Background: Diabetes is a chronic disease requiring medical treatment and self-management. Group visits (GVs) are one way to deliver care and provide self-management education to patients with diabetes. While studies have examined the impact of GVs on clinical outcomes, no study to date has examined factors related to recruitment and retention of patients in diabetes GVs.
Methods: We examined the association between patient characteristics and GV attendance of 83 patients enrolled in a GV intervention in six Midwestern FQHCs in an ongoing cluster randomized trial. Patients with uncontrolled type 2 diabetes (A1C >8%) who were seen in clinic in the past year were eligible. Linear mixed models were used to evaluate associations between retention of patients and race, language, comorbidities burden, diabetes empowerment score, diabetes distress score, diabetes social support, and duration of diagnosis. A Chi-squared analysis was performed to compare enrolled and unenrolled patients and test for association with patient recruitment method.
Results: Of 280 eligible patients reached by FQHCs, 44% (24/55) of patients contacted in person were recruited into the study, compared to 25% (56/225) of those contacted by telephone and/or mail (P=0.006). In the multivariate analysis, patients with more GV attendance were associated with higher diabetes empowerment score (P=0.03) and likely heavier comorbidities burden (P=0.08).
Conclusion: In-person recruitment for group visits was more effective than recruitment by telephone or mail. Patients with more comorbidities and those who felt less empowered to manage their diabetes at baseline were most motivated to attend GVs, suggesting that patients with multiple chronic conditions who need more support in disease management may be most interested in receiving care in a group setting. This finding may be especially important for FQHC providers taking care of underserved populations who face greater barriers to self-management in traditional care settings.
A.G. Naik: None. E.M. Staab: None. J. Li: None. W. Wan: None. C.T. Schaefer: None. A. Campbell: None. M.T. Quinn: None. A.A. Baig: None.
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