Skip to main content

Main menu

  • Home
  • Current Issue
  • Content
    • Current Issue
    • Early Access
    • Multimedia
    • Podcast
    • Collections
    • Past Issues
    • Articles by Subject
    • Articles by Type
    • Supplements
    • Plain Language Summaries
    • Calls for Papers
  • Info for
    • Authors
    • Reviewers
    • Job Seekers
    • Media
  • About
    • Annals of Family Medicine
    • Editorial Staff & Boards
    • Sponsoring Organizations
    • Copyrights & Permissions
    • Announcements
  • Engage
    • Engage
    • e-Letters (Comments)
    • Subscribe
    • Podcast
    • E-mail Alerts
    • Journal Club
    • RSS
    • Annals Forum (Archive)
  • Contact
    • Contact Us
  • Careers

User menu

  • My alerts

Search

  • Advanced search
Annals of Family Medicine
  • My alerts
Annals of Family Medicine

Advanced Search

  • Home
  • Current Issue
  • Content
    • Current Issue
    • Early Access
    • Multimedia
    • Podcast
    • Collections
    • Past Issues
    • Articles by Subject
    • Articles by Type
    • Supplements
    • Plain Language Summaries
    • Calls for Papers
  • Info for
    • Authors
    • Reviewers
    • Job Seekers
    • Media
  • About
    • Annals of Family Medicine
    • Editorial Staff & Boards
    • Sponsoring Organizations
    • Copyrights & Permissions
    • Announcements
  • Engage
    • Engage
    • e-Letters (Comments)
    • Subscribe
    • Podcast
    • E-mail Alerts
    • Journal Club
    • RSS
    • Annals Forum (Archive)
  • Contact
    • Contact Us
  • Careers
  • Follow annalsfm on Twitter
  • Visit annalsfm on Facebook
Meeting ReportSocial determinants and vulnerable populations

The Diabetes Homeless Medication Support (D-HOMES) program: Results from a randomized pilot trial

Kate Vickery, Andrew Busch, Audrey Rose Hyson, Becky Ford, Moncies Franco, Ella Strother, Victor Montori and Lillian Gelberg
The Annals of Family Medicine November 2023, 21 (Supplement 3) 4833; DOI: https://doi.org/10.1370/afm.22.s1.4833
Kate Vickery
MD, MSc
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Andrew Busch
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Audrey Rose Hyson
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Becky Ford
PhD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Moncies Franco
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Ella Strother
BS
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Victor Montori
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Lillian Gelberg
MD, MSPH
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • eLetters
  • Info & Metrics
  • PDF
Loading

Abstract

Context: People experiencing homelessness have 3-6x higher diabetes mortality than their stably housed peers despite similar prevalence. Evidence supports health coach programs to improve diabetes care and behavioral activation (BA) to improve medication adherence in low-resource settings. Yet this evidence has not been applied to people experiencing homelessness.

Objective: To use community engaged research to develop a behavioral intervention to improve diabetes care tailored to the needs of people who have experienced homelessness.

Study design and analysis: Following the ORBIT model, we conducted several treatment development studies. Here we data from our randomized pilot trial comparing our intervention (D-HOMES) with enhanced usual care (EUC;i.e., brief diabetes education and referral for usual care). We used bi- and multivariate statistics to examine changes in outcome measures from baseline at 12-, 24-weeks.

Setting: Minneapolis, MN, a U.S. urban area with accessible safety net health care.

Population: Adults with type 2 diabetes who had experienced homelessness in the last 24 months, took diabetes medications and were willing to work on improved adherence, with HbA1c>7.5%.

Intervention: D-HOMES offered up to 10 individual, weekly, 30 min. coaching sessions over 12 weeks and 3 monthly, 15 min. booster calls. Trained, non-health-expert coaches used BA to improve adherence.

Outcome measures: We focused on feasibility (enrollment, retention) and acceptability (CSQ-8 survey). Our eventual primary outcome is glycemic control (HbA1c); behavioral targets include medication adherence, diabetes management (DSMQ, PAID-5), and psychological wellness (MHI-5).

Results: We randomized 38 participants but withdrew 2 due to ineligibility. 100% of eligible participants had 12-week assessment visits; 80+% of eligible participants had 24-week assessment visits.

Acceptability was high. Mean glycemic control improved among all participants at 12-weeks (-0.7%) with 81% of participants improving their HbA1c by −0.5% or more; we detected no significant between group difference at 12-weeks. Diabetes emotional distress, glucose control behaviors, and psychological wellness changed more in the hypothesized direction among D-HOMES participants compared to EUC at 12- and 24-weeks.

Conclusions: D-HOMES is highly feasible and acceptable to an under-studied population. Underpowered outcome measure analyses demonstrate mixed results. More study is needed in a fully powered trial.

  • © 2023 Annals of Family Medicine, Inc.
Previous
Back to top

In this issue

The Annals of Family Medicine: 21 (Supplement 3)
The Annals of Family Medicine: 21 (Supplement 3)
Vol. 21, Issue Supplement 3
1 Nov 2023
  • Table of Contents
  • Index by author
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on Annals of Family Medicine.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
The Diabetes Homeless Medication Support (D-HOMES) program: Results from a randomized pilot trial
(Your Name) has sent you a message from Annals of Family Medicine
(Your Name) thought you would like to see the Annals of Family Medicine web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
1 + 2 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
Citation Tools
The Diabetes Homeless Medication Support (D-HOMES) program: Results from a randomized pilot trial
Kate Vickery, Andrew Busch, Audrey Rose Hyson, Becky Ford, Moncies Franco, Ella Strother, Victor Montori, Lillian Gelberg
The Annals of Family Medicine Nov 2023, 21 (Supplement 3) 4833; DOI: 10.1370/afm.22.s1.4833

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Get Permissions
Share
The Diabetes Homeless Medication Support (D-HOMES) program: Results from a randomized pilot trial
Kate Vickery, Andrew Busch, Audrey Rose Hyson, Becky Ford, Moncies Franco, Ella Strother, Victor Montori, Lillian Gelberg
The Annals of Family Medicine Nov 2023, 21 (Supplement 3) 4833; DOI: 10.1370/afm.22.s1.4833
Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
  • eLetters
  • Info & Metrics
  • PDF

Related Articles

  • No related articles found.
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Characterizing nonfatal opioid overdose patients and receipt of medication for opioid use disorder at a safety net hospital
  • The effect of being uninsured on cancer screening practices in Puerto Rico
  • The impact of COVID-19 on gender-based intimate partner violence : a scoping review
Show more Social determinants and vulnerable populations

Similar Articles

Content

  • Current Issue
  • Past Issues
  • Early Access
  • Plain-Language Summaries
  • Multimedia
  • Podcast
  • Articles by Type
  • Articles by Subject
  • Supplements
  • Calls for Papers

Info for

  • Authors
  • Reviewers
  • Job Seekers
  • Media

Engage

  • E-mail Alerts
  • e-Letters (Comments)
  • RSS
  • Journal Club
  • Submit a Manuscript
  • Subscribe
  • Family Medicine Careers

About

  • About Us
  • Editorial Board & Staff
  • Sponsoring Organizations
  • Copyrights & Permissions
  • Contact Us
  • eLetter/Comments Policy

© 2025 Annals of Family Medicine