetes (AOR: 2.64, 95% CI: 1.89–3.39), longer duration of HIV (AOR: 1.72, 95% CI: 1.15–2.3), male sex (AOR: 1.62, 95% CI: 1.43–1.8), obesity (AOR: 2.89, 95% CI: 1.94–3.84), and older age (AOR: 2.25, 95% CI: 2.0–2.5), were the factors associated with the presence of hypertension in people living with human immune virus.ConclusionOur study shows that one in five peoples living with human immune virus have hypertension causing symptoms and impairment, therefore requiring treatment. Designing effective health screening and hypertension management intervention programs helps to prevent the occurrence of hypertension and promotes peoples’ overall quality of life.

The effectiveness and user experience of a biofeedback intervention program for stress management supported by virtual reality and mobile technology: a randomized controlled study

BackgroundHeart rate variability biofeedback (HRV-BF) can be used for stress management. Recent feasibility studies suggest that delivering HRV-BF in virtual reality (VR) is associated with better user experience (UX) and might yield more beneficial changes in HRV than two-dimensional screens. The effectiveness of a VR-supported HRV-BF intervention program has, however, not been investigated yet.MethodsIn this study, 87 healthy women and men were assigned to a VR-supported HRV-BF intervention (INT; n=44) or a wait-list control (WLC; n=43) group. The INT came to the lab for four weekly HRV-BF sessions in VR using a head-mounted display. Between lab sessions, participants were asked to perform breathing exercises without biofeedback supported by a mobile application. Stress-related psychological and psychophysiological outcomes were assessed pre- and post-intervention and at a follow-up four weeks after the intervention in both groups. A psychosocial stress test was conducted post-intervention to investigate changes in stress reactivity. UX was assessed after each HRV-BF session in the INT.ResultsAnalysis revealed that LF increased significantly from pre- to post-, whereas pNN50 increased and chronic stress decreased significantly from pre-intervention to follow-up in the INT compared to the WLC. Anxiety and mental fatigue decreased significantly, while mindfulness and health-related quality of life increased significantly from pre- to post- and from pre-intervention to follow-up in the INT compared to the WLC (all small effects). The two groups did not differ in their stress reactivity post-intervention. As for UX in the INT, the degree of feeling autonomous concerning technology adoption significantly decreased over time. Competence, involvement, and immersion, however, increased significantly from the first to the last HRV-BF session, while hedonic motivation significantly peaked in the second session and then gradually returned to first-session levels.ConclusionsThis HRV-BF intervention program, supported by VR and mobile technology, was able to significantly improve stress indicators and stress-related symptoms and achieved good to very good UX. Future studies should control for potential placebo effects and emphasize higher degrees of personalization and adaptability to increase autonomy and, thereby, long-term health and well-being. These findings may serve as a first step towards future HRV-BF applications of cutting-edge, increasingly accessible technologies, such as wearables, VR, and smartphones, in the service of mental health and healthcare.Trial registrationThe study was registered retrospectively as a clinical trial on ISRCTN registry (ISRCTN11331226, 26 May 2023).

Understanding the perception of buffer zone communities to gharial (Gavialis gangeticus) conservation in Chitwan National Park, Nepal

The gharial (Gavialis gangeticus) is a Critically Endangered species found in Nepal and India. In Nepal, gharials are distributed in Chitwan and Bardia National Parks. Gharials are highly threatened due to various and severe anthropogenic activities. In this study, we assess the attitude, perception and willingness of a range of stakeholders living around Chitwan National Park to participate in gharial conservation. We conducted semi-structured questionnaire surveys with open ended questions. We interviewed national park officials (n = 8), local community group members (n = 54), hoteliers (n = 12), conservation partners (n = 5), local elected representatives (n = 38), fishing community members (n = 14), fishing net sellers (n = 15) and students (n = 9). Our study revealed that respondents are familiar with existing conservation awareness activities and expressed their willingness to participate in gharial conservation activities which can be capitalized on for future conservation initiatives for gharials. Further, we suggest to concentrate efforts particularly on local representatives, fishing net sellers and river dependent communities. These efforts include community level gharial knowledge sharing and interaction program, school teaching program, participating community in gharial conservation and its habitat management intervention and livelihood programs.

Does Interdisciplinary Care Team Care Management Improve Health Quality and Demonstrate Cost-Effectiveness?

This study evaluated the impact of an interdisciplinary care teams (IDCT) care management program on cost and quality outcomes using a novel algorithm to identify 400 high-risk patients out of 48,235 Medicare Advantage (MA) beneficiaries. Of the 400, 252 were enrolled in the IDCT care management intervention program, while the remaining 148 were not enrolled. A second comparison group consisted of 660 who were referred to the IDCT program but not selected by the algorithm. The program's effectiveness was evaluated 1-year postintervention. Analyses found that health care costs for members enrolled in the IDCT program were reduced by US$1,121.76 and US$1,625.61 per member per month, respectively, relative to those not enrolled and those enrolled by referral. The cost reduction from the program generated a net savings of US$1.9MM, covering the program's cost. Findings suggest IDCTs can cost-effectively manage populations of high-risk patients with better selection and fostering greater interdependence.

