Medication Use Among American Indians Adults
Study Details
Study Description
Brief Summary
The goal of this study is to explore facilitators of and barriers to medication adherence within the context of local social determinants of health (SDOH) that are not available in the EHR.
for American Indians with type 2 diabetes. The main aim is:
Identify facilitators of and barriers to medication adherence within the context of SDOH, Electronic Health Record (EHR) derived medication adherence [HbA1c < 7 (at target); HbA1c >7% to ≤9% (above target); and HbA1c > 9% (uncontrolled)].
Condition or Disease | Intervention/Treatment | Phase |
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Detailed Description
The investigators will identify potential participants by drawing a sub sample of 90 patients from the larger sample (based on findings from aims 1 and 2).
Once patients are identified University of Florida (UF) study team members will provide a coded list of eligible patients, from the limited dataset, to the Choctaw Nation of Oklahoma (CNO) Information Management team. The CNO Information Management team will provide the contact information for 135 individuals directly to the CNO community health worker who will then contact patients. UF study team members will not have access to the identifiable data.
The CNO community health worker (not UF study team members) will contact by telephone or in person at a scheduled visit the identified patients within each of the sampling groups (labeled 1-6) to introduce the study and screen for eligibility.
After reviewing the consent, answering any questions, and obtaining written consent for the study, the CNO community health worker will use a structured interview guide containing semi-structured and open-ended questions with probes to collect in-depth information from the patient. As part of the interview session patients will be asked to complete 3 sets of questionnaire items: demographic, SDOH, and medication and utilization.
All interviews will be audio recorded and professionally transcribed and validated for accuracy. Instead of using patient names CNO will link each transcript back to the code number provided by the UF study team. The UF study team will not have access to the link of the code number to the patient identifier. The de-identified transcripts will be sent to UF Study team members for analysis. A UF study team member will use a qualitative data management program to aid in analyzing and managing the data.
Study Design
Outcome Measures
Primary Outcome Measures
- Semi-structured and Open-Ended Interview Questions [1 day]
We will use a semi-structured interview guide that is structured based on medication adher
Secondary Outcome Measures
- Demographic Questionnaire [1 day]
Each patient will be asked to fill out a questionnaire regarding their demographic information (e.g., age, sex, income, education).
- Social Determinants of Health Questionnaire [1 day]
We will assess facilitators of and barriers to medication adherence within the context of SDOH using adaptation of validated questions from the Toolkit.7 Questions related to housing, transportation, miles to grocery store and tribal clinic, involvement with CNO cultural activities, use of CNO food distribution.
Eligibility Criteria
Criteria
Inclusion Criteria:
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enrolled tribal member
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18 years and older
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have been diagnosed with type 2 diabetes
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live within CNOs 10.5 county service area
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use CNO Tribal Health Services
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for whom cardiometabolic levels and medication adherence level will have been generated from the aim 1 analysis of CNO data
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willing and able to participant in a 60-90-minute interview focused on facilitators of and barriers to medication adherence.
Exclusion Criteria:
(1) has end-stage renal disease
Contacts and Locations
Locations
No locations specified.Sponsors and Collaborators
- University of Florida
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- IRB202301346