TY - JOUR
AU - M. E. Lacy
AU - J. Elliott
AU - V. Drakeford
AU - L. Wright
AU - B. McKune
AU - K. C. Douthitt
AU - A. J. Kruse-Diehr
AU - J. W. Keck
A1 - 
AB - BACKGROUND: Diabetes self-management education and support (DSMES) is an evidence-based intervention that improves outcomes for people with diabetes, but uptake is <10%. We conducted a pilot pragmatic trial to increase DSMES in rural primary care clinics that integrated health information technology with a quality improvement (QI) learning collaborative. METHODS: Two healthcare systems from rural Kentucky participated in the study. Within each system, 2 clinics received the intervention and 1 clinic served as a control (N = 6 clinics). Each intervention clinic identified a QI team (5-6 individuals) who participated in a 9-month QI learning collaborative followed by 5 months of follow-up. Our primary outcome was DSMES referrals; secondary outcomes were DSMES attendance and percentage with A1c >9%. RESULTS: The 6 study clinics served 1,803 patients with diabetes; n = 1083 (60.1%) from 4 intervention clinics and n = 720 (39.9%) from 2 control clinics. DSMES referrals significantly increased in the intervention clinics compared to the control clinics (31.7% vs 0.1%, P < .001) and continued to increase throughout 5-month follow-up (40.0% vs 0.1%, P < .001). CONCLUSIONS: A structured QI intervention can significantly increase DSMES referral rates in primary care clinics. Findings highlight the potential of systems-level approaches to address persistent gaps in diabetes care delivery in rural settings. CLINICAL TRIAL REGISTRY: Using Practice Facilitation and Operationalizing Referral Information Technology to Increase DSMES Utilization (Clinicaltrials.gov registration number no. NCT05472142). CLINICALTRIALS: gov URL (https://clinicaltrials.gov/study/NCT05472142).
AD - University of Kentucky College of Public Health, Lexington, KY, USA.; University of Kentucky HealthCare, Lexington, KY, USA.; University of Kentucky College of Medicine, Lexington, KY, USA.; Augusta University School of Public Health, GA, USA.; University of Alaska Anchorage, AK, USA.
AN - 41805383
BT - J Prim Care Community Health
C5 - Healthcare Disparities; HIT & Telehealth
DA - Jan-Dec
DO - 10.1177/21501319261428883
DP - NLM
ET - 20260310
JF - J Prim Care Community Health
LA - eng
N2 - BACKGROUND: Diabetes self-management education and support (DSMES) is an evidence-based intervention that improves outcomes for people with diabetes, but uptake is <10%. We conducted a pilot pragmatic trial to increase DSMES in rural primary care clinics that integrated health information technology with a quality improvement (QI) learning collaborative. METHODS: Two healthcare systems from rural Kentucky participated in the study. Within each system, 2 clinics received the intervention and 1 clinic served as a control (N = 6 clinics). Each intervention clinic identified a QI team (5-6 individuals) who participated in a 9-month QI learning collaborative followed by 5 months of follow-up. Our primary outcome was DSMES referrals; secondary outcomes were DSMES attendance and percentage with A1c >9%. RESULTS: The 6 study clinics served 1,803 patients with diabetes; n = 1083 (60.1%) from 4 intervention clinics and n = 720 (39.9%) from 2 control clinics. DSMES referrals significantly increased in the intervention clinics compared to the control clinics (31.7% vs 0.1%, P < .001) and continued to increase throughout 5-month follow-up (40.0% vs 0.1%, P < .001). CONCLUSIONS: A structured QI intervention can significantly increase DSMES referral rates in primary care clinics. Findings highlight the potential of systems-level approaches to address persistent gaps in diabetes care delivery in rural settings. CLINICAL TRIAL REGISTRY: Using Practice Facilitation and Operationalizing Referral Information Technology to Increase DSMES Utilization (Clinicaltrials.gov registration number no. NCT05472142). CLINICALTRIALS: gov URL (https://clinicaltrials.gov/study/NCT05472142).
PY - 2026
SN - 2150-1319 (Print); 2150-1319
SP - 21501319261428883
ST - Increasing Uptake of Diabetes Self-Management Education and Support (DSMES) in Rural Kentucky Primary Care Clinics: Findings From a Pilot Pragmatic Cluster-Randomized Trial
T1 - Increasing Uptake of Diabetes Self-Management Education and Support (DSMES) in Rural Kentucky Primary Care Clinics: Findings From a Pilot Pragmatic Cluster-Randomized Trial
T2 - J Prim Care Community Health
TI - Increasing Uptake of Diabetes Self-Management Education and Support (DSMES) in Rural Kentucky Primary Care Clinics: Findings From a Pilot Pragmatic Cluster-Randomized Trial
U1 - Healthcare Disparities; HIT & Telehealth
U3 - 10.1177/21501319261428883
VL - 17
VO - 2150-1319 (Print); 2150-1319
Y1 - 2026
ER -