An evidence gap exists between the findings of decades of research to improve diabetes outcomes in low resource communities and persistently poor outcomes and premature mortality among people experiencing homelessness with diabetes compared to their stably housed peers. The Hennepin Healthcare team found that from 2017-2021, Minnesotans who used homeless services had a diabetes mortality rate 3.2 times higher than the general population. People living with diabetes who experience homelessness (DH) are hospitalized for complications up to 10 years prior to those with stable housing. Low-cost, effective medications improve glycemic control and long-term outcomes. However, adherence is low, especially among DH. Since 2018 the Hennepin team has used community engaged research to center people with lived experience in their research to develop a behavioral intervention to improve diabetes control and psychological wellness among DH. The Hennepin team developed the Diabetes Homeless Medication Support (D-HOMES) program using existing evidence, qualitative data, and key input from a community-engaged research team. The team conducted an open trial offering D-HOMES to 10 participants and a randomized pilot trial comparing D-HOMES to brief diabetes education among 36 participants. The team combined trust and team-building activities with learning about diabetes and behavioral science while following the results of each phase of the project. The team is now developing community-focused dissemination materials and events alongside presentation at scientific conferences/publications.
Speaker: Katherine Vickery, MD, MSc, Hennepin Healthcare
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