Project title: Empowering Patients in Chronic Care (EPIC)
Faculty Supervisor/and contact information:
LeChauncy Woodard, MD, MPH
Located at: HSR&D Center
This project does involve confidential data and will require security clearances.
Description of the project:
Type 2 diabetes affects nearly 20% of Veterans who use the VA healthcare system, or more than one million Veterans at any given time. Diabetes is a leading cause of blindness, end-stage renal disease, and amputation in the U.S. Further, up to 80% of patients with diabetes will develop or die from macrovascular disease, such as heart attack and stroke. The cost of treating diabetes and its complications is enormous. While there is no cure, diabetes control, characterized by reductions in hemoglobin (Hb)A1c, blood pressure, and cholesterol levels, is directly associated with lower morbidity and mortality. Because diabetes is a self-managed condition, achieving diabetes control requires both the involvement of the patient and the doctor in most aspects of treatment planning and management. As a result, self-management training and support is a cornerstone of evidence-based treatment for diabetes in primary care. Providing diabetic patients with effective self-management training and support can be challenging however due to time constraints at primary care appointments and limited clinician training with behavior change.
Our previous study demonstrated that a group-based, VA primary care intervention to help Veterans set highly effective, evidence-based diabetes goals (called Empowering Patients in Chronic Care) had a positive impact on both diabetes self-efficacy and hemoglobin (Hb) A1c levels. Our current project expands upon that work by training existing primary care staff to use the EPIC intervention with their patients to improve diabetes outcomes. EPIC integrates personalized information about a Veteran’s capacity (i.e., functional health literacy) and motivation (i.e., activation) into the collaborative goal-setting process. While validated, practical measures of health literacy and activation levels exist, they have not been effectively integrated into routine primary care practice. Assessing a Veteran’s health literacy and level of activation may allow primary care staff to better personalize goals and action plans within a Veteran’s particular limitations and preferences for care. A sample of 284 Veterans will be enrolled in the research trial. Approximately 40 VA primary care staff will be enrolled as EPIC facilitators. Data will be collected before the start of the intervention, immediately after the intervention and 1 year following the intervention to compare EPIC against usual care practices in improving diabetes outcomes.
Expectations of the Rice Student:
- 8-10 hours per week (consistent with a 3-credit course)
- Attend a weekly team meeting to see how a multi-disciplinary research team works
- Conduct medical chart reviews to identify eligible Veterans
- Recruit Veterans to participate in the research trial
- Administer telephone surveys with Veterans for data collection
- Assist with administrative tasks, such as scheduling research subjects and coordinating study mailings
- Assist with literature reviews and manuscript development, as appropriate
Products: Literature review, conference abstract and/or poster (and possibly co-authored manuscript)
Knowledge and skills gained: Practical experience in a dynamic research environment; Professionalism; Teamwork and the development of strong inter-personal skills; Self-confidence in communication; Working independently; Quantitative research methods; MS Office, including MS Access database software
Suggested prerequisite training or experience:
- This experience is ideal for students who are interested in attending graduate school programs in the social/behavioral sciences or public health.
- Should have excellent reading, writing, and communication skills, ability to follow detailed instructions, and must be able to work independently as well as part of a team.
- Prerequisite training: Upper-division coursework in sociology, psychology, anthropology, communications, or health education.
- Some prior research experience preferred, but not required.