Please use this identifier to cite or link to this item: https://observatorio.fm.usp.br/handle/OPI/18902
Full metadata record
DC FieldValueLanguage
dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP-
dc.contributor.authorNASCIMENTO, Thais Moura Ribeiro do Valle-
dc.contributor.authorRESNICOW, Ken-
dc.contributor.authorNERY, Marcia-
dc.contributor.authorBRENTANI, Alexandra-
dc.contributor.authorKASELITZ, Elizabeth-
dc.contributor.authorAGRAWAL, Pooja-
dc.contributor.authorMAND, Simanjit-
dc.contributor.authorHEISLER, Michele-
dc.date.accessioned2017-04-07T15:10:40Z-
dc.date.available2017-04-07T15:10:40Z-
dc.date.issued2017-
dc.identifier.citationBMC HEALTH SERVICES RESEARCH, v.17, article ID 32, 10p, 2017-
dc.identifier.issn1472-6963-
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/18902-
dc.description.abstractBackground: Rates of noncommunicable diseases (NCDs) such as type 2 diabetes are escalating in low and middle-income countries such as Brazil. Scalable primary care-based interventions are needed to improve self-management and clinical outcomes of adults with diabetes. This pilot study examines the feasibility, acceptability, and outcomes of training community health agents (CHAs) in Motivational Interviewing (MI)-based counseling for patients with poorly controlled diabetes in a primary care center in Sao Paulo, Brazil. Methods: Nineteen salaried CHAs participated in 32 h of training in MI and behavioral action planning. With support from booster training sessions, they used these skills in their regular monthly home visits over a 6 month period with 57 diabetes patients with baseline HbA1cs > 7.0%. The primary outcome was patients' reports of the quality of diabetes care as measured by the Portuguese version of the Patient Assessment of Chronic Illness Care (PACIC) scale. Secondary outcomes included changes in patients' reported diabetes self-management behaviors and in A1c, blood pressure, cholesterol and triglycerides. We also examined CHAs' fidelity to and experiences with the intervention. Results: Patients reported improvements over the 6 month period in quality of diabetes care received (PACIC score improved 33 (+/-19) to 68 (+/-21) (p < .001)). They reported increases in physical activity (p = .001), consumption of fruits and vegetables (p < .001) and medication adherence (p = .002), but no decreases in consumption of high-fat foods (p = .402) or sweets (p = .436). Participants had mean 6-month A1c levels 0.34% points lower than at baseline (p = .08) and improved mean LDL (-16.1 mg/dL, p = .005) and triglyceride levels (-38.725 mg/dL, p = .002). Of the 16 CHAs observed in fidelity assessments, 13 were categorized as medium-or high-performing on MI skills, while 3 were low-performing. CHAs expressed enthusiasm about learning new skills, and many described a shift from advice-giving to encouraging patients to define their own goals. Conclusion: In resource-scarce settings, it is essential to fully utilize existing primary care resources to stem the epidemic of diabetes and other NCDs. Our pilot results support the potential of training CHAs to incorporate effective diabetes self-management support into their routine patient encounters.-
dc.description.sponsorshipSao Paulo Research Foundation (FAPESP) [2013/10313-6]-
dc.description.sponsorshipNational Institute of Diabetes and Digestive and Kidney Diseases [P30DK092926]-
dc.language.isoeng-
dc.publisherBIOMED CENTRAL LTD-
dc.relation.ispartofBMC Health Services Research-
dc.rightsopenAccess-
dc.subjectDiabetes-
dc.subjectCommunity health worker-
dc.subjectPilot study-
dc.subjectSelf-management-
dc.subjectMotivational Interviewing-
dc.subjectBrazil-
dc.subjectPrimary care-
dc.subject.otherrandomized controlled-trial-
dc.subject.otherlife-style-
dc.subject.othernoncommunicable diseases-
dc.subject.otherworker intervention-
dc.subject.otherpatient assessment-
