UVM Theses and Dissertations
Format:
Print
Author:
Todd, Frances
Title:
Dept./Program:
Nursing
Year:
2004
Degree:
M.S.
Abstract:
The American Diabetes Association (ADA) has taken the position there is insufficient evidence to conclude that community screening is a cost-effective approach to reduce the morbidity and mortality associated with type II diabetes in presumably healthy individuals and community screening for type II diabetes is not recommended. The ADA posits that other less costly approaches may be more appropriate. The community of Vermont professionals working in the field of diabetes disagrees with the ADA recommendations and continues to perform community screenings for diabetes in the general population by administering both the ADA risk assessment and a random capillary blood glucose (CBG) test. A randomized clinical trial research method was used to investigate the efficacy and effectiveness of casual community screenings for diabetes and to determine the sample size and protocol rigor required for a larger randomized clinical trial.
The specific aim of this pilot study was to determine if performing a CBG test along with the ADA risk assessment survey at a casual community screening is associated with an increased rate of participant follow-up with a healthcare provider when compared to performing the ADA risk assessment survey alone. Other factors investigated were cost, number of uninsured people participating in this screening, presence of clinical symptoms of diabetes at the time of this screening. A total of 631 volunteers were screened for diabetes with 387 (61.3%) volunteering to participate in this clinical study. The intervention group received an ADA risk factor assessment and a random CBG test and the control group received a risk factor assessment only. The chi- square test was used to determine proportional differences between the two groups in rates of follow-up with a healthcare provider. Results indicated there were not significant proportional differences in rates of follow-up with a healthcare provider between the two groups and an estimated 3,459 subjects would need to be screened to make these findings significant.
The diabetes detection rate was low at 1.8% and the cost of screening per participant diagnosed with diabetes was $249. Insurance status did not appear to affect a participant's decision to be screened. The correlation between participant test scores and the presence of many of the symptoms of diabetes was significant (p< 0.05). Although the detection rate was low, 62 (34.3%) did make follow-up appointments with their healthcare providers as a result of education received during screening. This rate of follow-up is significant when the correlation between participant test scores and the presence of symptoms associated with diabetes is considered.
The specific aim of this pilot study was to determine if performing a CBG test along with the ADA risk assessment survey at a casual community screening is associated with an increased rate of participant follow-up with a healthcare provider when compared to performing the ADA risk assessment survey alone. Other factors investigated were cost, number of uninsured people participating in this screening, presence of clinical symptoms of diabetes at the time of this screening. A total of 631 volunteers were screened for diabetes with 387 (61.3%) volunteering to participate in this clinical study. The intervention group received an ADA risk factor assessment and a random CBG test and the control group received a risk factor assessment only. The chi- square test was used to determine proportional differences between the two groups in rates of follow-up with a healthcare provider. Results indicated there were not significant proportional differences in rates of follow-up with a healthcare provider between the two groups and an estimated 3,459 subjects would need to be screened to make these findings significant.
The diabetes detection rate was low at 1.8% and the cost of screening per participant diagnosed with diabetes was $249. Insurance status did not appear to affect a participant's decision to be screened. The correlation between participant test scores and the presence of many of the symptoms of diabetes was significant (p< 0.05). Although the detection rate was low, 62 (34.3%) did make follow-up appointments with their healthcare providers as a result of education received during screening. This rate of follow-up is significant when the correlation between participant test scores and the presence of symptoms associated with diabetes is considered.