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J Ambul Care Manage. 2014 Apr-Jun;37(2):127-37. doi: 10.1097/JAC.0000000000000019.

Diabetes health information technology innovation to improve quality of life for health plan members in urban safety net.

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General Internal Medicine and UCSF Center for Vulnerable Populations at San Francisco General Hospital and Trauma Center, University of California, San Francisco (Drs Ratanawongsa, Handley, Sarkar, Quan, and Schillinger, and Ms Soria); Department of Epidemiology and Biostatistics, Division of Preventive Medicine and Public Health, University of California, San Francisco (Dr Handley); San Francisco Health Plan, San Francisco, California (Dr Pfeifer); and California Diabetes Program, California Department of Public Health, Sacramento (Dr Schillinger).


Safety net systems need innovative diabetes self-management programs for linguistically diverse patients. A low-income government-sponsored managed care plan implemented a 27-week automated telephone self-management support/health coaching intervention for English-, Spanish-, and Cantonese-speaking members from 4 publicly funded clinics in a practice-based research network. Compared to waitlist, immediate intervention participants had greater 6-month improvements in overall diabetes self-care behaviors (standardized effect size [ES] = 0.29, P < .01) and 12-Item Short Form Health Survey physical scores (ES = 0.25, P = .03); changes in patient-centered processes of care and cardiometabolic outcomes did not differ. Automated telephone self-management is a strategy for improving patient-reported self-management and may also improve some outcomes.

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