P-I-C-O-T: In uninsured diabetics (P), what is the effect of community based programs that provide medical care, proper nutrition, and testing devices (I) on diabetes management (O) compared to individual management (C) within a one-year study (T)?
Study Design
The experiment design will be a quasi-experimental as there will be no control group. According to Campbell and Stanley (2014), a quasi-experimental design would be the best description of this study as the time series-designs involves multiple data collection points, no control group, and no randomization.
Setting/Sample
Participants for this study will be gathered through a community outreach program. As the participants are uninsured diabetes patients, recruitment will take place through the local free clinic and the county health department. The patients will be referred by these facilities with the understanding that the program will involve educational materials and testing strips through the fundraisers and community involvement. It is anticipated that recruitment will yield 25-40 uninsured diabetic participants.
Confidentiality
As previous medical records and ongoing data collection will be utilized and will also contain confidential information, it is important that these records are maintained in a manner that is in compliance with HIPAA regulations. All data will be collected and coded by numbers that are assigned to each participant in order to prevent any identifiable information from being stored. The files will be contained on a password protected file whereas only the researcher has access to the password. The data collection aids will document the findings at each interval according to the assigned number and provide this documentation to the researcher. Upon entering the data onto the protected file, the researcher will shred the documents and update the password at each data collection point.
Procedures/Intervention
Upon recruiting and compiling baseline data for the participants, the intervention procedures involve a community based program that focuses on the improved diabetes management of the uninsured participants. The participants will attend gatherings that involve workshops and seminars. The workshops will involve group discussions involving different topics of interest for diabetes management. Seminars will involve speakers in the health care professions. Fundraiser participation as well as task in the community garden will be based on the abilities of the participants. Participation in seminars and workshops will be evaluated at 50% participation being required to receive the free testing supplies in order to promote participation and gain a better indication as to the overall outcomes of the study.
Instruments/Scales
The study will utilize quantitative data in order to assess changes in the BMI, systolic blood pressure, glucose levels, and HbA1c through physical evaluations and previous medical records. Health literacy will be assessed qualitatively the California Health Interview Survey and the Newest Vital Sign scale (Choi, Rush, & Henry, 2013). Validity of the physical examinations is evident through the medical evaluations and ongoing use of these measurements in the health care profession. Validity for the health literacy assessments is established through the use of these tools in previous research as noted. These tools have been selected to promote the repeatability of the study as it is important to be able to repeat the research as a means to further validate the findings that are presented. As the research indicates an improved condition, comparative data is necessary to support these claims.
Data Collection
Data collection is essential to the study as the comparative information will serve to determine the effectiveness of the intervention method as it applies to the uninsured diabetics in the community. As it is the intention of this researcher to provide a guideline for improving the conditions of diabetes management for the uninsured diabetes in a given community, it is important to establish the methods and procedures that are necessary to repeat the study in other communities. In order to promote this replicability, these procedures are outlined in the following segments.
Methods
The data collection for BMI, systolic blood pressure, glucose levels, and HbA1c are collected through physical examinations and comparative assessments. Health literacy assessments are made through the California Health Interview Survey and the Newest Vital Sign scale. Again, validity has been established through the previous use of these data collection tools. It is important to recognize these methods as being utilized in research and the medical profession.
Testing Frequency
Health literacy assessments will be made pre, mid, and post intervention. This will provide for a baseline, a reference for any necessary changes in the program, and a final collection point for comparative findings. Physical evaluations will be based on previous medical records along with pre-intervention assessments for baseline. Physical examinations will take place every two months in order to have multiple data points of reference. The purpose for a higher frequency in data collection for the physical data than for the health literacy assessment is that other factors such as holidays and special events may alter the data in the physical examinations. Multiple data collection points will allow for the researcher to notate any trends that may have these types of associations that would warrant an explanation in the findings and results.
- Campbell, D. T., & Stanley, J. C. (2015). Experimental and quasi-experimental designs for research. Ravenio Books.
- Choi, S. E., Rush, E., & Henry, S. (2013). Health literacy in Korean immigrants at risk for type 2 diabetes. Journal of Immigrant and
Minority Health, 15(3), 553-559.