dc.subject.otherafrican-american-
dc.subject.otherrisk-
dc.subject.otherprevention-
dc.subject.otheroutcomes-
dc.subject.otherobesity-
dc.titleA pilot study of a Community Health Agent-led type 2 diabetes self-management program using Motivational Interviewing-based approaches in a public primary care center in Sao Paulo, Brazil-
dc.typearticle-
dc.rights.holderCopyright BIOMED CENTRAL LTD-
dc.identifier.doi10.1186/s12913-016-1968-3-
dc.identifier.pmid28086870-
dc.subject.wosHealth Care Sciences & Services-
dc.type.categoryoriginal article-
dc.type.versionpublishedVersion-
hcfmusp.author.externalRESNICOW, Ken:Univ Michigan, Sch Publ Hlth, Dept Hlth Behav & Hlth Educ, Ann Arbor, MI 48109 USA-
hcfmusp.author.externalKASELITZ, Elizabeth:Univ Michigan, Sch Med, Ann Arbor, MI 48109 USA-
hcfmusp.author.externalAGRAWAL, Pooja:Univ Michigan, Sch Med, Ann Arbor, MI 48109 USA-
hcfmusp.author.externalMAND, Simanjit:Univ Michigan, Sch Med, Ann Arbor, MI 48109 USA-
hcfmusp.author.externalHEISLER, Michele:Univ Michigan, Sch Med, Ann Arbor, MI 48109 USA; Univ Michigan, Sch Med, Dept Internal Med, Ann Arbor, MI 48109 USA; Ann Arbor Vet Affairs VA Healthcare Syst, Ctr Clin Management Res, 1600 Plymouth Dr,Bldg 16, Ann Arbor, MI 48109 USA-
hcfmusp.description.articlenumber32-
hcfmusp.description.volume17-
hcfmusp.origemWOS-
hcfmusp.origem.id2-s2.0-85009495103-
hcfmusp.origem.idWOS:000391925000001-
hcfmusp.publisher.cityLONDON-
hcfmusp.publisher.countryENGLAND-
hcfmusp.relation.referenceAcock A. C., 2014, GENTLE INTRO STATA-
hcfmusp.relation.referenceAllicock M, 2012, J NUTR EDUC BEHAV, V44, P530, DOI 10.1016/j.jneb.2011.09.002-
hcfmusp.relation.referenceArmstrong MJ, 2011, OBES REV, V12, P709, DOI 10.1111/j.1467-789X.2011.00892.x-
hcfmusp.relation.referenceBalcazar H, 2011, AM J PUBLIC HEALTH, V101, P2199, DOI 10.2105/AJPH.2011.300386-
hcfmusp.relation.referenceBalcazar HG, 2010, PREV CHRONIC DIS, V7-
hcfmusp.relation.referenceBertoldi AD, 2013, GLOBALIZATION HEALTH, V9, DOI 10.1186/1744-8603-9-62-
hcfmusp.relation.referenceBrownstein JN, 2007, AM J PREV MED, V32, P435, DOI 10.1016/j.amepre.2007.01.011-
hcfmusp.relation.referenceCheckley William, 2014, Glob Heart, V9, P431, DOI 10.1016/j.gheart.2014.11.003-
hcfmusp.relation.referenceChow CK, 2015, JAMA-J AM MED ASSOC, V314, P1255, DOI 10.1001/jama.2015.10945-
hcfmusp.relation.referenceChristie D, 2014, DIABETES OBES METAB, V16, P381, DOI 10.1111/dom.12195-
hcfmusp.relation.referenceCoutinho WF, 2015, ANN GLOB HEALTH, V81, P735, DOI 10.1016/j.aogh.2015.12.010-
hcfmusp.relation.referenceDanaei G, 2014, LANCET DIABETES ENDO, V2, P634, DOI 10.1016/S2213-8587(14)70102-0-
hcfmusp.relation.referencede Almeida-Pititto Bianca, 2015, Diabetes Metab Syndr Obes, V8, P17, DOI 10.2147/DMSO.S72542-
hcfmusp.relation.referenceHelena ETD, 2008, REV SAUDE PUBL, V42, P764-
hcfmusp.relation.referenceDewing S, 2014, J CONSULT CLIN PSYCH, V82, P19, DOI 10.1037/a0034659-
hcfmusp.relation.referenceEkong G, 2016, PATIENT EDUC COUNS, V99, P944, DOI 10.1016/j.pec.2015.11.022-
hcfmusp.relation.referenceFindley Sally E, 2009, Health Promot Pract, V10, p128S, DOI 10.1177/1524839909331544-
hcfmusp.relation.referenceGibbons M Christopher, 2007, Prog Community Health Partnersh, V1, P371, DOI 10.1353/cpr.2007.0035-
hcfmusp.relation.referenceGlasgow RE, 2005, DIABETES CARE, V28, P2655, DOI 10.2337/diacare.28.11.2655-
hcfmusp.relation.referenceGlasgow RE, 2005, MED CARE, V43, P436, DOI 10.1097/01.mlr.0000160375.47920.8c-
hcfmusp.relation.referenceGreaves CJ, 2008, BRIT J GEN PRACT, V58, P535, DOI 10.3399/bjgp08X319648-
hcfmusp.relation.referenceHargraves J Lee, 2012, J Ambul Care Manage, V35, P15, DOI 10.1097/JAC.0b013e31822cbe35-
hcfmusp.relation.referenceHeckman CJ, 2010, TOB CONTROL, V19, P410, DOI 10.1136/tc.2009.033175-
hcfmusp.relation.referenceHeisler M, 2008, CLIN DIABETES, V26, P161, DOI 10.2337/diaclin.26.4.161-
