A codesigned integrated kidney and diabetes model of care improves patient activation among patients from culturally and linguistically diverse backgrounds

BACKGROUND: Little is known about the relationship between patients' cultural and linguistic backgrounds and patient activation, especially in people with diabetes and chronic kidney disease (CKD). We examined the association between culturally and linguistically diverse (CALD) background and p...

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Autores principales: Zimbudzi, Edward, Lo, Clement, Ranasinha, Sanjeeva, Usherwood, Tim, Polkinghorne, Kevan R., Fulcher, Gregory, Gallagher, Martin, Jan, Stephen, Cass, Alan, Walker, Rowan, Russell, Grant, Johnson, Greg, Kerr, Peter G., Zoungas, Sophia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10632627/
https://www.ncbi.nlm.nih.gov/pubmed/37635378
http://dx.doi.org/10.1111/hex.13859
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author Zimbudzi, Edward
Lo, Clement
Ranasinha, Sanjeeva
Usherwood, Tim
Polkinghorne, Kevan R.
Fulcher, Gregory
Gallagher, Martin
Jan, Stephen
Cass, Alan
Walker, Rowan
Russell, Grant
Johnson, Greg
Kerr, Peter G.
Zoungas, Sophia
author_facet Zimbudzi, Edward
Lo, Clement
Ranasinha, Sanjeeva
Usherwood, Tim
Polkinghorne, Kevan R.
Fulcher, Gregory
Gallagher, Martin
Jan, Stephen
Cass, Alan
Walker, Rowan
Russell, Grant
Johnson, Greg
Kerr, Peter G.
Zoungas, Sophia
author_sort Zimbudzi, Edward
collection PubMed
description BACKGROUND: Little is known about the relationship between patients' cultural and linguistic backgrounds and patient activation, especially in people with diabetes and chronic kidney disease (CKD). We examined the association between culturally and linguistically diverse (CALD) background and patient activation and evaluated the impact of a codesigned integrated kidney and diabetes model of care on patient activation by CALD status in people with diabetes and CKD. METHODS: This longitudinal study recruited adults with diabetes and CKD (Stage 3a or worse) who attended a new diabetes and kidney disease service at a tertiary hospital. All completed the patient activation measure at baseline and after 12 months and had demographic and clinical data collected. Patients from CALD backgrounds included individuals who spoke a language other than English at home, while those from non‐CALD backgrounds spoke English only as their primary language. Paired t‐tests compared baseline and 12‐month patient activation scores by CALD status. RESULTS: Patients from CALD backgrounds had lower activation scores (52.1 ± 17.6) compared to those from non‐CALD backgrounds (58.5 ± 14.6) at baseline. Within‐group comparisons showed that patient activation scores for patients from CALD backgrounds significantly improved by 7 points from baseline to 12 months follow‐up (52.1 ± 17.6–59.4 ± 14.7), and no significant change was observed for those from non‐CALD backgrounds (58.5 ± 14.6–58.8 ± 13.6). CONCLUSIONS: Among patients with diabetes and CKD, those from CALD backgrounds report worse activation scores. Interventions that support people from CALD backgrounds with comorbid diabetes and CKD, such as the integrated kidney and diabetes model of care, may address racial and ethnic disparities that exist in patient activation and thus improve clinical outcomes. PATIENT OR PUBLIC CONTRIBUTION: Patients, caregivers and national consumer advocacy organisations (Diabetes Australia and Kidney Health Australia) codesigned a new model of care in partnership with healthcare professionals and researchers. The development of the model of care was informed by focus groups of patients and healthcare professionals and semi‐structured interviews of caregivers and healthcare professionals. Patients and caregivers also provided a rigorous evaluation of the new model of care, highlighting its strengths and weaknesses.