Talent Management Intervention Program for First Line Nurse Managers and Its Effect on Their Job Performance

Talent Management Intervention Program for First Line Nurse Managers and Its Effect on Their Job Performance

Effect of a waste management intervention program on knowledge, attitude, and practice (KAP) of nurses and housekeepers: a quasi-experimental study, Egypt

BackgroundImproper healthcare waste management practice is alarming in developing countries because resources are inadequate and waste management is often delegated to poorly educated and untrained laborers. This study aimed to compare the pre-KAP versus post-KAP towards the waste management program for nurses and housekeepers. In addition, it aimed to explore possible factors affecting the pre- and post-KAP in Mansoura Emergency University Hospital, Egypt.Subjects and methodsOne hundred thirty-three newly employed nurses, housekeepers, and those who need refreshment training as nominated by head nurses and link occupational health and safety nurses in the hospital were recruited for the study. The study’s intervention included multiple training sessions using a PowerPoint presentation in Arabic with appropriate illustrations followed by an open discussion. An Arabic self-administered questionnaire containing demographic and occupational history, knowledge (27 questions), attitude (10 questions), and practice (9 questions) was used pre- and post-intervention.ResultsThe overall KAP scores among the studied healthcare workers were significantly higher after the intervention. The pre- and post-knowledge scores were significantly different with respect to education, job description, and duration of employment (p < 0.05). The post-attitude scores were significantly different with respect to education and job description only (p < 0.05). The total pre-practice scores were significantly different with respect to education and job description (p < 0.05). However, the post-practice scores were significantly different with respect to sex, age, education, and job description (p < 0.05).ConclusionThere was a significant improvement in the KAP scores post-intervention. The post-knowledge and attitude scores were significantly better in nurses and participants with a higher education. The post-practice score was significantly better for females, participants with an age ≥ 30 years, higher education, and nursing jobs. The combination of training and supervision was crucial for the success of waste management programs. Higher education levels are required for housekeepers to be capable of gaining better knowledge, follow rules, and be ready for any challenges in the future.

Lived Experience of Violence Perpetrated by Treated Patients and Their Visitors in Intensive Care Units: A Qualitative Study of Nurses.

Patient and visitor violence (PVV) is a widespread problem for health professionals. Nurses working in intensive care units (ICUs) face a relatively high risk of experiencing PVV, which significantly impacts both the health of nurses and the institution as a whole. The subjective perceptions of ICU nurses regarding PVV are inadequately explored in the literature. The purpose of this study was to explore the perspectives, experiences, and perceptions of PVV in ICU nurses and to better understand the precipitating factors of violence. A phenomenological qualitative design and purposive sampling were used. A semistructured interview guide was used to conduct in-depth interviews with 12 ICU nurses with PVV experiences. Giorgi's method of analysis was used to discover and identify the essential categories of experience. Five main experience categories were identified: family and patient factors as flashpoints, managing suppressed emotions by weathering the emotional storm, spiritual awakening after violence, and strategies for surviving further violence. The participants' experiences with PVV included a range of caring and mental health difficulties. In ICU settings, patient progress is often unpredictable, resulting in discrepancies between patient/family expectations and reality. Because feelings of frustration and powerlessness can eventually cause exhaustion in ICU nurses, implementing effective emotional management, stress adjustment, psychological counseling, team support, and violence intervention programs are crucial. This study provides new information on the process by which nurses can progress from inner trauma to self-recovery, moving from a negative affectivity disposition to a better understanding of threat appraisals and coping response options. Nurses should increase their awareness of the complexity of the phenomenon and of the interplay among the factors underlying PVV. The results of this study suggest that routine confusion and delirium assessments to rule out patients with ICU delirium in ICUs are important to preventing PVV. This study considers some of the implications of the research findings for nursing managers. Interventions, training programs, and/or management action should be used to ensure psychological and mental support is extended to all witnesses of PVV events and not only to those targeted by violence.

Stress management intervention program for teaching staff at private engineering colleges in Tamil Nadu to improve their job performance and well-being

PurposeStress at workplace is quite common in all sorts of environment. It can be occurring when the demand in the job does not match with the requirements; thereby, it affects their performance. The study was conducted with the aim to identify the major factors that induce stress for teaching professionals in private engineering colleges and its impact towards job performance. From the observation and discussion, it was found that Workload, Working Hour, Salary, Role Ambiguity and Lack of Social Support are the major factors for stress.Design/methodology/approachA structured questionnaire was framed with the help of stress-causing factors and their effect on job performance. In addition to this, a few questions were asked related to stress management intervention program. The survey was conducted with 370 respondents, while further analysis was carried out with the filled 260 respondent’s data using descriptive statistics, correlation, regression, ANOVA and SEM.FindingsThe study reveals that workload plays a significant role in stress whereas other factors are consequently lower than that. Also, the primary-level intervention programs are more effective than secondary-level intervention programs to reduce the stress level of stressors.Originality/valueThe paper was originally done by collecting data from the staff.

