The course of the literature review involved two databases: Ebsco Host and Pub Med. These two were selected due to the ability to filter the search criteria and the availability of multiple peer reviewed journal articles. The search criteria for both databases was limited to the English language, published within the last 5 years, full text, and peer reviewed. This excluded articles that were not current or peer reviewed in order to ensure that the data collected is the most relevant and accurate available. Following is a chart evaluating three of the literature sources located. Each source is discussed as being relevant to the presently proposed study. A five point relevance gauge was utilized with the following terms considered: Diabetes, Intervention Programs, Community Programs, Management, and Uninsured. Each source was rated 1-5 based on the number of terms that were involved in the studies making the higher relevance rating a better fit for the present study.

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Evaluation Chart

Author
Type of Study
Participants
Intervention
Findings
Relevance Rating (1-5)
Mehuys, et al. (2011)
Randomized Control Trial
288
Community Pharmacy Program
Minimal long term differences in HbA1c at 18 month follow up
4
Sherifali, et al. (2011)
Mixed Methods
67
Housing Community Program
Improved diabetes awareness and management outcomes
5
Whittemore, et al. (2014).
Empirical/ Self-Reporting
2994
Volunteer Community Program
Improved self-management behaviors
4

Review and Synthesis
Of the literature located throughout the search, three articles were selected for the present stage of the ongoing project to allow for a platform of the research processes. As was shown in the evaluation chart, these sources ranged from 4-5 in the relevance ratings making them substantially relevant to the current P.I.C.O.T. question. The first of these articles presents a randomized control trial involving 288 participants. Mehuys, et al. (2011) randomly assigned the participants to either receive basic pharmacy services from the community pharmacist or to receive specialized training and counseling from these trusted members of the health care teams. While the participants who were given the training showed improvements during the study, there were no significant improvements to note as being continued following the study. While the study was based in the community, there was no other community influences or factors taken into consideration. The pharmacist served as an additional medical consultation and, upon removal of the intervention, the participants had not gained the skills necessary for maintaining these behaviors. Regarding the present study, this information will be helpful in selecting the types of individuals who will be able to speak and influence the diabetes management but the type of intervention in this article will not stand alone in the present study.

The other two studies are more closely designed as the present study. Sherifali, et al. (2011) present a mixed methods study with 67 diabetics being assigned home health care nurses to help to educate the participants. These participants were in public housing and in a lower socioeconomic status group associating this study to the limited health education that is often viewed among the uninsured. Whittemore, et al. (2014) present the outcomes for 2994 participants over a 7 year study with a community based program being assigned for the improvement of diabetes management. Self-reporting was utilized for documenting the level of educational and management compliance issues that were resolved through participation. This study will help to provide a basis for the presently proposed study.

    References
  • Mehuys, E., Van Bortel, L., De Bolle, L., Van Tongelen, I., Annemans, L., Remon, J., & Giri, M. (2011). Effectiveness of a community pharmacist intervention in diabetes care: a randomized controlled trial. Journal Of Clinical Pharmacy & Therapeutics, 36(5), 602-613. doi:10.1111/j.1365-2710.2010.01218.x
  • Sherifali, D., Greb, J., Amirthavasar, G., Gerstein, H., & Gerstein, S. (2011). A community-based approach for the self-management of diabetes. European Diabetes Nursing, 8(2), 54-59. doi:10.1002/edn.178
  • Whittemore, R., Rosenberg, A., Gilmore, L., Withey, M., & Breault, A. (2014). Implementation of a Diabetes Prevention Program in Public Housing Communities.Public Health Nursing, 31(4), 317-326. doi:10.1111/phn.12093