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spelling pubmed-106326272023-11-15 A codesigned integrated kidney and diabetes model of care improves patient activation among patients from culturally and linguistically diverse backgrounds Zimbudzi, Edward Lo, Clement Ranasinha, Sanjeeva Usherwood, Tim Polkinghorne, Kevan R. Fulcher, Gregory Gallagher, Martin Jan, Stephen Cass, Alan Walker, Rowan Russell, Grant Johnson, Greg Kerr, Peter G. Zoungas, Sophia Health Expect Original Articles BACKGROUND: Little is known about the relationship between patients' cultural and linguistic backgrounds and patient activation, especially in people with diabetes and chronic kidney disease (CKD). We examined the association between culturally and linguistically diverse (CALD) background and patient activation and evaluated the impact of a codesigned integrated kidney and diabetes model of care on patient activation by CALD status in people with diabetes and CKD. METHODS: This longitudinal study recruited adults with diabetes and CKD (Stage 3a or worse) who attended a new diabetes and kidney disease service at a tertiary hospital. All completed the patient activation measure at baseline and after 12 months and had demographic and clinical data collected. Patients from CALD backgrounds included individuals who spoke a language other than English at home, while those from non‐CALD backgrounds spoke English only as their primary language. Paired t‐tests compared baseline and 12‐month patient activation scores by CALD status. RESULTS: Patients from CALD backgrounds had lower activation scores (52.1 ± 17.6) compared to those from non‐CALD backgrounds (58.5 ± 14.6) at baseline. Within‐group comparisons showed that patient activation scores for patients from CALD backgrounds significantly improved by 7 points from baseline to 12 months follow‐up (52.1 ± 17.6–59.4 ± 14.7), and no significant change was observed for those from non‐CALD backgrounds (58.5 ± 14.6–58.8 ± 13.6). CONCLUSIONS: Among patients with diabetes and CKD, those from CALD backgrounds report worse activation scores. Interventions that support people from CALD backgrounds with comorbid diabetes and CKD, such as the integrated kidney and diabetes model of care, may address racial and ethnic disparities that exist in patient activation and thus improve clinical outcomes. PATIENT OR PUBLIC CONTRIBUTION: Patients, caregivers and national consumer advocacy organisations (Diabetes Australia and Kidney Health Australia) codesigned a new model of care in partnership with healthcare professionals and researchers. The development of the model of care was informed by focus groups of patients and healthcare professionals and semi‐structured interviews of caregivers and healthcare professionals. Patients and caregivers also provided a rigorous evaluation of the new model of care, highlighting its strengths and weaknesses. John Wiley and Sons Inc. 2023-08-27 /pmc/articles/PMC10632627/ /pubmed/37635378 http://dx.doi.org/10.1111/hex.13859 Text en © 2023 The Authors. Health Expectations published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Zimbudzi, Edward
Lo, Clement
Ranasinha, Sanjeeva
Usherwood, Tim
Polkinghorne, Kevan R.
Fulcher, Gregory
Gallagher, Martin
Jan, Stephen
Cass, Alan
Walker, Rowan
Russell, Grant
Johnson, Greg
Kerr, Peter G.
Zoungas, Sophia
A codesigned integrated kidney and diabetes model of care improves patient activation among patients from culturally and linguistically diverse backgrounds
title A codesigned integrated kidney and diabetes model of care improves patient activation among patients from culturally and linguistically diverse backgrounds
title_full A codesigned integrated kidney and diabetes model of care improves patient activation among patients from culturally and linguistically diverse backgrounds
title_fullStr A codesigned integrated kidney and diabetes model of care improves patient activation among patients from culturally and linguistically diverse backgrounds
title_full_unstemmed A codesigned integrated kidney and diabetes model of care improves patient activation among patients from culturally and linguistically diverse backgrounds
title_short A codesigned integrated kidney and diabetes model of care improves patient activation among patients from culturally and linguistically diverse backgrounds
title_sort codesigned integrated kidney and diabetes model of care improves patient activation among patients from culturally and linguistically diverse backgrounds
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10632627/
https://www.ncbi.nlm.nih.gov/pubmed/37635378
http://dx.doi.org/10.1111/hex.13859
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