Examining Variations in Action Plan Quality Among Adults With Type 2 Diabetes in Primary Care

Pernille H Kjaer, Lawrence Fisher, Michael B Potter, Mansi Dedhia, José Parra, Niels Ejskjaer, Søren Skovlund, Danielle Hessler

Research output: Contribution to journalJournal articleResearchpeer-review

1 Citation (Scopus)

Abstract

INTRODUCTION: Collaborative goal setting and action-planning are key elements of self-management support for people with type 2 diabetes mellitus (T2DM), however little is known regarding action plan quality or correlation of quality in primary T2DM care.

METHODS: T2DM patients from 12 primary care sites participated in either: Connection to Health (CTH; 6 practices), consisting of a health survey followed by collaborative action planning, or Enhanced Engagement CTH (EE-CTH; 6 practices), including additional training in relationship building promoting patient engagement. Action plan quality was rated using an adapted version of the Goal-Setting Evaluation Tool for Diabetes (GET-D) (dual coding of 20%, inter-rater reliability [IRR] >80%). Associations with patient characteristics were examined using generalized linear mixed models adjusting for clustering by clinic and intervention arm.

RESULTS: With a mean score ± standard deviation (SD) of 14.62 ± 3.87 on a 0 to 20 scale (n = 725), overall action plan quality was moderate-high. Higher health literacy (β = 1.184, 95% CI, 0.326-2.041; P = .007), and having no social risks (β = 0.416; 95% CI, 0.062-0.770; P = .021) were associated with higher action plan quality, whereas sex, age, language, education level, depression, stress, and health distress were unrelated to quality (P value not significant). Higher quality was associated with greater patient confidence in the plan (β = 0.050; 95% CI, 0.016-0.084, P = .004).

CONCLUSIONS: Although there was a considerable difference in action plan quality ratings, ratings did not systematically differ based on most patient demographic or mental health measures. Results suggest that action planning should be tailored to health literacy and social risks. Further research should examine associations between quality and longer-term clinical outcomes.

Original languageEnglish
JournalJournal of the American Board of Family Medicine
Volume34
Issue number3
Pages (from-to)608-617
Number of pages10
ISSN1557-2625
DOIs
Publication statusPublished - 6 Jun 2021

Bibliographical note

© Copyright 2021 by the American Board of Family Medicine.

Keywords

  • Chronic Disease
  • Disease Management
  • Health Literacy
  • Health Surveys
  • Patient Participation
  • Patient-Centered Care
  • Patient-Reported Outcome Measures
  • Primary Health Care
  • Self-Management
  • Type 2 Diabetes Mellitus

Fingerprint

Dive into the research topics of 'Examining Variations in Action Plan Quality Among Adults With Type 2 Diabetes in Primary Care'. Together they form a unique fingerprint.

Cite this