Posted By Prucia Buscell,
Thursday, November 01, 2012
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cost the nation about $100 billion a year, and researchers say some of
the most powerful preventive measures are behavior changes among care
providers as well as life style changes among people who have the
illness and are at risk to get it.
Monica Peek, MD, is a Robert Wood Johnson Foundation
Harold Amos Medical Faculty Development Program scholar who studies how
the social determinants of health impact African Americans. In an
October 2012 presentation at the American Public Health Association, and
a recent article described on the RWJF website, Dr. Peek reports:
"We found that race, as a social construct, has the potential to
influence two key domains of patient trust-interpersonal relationships
and medical skills and technical competence. For example, African
Americans in our study were concerned that physicians might be biased or
using them in medical experiments without their consent. This
influenced their perceptions about physicians’ overall competence,
bedside manner, and ability to provide them with high-quality care.”
has shown that when diabetics engage in shared decision making with
their care providers, their compliance with medication regimens, healthy
life style choices, and management of blood pressure and blood glucose
improve. In their paper "Patient Trust in Physicians and Shared Decision Making Among African Americans with Diabetes,"
Dr. Peek and colleagues say methods of building trust include enhanced
patient education, physician training in interpersonal skills and
cultural competence and efforts to engage patients in decision about
their care. Although her research focused on African Americans, Dr. Peek
believes the findings are applicable to other ethnic and cultural
groups struggling with diabetes.
Peek is also an assistant professor of medicine at University of
Chicago Medicine and co-principal investigator of an innovative project
called Improving Diabetes Care and Outcomes on the South Side of Chicago,
where high rates of diabetes impact a large African American
population. The project involves collaboration among six clinics,
academic institutions, and community organizations and businesses to provide education and increase access to care. In one program, a nutritionist toured grocery stores
with diabetes patients, illustrating healthy food choices, and showing
how label information can help manage carbohydrate and sugar intake. In a
initiative, patients who visit one of the clinics can get a coupon for
$5 off a $20 order of healthy food at participating Walgreen stores, and
a $3 voucher for a weekly farmers market. Dr. Peek says the initiatives
put the power of a doctor’s prescription behind nutritional advice.
Because many shoppers were buying food at Save-A-Lot stores, initiative
leaders established a relationship with the chain, which is now opening
more stores in "underserved” neighborhoods that have been described as a
"food deserts” and is offering educational information to customers.
The store also sponsored a diabetes awareness cooking contest for healthy recipes.
The Improving Diabetes Care and Outcomes project is funded by the Merck Company Foundation through its Alliance to Reduce Disparities in Diabetes across five U.S. cities, and the National Institutes of Health, with the University of Chicago’s Institute for Translational Medicine.
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