This week, in working with the synthesis tables, it was important for me to not just review my evaluation table but also to reread the studies and focus on the abstracts. I know that, time and time again, I state that I take the longer road to these processes, but I want to be confident in my selections of supporting evidence. I believe that the actually portion of the assignment involving the synthesis was much easier by examining the previous week’s work and assessing the level of evidence for each study. Following are two of the “keeper studies” that I selected along with my rationale and practical purpose for inclusion.

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Study 1
Carrasquillo, O., Patberg, E., Alonzo, Y., Li, H., & Kenya, S. (2014). Rationale and design of the Miami Healthy Heart Initiative: a
randomized controlled study of a community health worker intervention among Latino patients with poorly controlled
diabetes. Int J Gen Med, 7, 115-126.

This level two source presents a study of 300 Latino patients with diabetes utilizing community workers as an intervention method for the improvement of diabetes management. Noting the health disparities related to navigating the health care system, community health care workers were assigned to aid the patients in the intervention group. Using linear mixed models for continuous variables, the study monitored changes in systolic blood pressure, low-density lipoprotein, and HbA1c. Based on the findings, community health workers (CHWs) significantly improved diabetes management.

Regarding the presently proposed study, several factors contributed to this research being included. Low health literacy and lower socioeconomic status groups are frequently viewed among the uninsured which is noted in the study. Additionally, the use of community health care workers will be utilized in the training sessions of the present research. The conceptual framework of this study, contemporary models of successful interventions aimed at improving health among racially and ethnically diverse communities, will be useful in determining the level of influence that these workers will have on the program.

Study 2
Micklethwaite, A., Brownson, C. A., O’Toole, M. L., & Kilpatrick, K. E. (2012). The Business Case for a Diabetes Self-Management
Intervention in a Community General Hospital. Population Health Management, 15(4), 230-235. doi:10.1089/pop.2011.0051

This level four source presents a case Study in a before-after design with no comparison group. The study involves a self-management intervention with 505 patients in a community general hospital in Southern Missouri targeting an underserved population who have significant barriers to receiving regular health care. The research monitored health literacy, lifestyle changes, improvement in HbA1c, and financial costs associated with the implementation of the program in comparison with the costs of providing services to the under and uninsured diabetic patients. The results of the study showed HbA1c improvements of .77% and financial savings of $551 per participant.

When considering the budget for the presently proposed research study, it is important to be able to evaluate the costs/benefits of the implementation and to be able to present these to the stakeholders of the program. The purpose of including this study is to provide a basis of the financial costs and benefits of providing this essential community based intervention method for improved diabetes management.

    References
  • Carrasquillo, O., Patberg, E., Alonzo, Y., Li, H., & Kenya, S. (2014). Rationale and design of the Miami Healthy Heart Initiative: a
    randomized controlled study of a community health worker intervention among Latino patients with poorly controlled
    diabetes. Int J Gen Med, 7, 115-126.
  • Micklethwaite, A., Brownson, C. A., O’Toole, M. L., & Kilpatrick, K. E. (2012). The Business Case for a Diabetes Self-Management
    Intervention in a Community General Hospital. Population Health Management, 15(4), 230-235. doi:10.1089/pop.2011.0051
    diabetes education curriculum. International journal of clinical and experimental medicine, 7(3), 758.