Assessing the Association Between Exercise Status and Poor Glycemic Control

Background: Increased physical activity may be associated with greater glycemic control among adults with diabetes mellitus. However, the area is understudied. The objective of the study was to examine the independent association of exercise status with poor glycemic control, adjusting for patient-level covariates. Methods: We studied a population of Kaiser Permanente Northwest members with type 2 diabetes mellitus who were in: 1) good glycemic control (hemoglobin A1c [HbA1c] \u3c 8%; n = 15,891), or 2) poor glycemic control (HbA1c \u3e 9%; n = 3,709). Additional inclusion criteria included an HbA1c test between July 1, 2014, and June 30, 2015, age 18-plus at time of test, and continuous health plan coverage 12 months prior to HbA1c test. The primary independent was current physical activity status — whether an individual exercised 4 or more times per week (yes vs no) — and was assessed as closely as possible to the HbA1c test date. Multiple logistic regression was used to analyze the independent association of exercise status with poor glycemic control, adjusting for demographics, medication adherence, medical comorbidities, health care utilization, receipt of diabetes mellitus care management services and intensity of diabetes mellitus treatments. Results: Those who exercised 4 or more times per week were less likely to have poor glycemic control (odds ratio: 0.75; 95% confidence interval: 0.68–0.82; P \u3c 0.0001) compared with those who exercised 3 or fewer times per week. Conclusion: Increased exercise is independently associated with a lower likelihood of poor glycemic control among an adult population with type 2 diabetes mellitus. Because physical activity is a potentially modifiable factor, further studies are needed to evaluate whether interventions aimed at increasing physical activity result in subsequent gains in glycemic control

Design, Implementation, and Response Rates From an Online Patient Survey to Assess Genitourinary Symptoms and Related Health Care Experiences of Postmenopausal Women

Background/Aims: Nearly 50% of postmenopausal women experience symptoms related to genitourinary syndrome of menopause (GSM), including vulvovaginal dryness and irritation, painful intercourse and urinary incontinence. As part of a clinician-focused intervention to improve diagnosis and management of GSM at Kaiser Permanente Northwest, we conducted an online survey of women with a well-woman visit to primary care and obstetrics/gynecology (OB/GYN) to assess patient vulvovaginal, urinary and sexual symptoms and related health care experiences. Our goal was to maximize patient participation while minimizing staffing requirements. Methods: Electronic communication was used for all contact with patients, including recruitment, consent, eligibility screening, survey and thank you gift cards. REDCap was used for everything except e-gift card ($5) delivery, which required a separate system. We sent an email invitation to all women ≥ 55 years old with a well-woman visit to primary care or OB/GYN during the previous week and an email address on file. Eligible patients were identified from the electronic medical record and uploaded to REDCap weekly. An initial recruitment email, which included a link to the survey, was sent each Tuesday morning. Patients who did not respond were re-sent the email the next Monday afternoon. Patients who clicked the survey link were taken to the REDCap site, which explained the study and contained the IRB-required consent language. Participants who actively agreed to participate then completed an eligibility screening page and, finally, the survey. For security, only one-time access was allowed to the survey. E-gift cards were sent weekly to all new respondents. REDCap and SAS software reports were run weekly to track recruitment patterns and watch for data anomalies. Results: Email addresses were found for 80% of eligible women (5,961/7,483). The overall response rate was 25% (1,483/5,961) and varied across the 18 randomized clinics from 19% to 34%. The response rate was lower for women ≥ 75 years old (18% vs. 26% for \u3c 75). The active refusal rate was 2%. Conclusion: Electronic surveys can successfully be used at relatively low cost, even for topics that are sensitive in nature. Lessons learned and copies of recruitment, consent, screening and survey materials as well as recruitment reports will be presented

Design, Implementation, and Response Rates From an Online Patient Survey to Assess Genitourinary Symptoms and Related Health Care Experiences of Postmenopausal Women

Background/Aims: Nearly 50% of postmenopausal women experience symptoms related to genitourinary syndrome of menopause (GSM), including vulvovaginal dryness and irritation, painful intercourse and urinary incontinence. As part of a clinician-focused intervention to improve diagnosis and management of GSM at Kaiser Permanente Northwest, we conducted an online survey of women with a well-woman visit to primary care and obstetrics/gynecology (OB/GYN) to assess patient vulvovaginal, urinary and sexual symptoms and related health care experiences. Our goal was to maximize patient participation while minimizing staffing requirements. Methods: Electronic communication was used for all contact with patients, including recruitment, consent, eligibility screening, survey and thank you gift cards. REDCap was used for everything except e-gift card ($5) delivery, which required a separate system. We sent an email invitation to all women ≥ 55 years old with a well-woman visit to primary care or OB/GYN during the previous week and an email address on file. Eligible patients were identified from the electronic medical record and uploaded to REDCap weekly. An initial recruitment email, which included a link to the survey, was sent each Tuesday morning. Patients who did not respond were re-sent the email the next Monday afternoon. Patients who clicked the survey link were taken to the REDCap site, which explained the study and contained the IRB-required consent language. Participants who actively agreed to participate then completed an eligibility screening page and, finally, the survey. For security, only one-time access was allowed to the survey. E-gift cards were sent weekly to all new respondents. REDCap and SAS software reports were run weekly to track recruitment patterns and watch for data anomalies. Results: Email addresses were found for 80% of eligible women (5,961/7,483). The overall response rate was 25% (1,483/5,961) and varied across the 18 randomized clinics from 19% to 34%. The response rate was lower for women ≥ 75 years old (18% vs. 26% for \u3c 75). The active refusal rate was 2%. Conclusion: Electronic surveys can successfully be used at relatively low cost, even for topics that are sensitive in nature. Lessons learned and copies of recruitment, consent, screening and survey materials as well as recruitment reports will be presented