Cynthia T. Schaefer

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OBJECTIVE To evaluate the Diabetes Health Disparities Collaborative, an initiative by the Bureau of Primary Health Care to reduce health disparities and improve the quality of diabetes care in community health centers. RESEARCH DESIGN AND METHODS One year before- after trial. Beginning in 1998, 19 Midwestern health centers undertook a diabetes quality(More)
OBJECTIVES We sought to compare quality of diabetes care by insurance type in federally funded community health centers. Method. We categorized 2018 diabetes patients, randomly selected from 27 community health centers in 17 states in 2002, into 6 mutually exclusive insurance groups. We used multivariate logistic regression analyses to compare quality of(More)
Health literacy involves reading, numeracy, comprehension, and the ability to make appropriate decisions about healthcare. The nurse needs to understand the impact health literacy has on patient education. Sixteen research articles that used an experimental design were reviewed in this integrated review to examine the effectiveness of intervention(More)
OBJECTIVE We aimed to identify barriers to improving care for individuals with diabetes in community health centers. These findings are important because many such patients, as in most other practice settings, receive care that does not meet evidence-based standards. RESEARCH DESIGN AND METHODS In 42 Midwestern health centers, we surveyed 389 health(More)
BACKGROUND In 1998, the Health Resources and Services Administration's Bureau of Primary Health Care began the Health Disparities Collaboratives (HDC) to improve chronic disease management in community health centers (HCs) nationwide. The HDC incorporates rapid quality improvement, a chronic care model, and best practice learning sessions. OBJECTIVES To(More)
OBJECTIVE To examine techniques used by community health center (HC) providers to care for patients with limited health literacy (LHL). METHODS Survey mailed to 803 HC providers in 10 Midwestern states. Response rate was 47.5%. Associations between variables were examined using generalized estimating equations (GEE) models to account for clustering of(More)
OBJECTIVES This study assessed the quality of diabetes care in community health centers. METHODS In 55 midwestern community health centers, we reviewed the charts of 2865 diabetic adults for American Diabetes Association measures of quality. RESULTS On average, 70% of the patients in each community health center had measurements of glycosylated(More)
INTRODUCTION Quality improvement (QI) interventions are usually evaluated for their intended effect; little is known about whether they generate significant positive or negative spillovers. METHODS We mailed a 39-item self-administered survey to the 1256 staff at 135 federally qualified health centers (FQHC) implementing the Health Disparities(More)
The rate of successful health care innovation implementation is dismal. Middle managers have a potentially important yet poorly understood role in health care innovation implementation. This study used self-administered surveys and interviews of middle managers in health centers that implemented an innovation to reduce health disparities to address the(More)
OBJECTIVE To identify predictors of changes in staff morale and burnout associated with participation in a quality improvement (QI) initiative at community health centers (HCs). DATA SOURCES Surveys of staff at 145 HCs participating in the Health Disparities Collaboratives (HDC) program in 2004. DATA COLLECTION AND STUDY DESIGN: Self-administered(More)