Assessing the effectiveness of concurrent peer-review visits in reducing cardiovascular risk factors in low-income patients
The Foundation's initiative, Finding Answers: Disparities Research for Change, was designed to use research and evaluation to test hypothetical solutions for reducing racial and ethnic disparities in health care settings and actual disparity reduction outcomes in ongoing programs.Access and availability of mental health services for Latino populations are limited. This intervention directly integrates culturally appropriate mental health care into the primary care of Latino patients and all diabetic patients in a predominantly minority population (65 percent Latino, 20 percent African American). Culturally and linguistically appropriate mental health care will be provided at point of care to patients seeking general medical care. First, Westside Health will examine differences in Latino and non-Latino mental health definitions. Secondly, Westside will examine the impact of this intervention on chronic disease care in all diabetic patients. Finally, the cost effectiveness of the intervention will be examined. In the first part of this evaluation, a simplified tool for mood symptoms based on the Diagnostic and Statistical Manual IV will be created and used. This tool will describe (qualitative) symptom clusters for patients in this group and track symptom changes following the 16-week intervention. Secondly, prospective and retrospective data from a diabetes registry will be used to create a paired cohort and track quality of care in diabetics. With these data, Westside Health can construct three time points and establish a rate of change for any given variable, both pre- and post-intervention. The primary outcome will be glycosylated hemoglobin or hemoglobin A1C (HBA1C). The study will have 80 percent power to detect a 10 percent difference over one year in the target enrollment population of 200. Secondary outcome variables include retinal examination, foot examination, cholesterol, microalbumin and blood pressure. Finally, this project includes formal cost analysis. Using two simulation models (bootstrap analysis and net benefit analysis), this evaluation will determine the cost of the intervention and the impact on life expectancy. This model analysis will calculate the cost per life year saved and per death averted.
Amount Awarded $236,914.00
Awarded on: 11/22/2006
Time frame: 12/1/2006 - 10/31/2009
Grant Number: 59768