A Nurse-Practitioner-Led Collaborative Care Model Of Shared Medical Visits For Adult Patients With Diabetes Using The Centering® Group Healthcare Model
Purpose The purpose of this paper is to describe a novel Shared Medical Visit (SMV) intervention to address the health needs and challenges of an adult population with type-2 diabetes (T2D) in a Federally Qualified Health Center (FQHC) setting, the fidelity to the intervention, as well as to determine the feasibility and acceptability of this intervention. Methods The study method was a quasi-experimental post-test design and the intervention consisted of eight monthly two-hour shared medical visits (defined as inter-professional medical visits), which used the American Association of Diabetic Educators AADE7 diabetes education topics for content and the Centering® Healthcare Model of group visits for structure and process. There were also 19 weekly 60-minute Self-Management Support (SMS) visits to help with goal setting, coping, and problem solving. Feasibility and acceptability were evaluated by measuring attendance, model fidelity, participant satisfaction, and staff satisfaction. Results The SMVs and SMS visits were completed as planned and fidelity was maintained. Attendance was low for both intervention components, but participants and staff reported positive experiences and interest in continuing with this format. Conclusions Attendance was a major challenge for participants. The pilot program showed that this format can benefit from a shorter overall duration, which may require alternative self-management support interventions, such as text messaging.
Centering, diabetes, group visits, self management support, shared medical visits
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