hcfmusp.relation.referenceIslam SMS, 2014, GLOBALIZATION HEALTH, V10, DOI 10.1186/s12992-014-0081-9-
hcfmusp.relation.referenceJansink R, 2009, BMC HEALTH SERV RES, V9, DOI 10.1186/1472-6963-9-19-
hcfmusp.relation.referenceJones AC, 2012, GLOBAL HEALTH ACTION, V5, P1, DOI 10.3402/gha.v5i0.18847-
hcfmusp.relation.referenceJoshi R, 2014, PLOS ONE, V9, DOI 10.1371/journal.pone.0103754-
hcfmusp.relation.referenceKrantz Mori J, 2013, Am J Public Health, V103, pe19, DOI 10.2105/AJPH.2012.301068-
hcfmusp.relation.referenceLandim CAP, 2012, THESIS-
hcfmusp.relation.referenceLevensky ER, 2007, AM J NURS, V107, P50-
hcfmusp.relation.referenceMacinko J, 2015, NEW ENGL J MED, V372, P2177, DOI 10.1056/NEJMp1501140-
hcfmusp.relation.referenceMcMaster F, 2015, PATIENT EDUC COUNS, V98, P499, DOI 10.1016/j.pec.2014.12.014-
hcfmusp.relation.referenceMichels MJ, 2010, ARQ BRAS ENDOCRINOL, V54, P644, DOI 10.1590/S0004-27302010000700009-
hcfmusp.relation.referenceMiller WR, 2012, MOTIVATIONAL INTERVI-
hcfmusp.relation.referenceMorisky DE, 2008, J CLIN HYPERTENS, V10, P348, DOI 10.1111/j.1751-7176.2008.07572.x-
hcfmusp.relation.referenceMwai GW, 2013, J INT AIDS SOC, V16, DOI 10.7448/IAS.16.1.18586-
hcfmusp.relation.referenceNaar-King S, 2012, CURR HIV-AIDS REP, V9, P335, DOI 10.1007/s11904-012-0132-x-
hcfmusp.relation.referenceNorris SL, 2006, DIABETIC MED, V23, P544, DOI 10.1111/j.1464-5491.2006.01845.x-
hcfmusp.relation.referenceOrdunez P, 2015, J CLIN HYPERTENS, V17, P499, DOI 10.1111/jch.12518-
hcfmusp.relation.referencePakpour AH, 2015, PEDIATRICS, V135, pE644, DOI 10.1542/peds.2014-1987-
hcfmusp.relation.referencePan American Health Organization and World Health Organization, 2014, DEATHS DUE NONC DIS-
hcfmusp.relation.referenceResnicow K, 2004, AM J PREV MED, V27, P97, DOI 10.1016/j.amepre.2004.04.009-
hcfmusp.relation.referenceResnicow K, 2015, PEDIATRICS, V135, P649, DOI 10.1542/peds.2014-1880-
hcfmusp.relation.referenceRothschild SK, 2014, AM J PUBLIC HEALTH, V104, P1540, DOI 10.2105/AJPH.2013.301439-
hcfmusp.relation.referenceRuggiero L, 2011, DIABETES EDUCATOR, V37, P564, DOI 10.1177/0145721711411107-
hcfmusp.relation.referenceSchulz KF, 2011, INT J SURG, V9, P672, DOI 10.1016/j.ijsu.2011.09.004-
hcfmusp.relation.referenceShah M, 2013, CURR DIABETES REP, V13, P163, DOI 10.1007/s11892-012-0359-3-
hcfmusp.relation.referenceSimoes EJ, 2015, BMC PUBLIC HEALTH, V15, DOI 10.1186/s12889-015-1787-1-
hcfmusp.relation.referenceSpencer MS, 2011, AM J PUBLIC HEALTH, V101, P2253, DOI 10.2105/AJPH.2010.300106-
hcfmusp.relation.referenceToobert D. J., 1994, HDB PSYCHOL DIABETES, P351-
hcfmusp.relation.referenceVos T, 2015, LANCET, V386, P743, DOI 10.1016/S0140-6736(15)60692-4-
hcfmusp.relation.referenceWalton JW, 2012, FAM COMMUNITY HEALTH, V35, P161, DOI 10.1097/FCH.0b013e31824651d3-
hcfmusp.relation.referenceWhiting DR, 2011, DIABETES RES CLIN PR, V94, P311, DOI 10.1016/j.diabres.2011.10.029-
hcfmusp.relation.referenceWorld Health Organizaton, 2010, GLOBAL STATUS REPORT-
hcfmusp.relation.referenceWilliams GC, 1998, DIABETES CARE, V21, P1644, DOI 10.2337/diacare.21.10.1644-
hcfmusp.relation.referenceWilliams G.C., 1998, PARTNERSHIPS HEALTHC, P67-
hcfmusp.relation.referenceWorld Economic Forum and the Harvard School of Public Health, 2011, GLOBAL EC BURDEN NON-
dc.description.indexMEDLINE-
hcfmusp.citation.scopus28-
hcfmusp.scopus.lastupdate2022-06-17-
Appears in Collections:

Artigos e Materiais de Revistas Científicas - FM/MPE
Departamento de Pediatria - FM/MPE

Artigos e Materiais de Revistas Científicas - HC/ICHC
Instituto Central - HC/ICHC

Artigos e Materiais de Revistas Científicas - ODS/03
ODS/03 - Saúde e bem-estar


Files in This Item:
File Description SizeFormat 
art_NASCIMENTO_A_pilot_study_of_a_Community_Health_Agentled_2017.PDFpublishedVersion (English)573.65 kBAdobe PDFThumbnail
View/Open

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.