6 research outputs found
Quality improvement strategies at primary care level to reduce inequalities in diabetes care: an equity-oriented systematic review
No full textAbstract Background There is evidence that disparities exist in diabetes prevalence, access to diabetes care, diabetes-related complications, and the quality of diabetes care. A wide range of interventions has been implemented and evaluated to improve diabetes care. We aimed to review trials of quality improvement (QI) interventions aimed to reduce health inequities among people with diabetes in primary care and to explore the extent to which experimental studies addressed and reported equity issues. Methods Pubmed, EMBASE, CINAHL, and the Cochrane Library were searched to identify randomized controlled studies published between January 2005 and May 2016. We adopted the PROGRESS Plus framework, as a tool to explore differential effects of QI interventions across sociodemographic and economic factors. Results From 1903 references fifty-eight randomized trials met the inclusion criteria (with 17.786 participants), mostly carried out in USA. The methodological quality was good for all studies. Almost all studies reported the age, gender/sex and race distribution of study participants. The majority of trials additionally used at least one further PROGRESS-Plus factor at baseline, with education being the most commonly used, followed by income (55%). Large variation was observed between these studies for type of interventions, target populations, and outcomes evaluated. Few studies examined differential intervention effects by PROGRESS-plus factors. Existing evidence suggests that some QI intervention delivered in primary care can improve diabetes-related health outcomes in social disadvantaged population subgroups such as ethnic minorities. However, we found very few studies comparing health outcomes between population subgroups and reporting differential effect estimates of QI interventions. Conclusions This review provides evidence that QI interventions for people with diabetes is feasible to implement and highly acceptable. However, more research is needed to understand their effective components as well as the adoption of an equity-oriented approach in conducting primary studies. Moreover, a wider variety of socio-economic characteristics such as social capital, place of residence, occupation, education, and religion should be addressed
Developing Standardized Language for Use in LGBT Health Research
Get PDFBACKGROUND: In the past two decades, the LGBT community in the United States has been more visible, active, and positively accepted by society. As acceptance progresses, research interests on the LGBT population have increased, driving the need for standard language for researchers to share for comparative and community-based participatory research. What term is right? is often the question researchers ask a very diverse LGBT community. In August 2012, the District of Columbia\u27s Office of LGBT Affairs identified incongruent language in a number of published reports commissioned by the Mayor\u27s Office. The Office realized the importance of standardized language for health services research in order for studies and findings to be generalized.
OBJECTIVE: To create an executive document for the Mayor\u27s Office of Gay, Lesbian, Bisexual and Transgender Affairs (GLBT) of standardized LGBT language that can be distributed and used by DC Government agencies in survey questions and other data collection tools in order to assess reliability and gain fidelity.
METHODS: Three previous research reports were analyzed along with the Philadelphia LGBT Community Assessment Report (2006) that presents the results of data collection and analysis about LGBT populations in the City of Philadelphia. These reports expanded upon a growing body of work being done nationally that examined the demographics and trends of LGBT communities and their cultures. The new ACA guidelines regarding HHS standards for data collection was also analyzed for this research. About 15-20 current studies, reports, and surveys on the LGBT community were also analyzed to gain knowledge of current language usage in LGBT research. Finally, a literature review was conducted to gather terms used in published works.
RESULTS: A glossary of thirty new standardized terms were created defining words, including homophobia, sexual identity, intimate partner, among others. The glossary was provided to the Mayor\u27s Office for utilization during data collection within the LGBT community and was distributed to DC Government agencies for drafting LGBT surveys, in-take forms, and other data collection tools.
CONCLUSIONS: The current climate surrounding LGBT issues calls for both politically correct and culturally sensitive language. Minimal research has been conducted to strengthen LGBT terminology for health services research. Creating a standardized glossary of terms for the Office of LGBT affairs was necessary to bring clarity and consistency to research conducted in the LGBT community
Additional file 2: of Quality improvement strategies at primary care level to reduce inequalities in diabetes care: an equity-oriented systematic review
No full textTable S1. Inclusion and exclusion criteria (PICOS). (DOCX 14 kb
Additional file 4: of Quality improvement strategies at primary care level to reduce inequalities in diabetes care: an equity-oriented systematic review
No full textTable S3. Characteristics of eligible studies assessing the efficacy of QI interventions in participants with type 2 diabetes. (DOCX 71 kb
