Evidence map›Paper›PMID 34244218›Full record

ArticleBMJ open diabetes research & care2021

Democratizing type 1 diabetes specialty care in the primary care setting to reduce health disparities: project extension for community healthcare outcomes (ECHO) T1D.

Ashby F Walker, Nicolas Cuttriss, Michael J Haller, Korey K Hood, Matthew J Gurka, Stephanie L Filipp, Claudia Anez-Zabala, Katarina Yabut, Xanadu Roque, Jessie J Wong and 10 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open diabetes research & care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed
3.7field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 33 citations in OpenAlex.

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  10. COVID-19 impacts and inequities among underserved communities with diabetes.Journal of clinical & translational endocrinology · 2024
    Article
  11. Article
  12. Multisite Quality Improvement Program Within the Project ECHO Diabetes Remote Network.Joint Commission journal on quality and patient safety · 2024
    Article
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  19. Project ECHO Diabetes Cost Modeling to Support the Replication and Expansion of Tele-mentoring Programs in Non-research Settings.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2023
    Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors at 4 institutions in 1 country.

Ashby F WalkerUniversity of Florida Diabetes Institute, Gainesville, FL, USA afwalker@ufl.edu.ORCID 0000-0002-7554-2344
Nicolas CuttrissDepartment of Pediatrics and Division of Pediatric Endocrinology and Diabetes, Stanford University, Palo Alto, California, USA.
Michael J HallerUniversity of Florida Diabetes Institute, Gainesville, FL, USA.ORCID 0000-0002-2803-1824
Korey K HoodDepartment of Pediatrics and Division of Pediatric Endocrinology and Diabetes, Stanford University, Palo Alto, California, USA.
Matthew J GurkaDepartment of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida, USA.
Stephanie L FilippDepartment of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida, USA.
Claudia Anez-ZabalaDepartment of Pediatrics, University of Florida, Gainesville, Florida, USA.
Katarina YabutDepartment of Pediatrics and Division of Pediatric Endocrinology and Diabetes, Stanford University, Palo Alto, California, USA.
Xanadu RoqueDepartment of Pediatrics, University of Florida, Gainesville, Florida, USA.
Jessie J WongDepartment of Pediatrics and Division of Pediatric Endocrinology and Diabetes, Stanford University, Palo Alto, California, USA.
Linda BaerDepartment of Pediatrics and Division of Pediatric Endocrinology and Diabetes, Stanford University, Palo Alto, California, USA.
Lauren FiggDepartment of Pediatrics and Division of Pediatric Endocrinology and Diabetes, Stanford University, Palo Alto, California, USA.
Angelina BernierDepartment of Pediatrics, University of Florida, Gainesville, Florida, USA.
Sarah WestenDepartment of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA.
Eugene LewitDepartment of Health Research and Policy, Stanford, Palo Alto, California, USA.
Eleni SheehanDepartment of Pediatrics, University of Florida, Gainesville, Florida, USA.
Marina BasinaDepartment of Pediatrics and Division of Pediatric Endocrinology and Diabetes, Stanford University, Palo Alto, California, USA.
Rayhan LalDepartment of Pediatrics and Division of Pediatric Endocrinology and Diabetes, Stanford University, Palo Alto, California, USA.
Jennifer MaizelCollege of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA.
David M MaahsDepartment of Pediatrics and Division of Pediatric Endocrinology and Diabetes, Stanford University, Palo Alto, California, USA.
Stanford University · USUniversity of Florida · USUniversity of Florida Health · USStanford Health Care · US

Funding

Diabetes, Endocrinology and Metabolism Training GrantT32DK007217 · NIDDK · STANFORD UNIVERSITY · PI Justin Pierce Annes, David Matthew Maahs · 1987 to 2026
$7.2M
Training Research Leaders in Type 1 DiabetesK12DK122550 · NIDDK · STANFORD UNIVERSITY · PI MAAHS, DAVID MATTHEW · 2019 to 2023
$2.1M
The Optimal Pathway to Implanted Autonomous Insulin DeliveryK23DK122017 · NIDDK · STANFORD UNIVERSITY · PI LAL, RAYHAN · 2020 to 2024
$958k
NIDDK NIH HHS K12 DK122550NIDDK NIH HHS K23 DK122017NIDDK NIH HHS T32 DK007217
6 · The paper itself

Abstract

introductionProject ECHO (Extension for Community Healthcare Outcomes) is a tele-education outreach model that seeks to democratize specialty knowledge to reduce disparities and improve health outcomes. Limited utilization of endocrinologists forces many primary care providers (PCPs) to care for patients with type 1 diabetes (T1D) without specialty support. Accordingly, an ECHO T1D program was developed and piloted in Florida and California. Our goal was to demonstrate the feasibility of an ECHO program focused on T1D and improve PCPs' abilities to manage patients with T1D. RESEARCH DESIGN AND

methodsHealth centers (ie, spokes) were recruited into the ECHO T1D pilot through an innovative approach, focusing on Federally Qualified Health Centers and through identification of high-need catchment areas using the Neighborhood Deprivation Index and provider geocoding. Participating spokes received weekly tele-education provided by the University of Florida and Stanford University hub specialty team through virtual ECHO clinics, real-time support with complex T1D medical decision-making, access to a diabetes support coach, and access to an online repository of diabetes care resources. Participating PCPs completed pre/post-tests assessing diabetes knowledge and confidence and an exit survey gleaning feedback about overall ECHO T1D program experiences.

resultsIn Florida, 12 spoke sites enrolled with 67 clinics serving >1000 patients with T1D. In California, 11 spoke sites enrolled with 37 clinics serving >900 patients with T1D. During the 6-month intervention, 27 tele-education clinics were offered and n=70 PCPs (22 from Florida, 48 from California) from participating spoke sites completed pre/post-test surveys assessing diabetes care knowledge and confidence in diabetes care. There was statistically significant improvement in diabetes knowledge (p≤0.01) as well as in diabetes confidence (p≤0.01).

conclusionsThe ECHO T1D pilot demonstrated proof of concept for a T1D-specific ECHO program and represents a viable model to reach medically underserved communities which do not use specialists.

Indexed as

Diabetes Mellitus, Type 1Community Health ServicesHealth PersonnelHumansPrimary Health CareSurveys and Questionnairesdiabetes mellitushealthcare disparitiespovertypublic healthtype 1

Identifiers

PMID34244218
PMCPMC8268922
OpenAlexW3177666551

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.