TY - JOUR
KW - Aged
KW - Behavior Therapy
KW - Chronic Disease
KW - Community Health Services
KW - Confidence Intervals
KW - Cross-Sectional Studies
KW - Diabetes Mellitus/diet therapy/prevention & control
KW - Diet
KW - Directive Counseling
KW - Disease Management
KW - Female
KW - Health Care Surveys
KW - Humans
KW - Logistic Models
KW - Male
KW - Middle Aged
KW - Models, Organizational
KW - Motor Activity
KW - Obesity/diet therapy/prevention & control
KW - Odds Ratio
KW - Primary Health Care
KW - Questionnaires
KW - Weight Loss
AU - P. A. Strickland
AU - S. V. Hudson
AU - A. Piasecki
AU - K. Hahn
AU - D. Cohen
AU - A. J. Orzano
AU - M. L. Parchman
AU - B. F. Crabtree
A1 - 
AB - BACKGROUND: The Chronic Care Model (CCM) was developed to improve chronic disease care, but it may also inform delivery of other types of preventive care. Using hierarchical analyses of service delivery to patients, we explored associations of CCM implementation with diabetes care and counseling for diet or weight loss and physical activity in community-based primary care offices. METHODS: Secondary analysis focused on baseline data from 25 practices (with an average of 4 physicians per practice) participating in an intervention trial targeting improved colorectal cancer screening rates. This intervention made no reference to the CCM. CCM implementation was measured through staff and clinical management surveys and was associated with patient care indicators (chart audits and patient questionnaires). RESULTS: Overall, practices had low levels of CCM implementation. However, higher levels of CCM implementation were associated with better diabetes assessment and treatment of patients (P = .009 and .015, respectively), particularly among practices open to "innovation." Physical activity counseling for obese and, particularly, overweight patients was strongly associated with CCM implementation (P = .0017), particularly among practices open to "innovation"; however, this association did not hold for overweight and obese patients with diabetes. CONCLUSIONS: Very modest levels of CCM implementation in unsupported primary care practices are associated with improved care for patients with diabetes and higher rates of behavioral counseling. Incremental incorporation of CCM components is an option, especially for community practices with stretched resources and with cultures of "innovativeness."
BT - Journal of the American Board of Family Medicine : JABFM
C5 - General Literature
CP - 3
CY - United States
DO - 10.3122/jabfm.2010.03.090141
IS - 3
JF - Journal of the American Board of Family Medicine : JABFM
N2 - BACKGROUND: The Chronic Care Model (CCM) was developed to improve chronic disease care, but it may also inform delivery of other types of preventive care. Using hierarchical analyses of service delivery to patients, we explored associations of CCM implementation with diabetes care and counseling for diet or weight loss and physical activity in community-based primary care offices. METHODS: Secondary analysis focused on baseline data from 25 practices (with an average of 4 physicians per practice) participating in an intervention trial targeting improved colorectal cancer screening rates. This intervention made no reference to the CCM. CCM implementation was measured through staff and clinical management surveys and was associated with patient care indicators (chart audits and patient questionnaires). RESULTS: Overall, practices had low levels of CCM implementation. However, higher levels of CCM implementation were associated with better diabetes assessment and treatment of patients (P = .009 and .015, respectively), particularly among practices open to "innovation." Physical activity counseling for obese and, particularly, overweight patients was strongly associated with CCM implementation (P = .0017), particularly among practices open to "innovation"; however, this association did not hold for overweight and obese patients with diabetes. CONCLUSIONS: Very modest levels of CCM implementation in unsupported primary care practices are associated with improved care for patients with diabetes and higher rates of behavioral counseling. Incremental incorporation of CCM components is an option, especially for community practices with stretched resources and with cultures of "innovativeness."
PP - United States
PY - 2010
SN - 1557-2625; 1557-2625
SP - 295
EP - 305
EP - 
T1 - Features of the Chronic Care Model (CCM) associated with behavioral counseling and diabetes care in community primary care
T2 - Journal of the American Board of Family Medicine : JABFM
TI - Features of the Chronic Care Model (CCM) associated with behavioral counseling and diabetes care in community primary care
U1 - General Literature
U2 - 20453175
U3 - 10.3122/jabfm.2010.03.090141
VL - 23
VO - 1557-2625; 1557-2625
Y1 - 2010
ER -