Interdisciplinary VCU research team overcomes obstacles to improve health for people with diabetes
By Anne Dreyfuss
VCU C. Kenneth and Dianne Wright Center for Clinical and Translational Research
At first, it seemed like it wasn’t going to happen. An interdisciplinary research team of Virginia Commonwealth University faculty members and students had applied for federal funding to create a virtual diabetes education program that would empower people living with diabetes to manage their disease, but their grant application was denied.
“We thought we were going to receive funding,” said Alex Krist, M.D., a family medicine professor at VCU School of Medicine. “At the last minute we didn’t, but Privia Medical Group offered to help us as part of their clinical mission.”
The academic research team partnered with a national, multi-specialty primary care practice called Privia Medical Group to launch a virtual diabetes education program that had been created by faculty members from the VCU School of Nursing along with faculty members from VCU School of Medicine’s Department of Family Medicine and Population Health. “The Privia Medical Group informatics team provided us with the expertise we needed to understand clinical workflow, which enabled the whole project,” Krist said.
The education program, called “DEAP: The Diabetes Engagement and Activation Platform,” is delivered through an electronic health record-linked patient portal. It was designed according to best practices in diabetes education outlined by the American Association of Diabetes Educators, integrating principles of health literacy with adult learning and utilizing videos and printed material to supplement online coursework.
“Several unforeseen challenges solidified our team and strengthened our commitment to a shared passion – improving the lives of patients with diabetes,” said VCU School of Nursing associate professor Jo Lynne Robins, Ph.D.
On Monday the team was recognized with the Great Team Science Contest Award in Informatics at the National Institutes of Health’s 2018 Clinical and Translational Science Awards Program Fall Meeting. As the only academic health center in Virginia to receive a Clinical and Translational Science Award, VCU’s C. Kenneth and Dianne Wright Center for Clinical and Translational Research belongs to a national consortium of 58 research hubs funded by the NIH’s National Center for Advancing Translational Sciences.
“The VCU project displayed collaboration across health care disciplines with an emphasis on the use of informatics,” said Team Science Workgroup co-chair Rebbecca Moen, who is the Chief Administrative Officer of the Duke Clinical & Translational Science Institute. The contest was developed in an effort to increase understanding of team science work underway at the CTSA-funded research hubs across the country. Submissions were rated in categories including importance, impact and innovation.
DEAP consists of nine modules on topics including healthy diets, mental health, blood sugar monitoring and diabetes-related health complications. Each module includes self-guided education handouts, videos, and questions assessing knowledge, confidence, and a desire for help.
The team initially sought to recruit 160 patients in the randomized clinical trial that compared health outcomes of patients who utilized the tool to those who did not. In just six months, however, they had recruited 1,400 patients from 24 primary care practices across the country.
“The project took on a life of its own,” said Krist, who also serves as co-director of community-engaged research at the Wright Center. “We had community-based physician practices approaching us requesting to be involved. By working with Privia, we were able to work the tool into their clinicians’ workflow in an easy, feasible, and meaningful way.” Recently, the tool became available to all 1,500 health care providers across the Privia Medical Group, which includes practices in the Mid-Atlantic, Georgia, Texas and the Gulf Coast.
While the team does not yet have clinical results, they hope the recognition they received from the initial study will improve their chances of receiving a NIH grant to continue the research next year. With NIH funding, they plan to analyze the impact the program has had on patients’ blood glucose and lipid levels, blood pressure and frequency of follow-up visits. They also expect NIH funding to enable them to study better linking the system to health care teams, which would eventually lead to the program’s translation into primary care practices across the country.
“When patients complete a nutrition, exercise or medication module, the system will link patients who have low confidence in managing that domain to care team members who can help augment their self-management support and improve outcomes,” Krist said.
Translating the virtual diabetes education program into clinical practices across the country could have profound effects on millions of lives. The American Diabetes Association recommends providing patients with self-management education but, despite insurance coverage, only about 25 percent of people living with diabetes receive formal education on the disease.
“Despite evidence that diabetes education programs improve health outcomes, few patients receive formal education on the disease,” Robins said. “We are effectively identifying and resolving barriers to patient-centered, accessible diabetes education.”
Categories Collaboration, Community Engagement, Data Science, Funding