440-P: Complications of Diabetes after 15 Years—Comparing Telemedicine with Conventional Care

Diabetes Tele-Management System (DTMS®), a telemedicine (TM)-based intervention and follow-up program for diabetes management comprising of a multidisciplinary team performs drug titration, provides dietary advice &amp; educates the patients and their caregivers periodically with the help of customized software and user interface. The study was done to examine the long-term effect of TM consultation along with face-to-face consultation (F-F) in metabolic control &amp; prevention of complications. A total of 495 T2D (62.91 ± 11.64 years (Y); 62.2% males, duration of diabetes: 8.41 ± 2.78 Y), were de-identified. The treatment group [TG- 63.41±11.73 Y; 62.92% males; 8.04±1.82 Y of T2D] included T2D with ≥1F-F and ≥5 TM consultations per year. The propensity score-matched control group [CG-62.17±11.50 Y; 58.69% males; 7.98±2.96 Y of T2D] included T2D who were not on regular follow-up with compromised F-F and TM visits. Data of 15±5 years were collected from DTMS and statistically analyzed. Significant improvement (p &amp;lt; 0.001) in clinical parameters including HbA1c, FBS, lipid profile, BP &amp; weight from baseline to 10 Y of follow up was observed in TG. 9.8% in TG and 82.1% in CG had diabetic complications (Table 1). This 15 year long real-world experience reveals a robust difference between the 2 arms providing compelling evidence to fund TM consultations. Disclosure J.Kesavadev: None. A.Shankar: None. K.Jothydev: None. S.R.Joshi: Advisory Panel; Biocon, Zydus Cadila, Torrent Pharmaceuticals Ltd, Franco India, Consultant; Glenmark Pharmaceuticals, Twin Health, Speaker's Bureau; Abbott Nutrition, Sanofi, Abbott, Novo Nordisk, Lupin Pharmaceuticals, Inc. G.Krishnan: None. G.Sanal: None. A.Basanth: None. G.B.Chandran: None. S.Jothydev: None.

1692-P: Designing and Testing a Novel Weight Navigation Program to Improve Obesity Treatment in Primary Care Settings

Background: We developed and tested a novel Weight Navigation Program (WNP). The WNP aims to (1) integrate American Board of Obesity Medicine Diplomates into primary care teams, (2) deliver preference-sensitive weight management treatment, and (3) optimize patients’ achievement of ≥5% weight loss through remote weight monitoring with proactive outreach to support patients with &amp;lt;5% weight loss. Methods: This is a quality improvement program conducted at an academic primary care site from October 2020 to September 2021. WNP inclusion criteria are BMI ≥30 and ≥1 weight-related condition. Primary outcomes were measures of feasibility, including rates of referral to and engagement in the WNP. Secondary outcomes were mean weight loss and percentage of patients achieving ≥5% weight loss. We compared rates of referral to weight management treatment programs (i.e., nutrition counseling, meal replacement (MR), bariatric surgery) and prescribing of weight management medications (WMMs) among WNP-eligible patients at the pilot site and at a nearby clinic (control). Rates are also reported for patients with a completed WNP visit. Results: Of 1,533 eligible patients, 238 (16%) were referred to the WNP and 135 (9%) completed a WNP visit. Mean percent weight change at 12-months for WNP patients was 5% and 39% achieved ≥5% weight loss. WNP-eligible patients at the WNP site (n=1,533) were referred to WMTs and prescribed WMMs at similar rates to WNP-eligible patients at the control site (n=2,913) (nutrition counseling 4.8% v. 6.8%, MR 1.0% v. 0.6%, WMM 2.0% v. 3.2%, bariatric surgery 1.2% vs. 1.8%). Patients with a completed WNP visit (n=135) received WMTs at substantially higher rates than the pilot and control sites (nutrition counseling 26.7%, MR 13.3%, WMM 11.9%, bariatric surgery 16.3%). Discussion: A WNP is feasible and may support achievement of ≥5% weight loss. Additional work is needed to compare the efficacy of WNP vs usual care for weight loss. Disclosure D.H.Griauzde: None. A.T.Kraftson: None. C.D.Turner: None. J.Henderson: None. A.Othman: None. L.Oshman: Stock/Shareholder; Abbott, AbbVie Inc., Merck &amp; Co., Inc., Procter &amp; Gamble, Johnson &amp; Johnson, Eli Lilly and Company. J.Gabison: None. E.Walford: None. P.K.Arizaca-dileo: None. D.I.Beckius: None. Funding University of Michigan Elizabeth Weiser Caswell Diabetes Institute; Michigan Center for Diabetes and Translational Research (P30DK092926-09 to D.H.G.); National Institute of Diabetes and Digestive and Kidney Diseases (K23DK123416-01A1 to D.H.G.)