Continuity of Care and Lifestyle Intervention Programs for Spanish-Speaking Immigrants Without Health Insurance at a Free Clinic in Rhode Island.

IF 4.4 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Preventing Chronic Disease Pub Date : 2024-11-21 DOI:10.5888/pcd21.240136

Chilsea Wang, Jocelyn Yang, Julia Testa, Muneet Gill, Morgan Leonard, Anne S De Groot

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引用次数: 0

Abstract

Introduction: We conducted a retrospective cohort study to evaluate changes in metabolic biomarkers among participants in Bridging the [Health Equity] Gap (BTG), a free program run by Clínica Esperanza/Hope Clinic (CEHC) for Spanish-speaking immigrants without health insurance in Rhode Island.

Methods: From July 2019 through June 2021, 471 people volunteered to participate in the BTG program. Participants enrolled in lifestyle change classes and visited quarterly with health care providers. We reviewed medical records to collect data on blood glucose, total cholesterol, hemoglobin A_1c (HbA_1c), and systolic and diastolic blood pressure at baseline and at 6, 12, 18, and 21 months after enrollment. We used paired t tests to identify changes in measurements and conducted a regression analysis to analyze trends in longitudinal patient outcomes.

Results: From baseline to 6-month follow-up, we observed significant decreases in all participants' mean HbA_1c (-0.71%), systolic (-5 mm Hg), and diastolic blood pressure (-2 mm Hg). At 12 months, significant decreases in mean HbA_1c persisted among participants with diabetes and prediabetes (-1.07%). At 12 months, participants with mean systolic blood pressure >120 mm Hg also had significant decreases in mean systolic blood pressure (-9 mm Hg), and patients with diastolic blood pressure >80 mm Hg had significant decreases in mean diastolic blood pressure (-9 mm Hg). Local population-level surges in COVID-19 due to Delta and Omicron variants were associated with increases in HbA_1c and blood glucose measurements above trendlines.

Conclusion: The BTG program demonstrated resilience in supporting improvement in the metabolic biomarkers of participants, despite disruptions caused by the COVID-19 pandemic, the continued engagement of participants in self-care despite limited health care access, and underscores the positive role of free clinics among low-income, Spanish-speaking immigrants.

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罗德岛州一家免费诊所为没有医疗保险的讲西班牙语移民提供的持续护理和生活方式干预计划。

简介我们开展了一项回顾性队列研究，以评估 "弥合[健康公平]差距"（BTG）计划参与者的代谢生物标志物变化：从 2019 年 7 月到 2021 年 6 月，共有 471 人自愿参加 BTG 计划。参与者参加了改变生活方式课程，并每季度向医疗服务提供者咨询一次。我们查阅了医疗记录，收集了基线时以及注册后 6、12、18 和 21 个月时的血糖、总胆固醇、血红蛋白 A1c (HbA1c)、收缩压和舒张压数据。我们使用配对 t 检验来确定测量结果的变化，并进行回归分析来分析患者纵向结果的趋势：从基线到 6 个月的随访，我们观察到所有参与者的平均 HbA1c（-0.71%）、收缩压（-5 毫米汞柱）和舒张压（-2 毫米汞柱）均显著下降。12 个月后，患有糖尿病和糖尿病前期的参与者的平均 HbA1c 持续大幅下降（-1.07%）。12 个月时，平均收缩压大于 120 毫米汞柱的参与者的平均收缩压也有显著下降（-9 毫米汞柱），舒张压大于 80 毫米汞柱的患者的平均舒张压也有显著下降（-9 毫米汞柱）。Delta和Omicron变异导致COVID-19在当地人群中激增，这与HbA1c和血糖测量值高于趋势线有关：尽管 COVID-19 大流行造成了干扰，但 BTG 计划在支持改善参与者的代谢生物标志物方面表现出了韧性；尽管医疗保健服务有限，但参与者仍继续参与自我保健；该计划还强调了免费诊所在低收入、讲西班牙语的移民中的积极作用。

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来源期刊

Preventing Chronic Disease PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

6.70

自引率

3.60%

发文量

期刊介绍： Preventing Chronic Disease (PCD) is a peer-reviewed electronic journal established by the National Center for Chronic Disease Prevention and Health Promotion. The mission of PCD is to promote the open exchange of information and knowledge among researchers, practitioners, policy makers, and others who strive to improve the health of the public through chronic disease prevention. The vision of PCD is to be the premier forum where practitioners and policy makers inform research and researchers help practitioners and policy makers more effectively improve the health of the population. Articles focus on preventing and controlling chronic diseases and conditions, promoting health, and examining the biological, behavioral, physical, and social determinants of health and their impact on quality of life, morbidity, and mortality across the life span.