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Summaries of Independent Scientist (K) Awards

Egede, Leonard E.

Institution: Medical University of South Carolina Grant
Grant Title: Collaborative Management of Diabetes in Blacks
Grant Number: K08 HS11418
Duration: 5 years (2001-2006)
Total Award: $632,900

Project Description: The objective of this grant is to develop collaborative management of type 2 diabetes in black Americans. This objective is to be accomplished by understanding patient, provider, and systems level barriers to the effective management of diabetes in primary care settings and the development of a collaborative model of care that has the potential to eliminate these barriers. This research has three specific goals:

  1. To identify the knowledge, beliefs, and attitudes of black patients that impact their diabetes outcomes.
  2. To identify impediments to improved diabetes outcomes in blacks that are attributable to health care providers.
  3. To identify external factors that impact on diabetes outcomes in blacks.

Career Goals:  Dr. Egede plans to develop effective interventions to improve patient-provider communications and reduce racial/ethnic differences in health outcomes in patients with type 2 diabetes. This will be accomplished by submitting new investigator initiated grants to Federal and non-Federal funding agencies based on the findings from the preliminary data collected as part of the career development award. These R01 and R21 grants will be used to develop and test innovative interventions to increase trust between minority patients with type 2 diabetes and the health care system, interventions to improve health provider-patient communication, interventions to decrease psychosocial barriers to effective diabetes self-management, and health systems interventions to improve quality of diabetes care for ethnic minorities.

Progress to Date:  The patient and provider survey components of the project have been completed. Multiple publications based on the surveys have been published. Clinic and community based interventions to improve quality of care for black Americans with diabetes are being developed. A pilot intervention to increase physical activity levels and improve self-care behaviors in black American women is in the process of testing in community sites. The awardee has competed and successfully obtained grant funding from the Department of Veterans' Affairs (VA) Health Services Research and Development Service (HSR&D), and has two R01 grants in the review process. The awardee was recently awarded an institutional grant to establish a Center for Health Disparities Research, which will further advance the objectives of the K08 award.

Future Plans: Data analysis will continue. In the next year, the awardee will continue to write R21 grants to pilot test the interventions that are being developed. It is anticipated that R01 grants based on the pilot interventions will be submitted within the next two years. Additional focus groups will be formed to examine the beliefs and attitudes about diabetes self-management, barriers to receiving culturally sensitive care, perceptions about health care providers and the health care system, and beliefs about patient autonomy. Multiple manuscripts are in press. The grantee will continue his limited clinical activities and teaching as well as develop Federal grant applications.

Highlights and Specific Accomplishments:

  • Professional Memberships:
    • Society of General Internal Medicine.
    • American Diabetes Association.
    • Academy of Health Services Research.
    • American Public Health Association.
    • Society of Behavior Medicine.
  • Associate Professor of Medicine, Medical University of South Carolina (MUSC).
  • Director, Charleston VA Targeted Research Enhancement Program (TREP).
  • Director, MUSC Center for Health Disparities Research.
  • Section Head for Health Services Research, Division of General Internal Medicine, MUSC.
  • Deputy Editor, Journal of General Internal Medicine.
  • Editorial board member, Current Diabetes Reviews.
  • Developing Scholars Award, Health Sciences Foundation, MUSC, August 2004.
  • American Diabetes Association Young Investigator Award, June 2003.
  • Member of National Institutes of Health (NIH) Center for Scientific Review Psychosocial Risk and Disease Prevention study section.
  • Member, VA HSR&D Scientific Medical Review Board—Equity

K-Generated Publications:

  • Egede LE, Michel Y. Perceived Difficulty of Diabetes Treatment in Primary Care: Does it differ by the Ethnicity of the Patient? Diabetes Education 2001;27(5):678-84.
  • Egede LE, Michel Y. The Attitudes of Internal Medicine Physicians toward Type 2 Diabetes. Southern Medical Journal 2002 Jan; 95(1):88-91.
  • Egede LE, Ye X, Zheng D, Silverstein MD. The Prevalence and Pattern of Complementary and Alternative Medicine Use in Individuals with Diabetes. Diabetes Care 2002;25(2):324-9.
  • Egede LE, Zheng D. Modifiable Cardiovascular Risk Factors in Adults with Diabetes: Prevalence and Missed Opportunities for Physician Counseling. Archieves of Internal Medicine 2002 Feb. 25; 162(4):427-33.
  • Egede LE, Zheng D, Simpson K. Comorbid Depression is Associated with  Increased Health Care Use and Expenditures among Individuals with Diabetes Mellitus. Diabetes Care 2002;25(3):464-70.
  • Egede LE. Beliefs and Attitudes of African Americans with Type 2 Diabetes toward Depression. Diabetes Education. 2002 Mar-Apr. 28(2):258-68.
  • Egede LE, Zheng D. Independent Factors Associated with Major Depressive Disorders in a National Sample of Adults with Diabetes. Diabetes Care 2003;26(1):104-11.
  • Egede LE, Zheng D. Racial/Ethnic Differences in Influenza and Pneumococcal Vaccination Rates in Individuals with Diabetes. American Journal of Public Health 2003;93:324-9.
  • Egede LE, Bonadonna RJ. Diabetes Self-Management in African Americans:  An Exploration of the Role of Fatalism. Diabetes Education 2003;29,(1):105-15.
  • Egede LE, Zheng D. Racial/Ethnic Differences in Influenza Vaccination in High-Risk Adults. American Journal of Public Health 2003 Dec; 93(12):2074-8.
  • Egede LE. Implementing Behavioral-Counseling Interventions in Primary Care to Modify Cardiovascular Disease Risk in Adults with Diabetes.  Cardiovascular Reviews and Reports 2003;24(6):306-12.
  • Egede LE. Lifestyle Modification to Improve Blood Pressure Control in Individuals with Diabetes: Is Physician Advice Effective? Diabetes Care 2003 Mar; 26(3):602-7.
  • Egede LE, Simpson K. Epidemiology, Treatment, and Costs of Depression in Adults with Type 2 Diabetes. Expert Review of Pharmacoeconomics & Outcomes Research. 2003;3(3):251-62.
  • Egede LE. Association between Number of Physician Visits and Influenza Vaccination Coverage among Diabetic Adults with Access to Care. Diabetes Care 2003 Sep; 26:2562-7.
  • Willi SM, Planton J, Egede L, Schwarz S. Benefits of Continuous Subcutaneous Insulin Infusion (CSII) in Children with Type 1 Diabetes. Journal of Pediatrics 2003 Dec; 143(6):796-801.
  • Egede LE. Diabetes, Major Depression, and Functional Disability among United States Adults. Diabetes Care 2004 Feb; 27(2):421-8.
  • Rubin RR, Ciechanowski P, Egede LE, Lin EH, Lustman PJ. Recognizing and Treating Depression in Patients with Diabetes. Current Diabetes Review 2004 Apr; 4(2):119-25.
  • Egede LE. Complementary and Alternative Medicine Use by Individuals with Diabetes. Geriatric Times 2004;5(3):8-11.
  • Egede LE. Behavioral Counseling Interventions for Primary Prevention of Coronary Heart Disease in Individuals with Type 2 Diabetes. Comprehensive Therapy 2004;30(3):141-7.
  • Egede LE. Influenza Prevention Strategies in Elderly African Americans: Egede Responds. American Journal of Public Health, Jun 2004;94:905-6.
  • Egede LE. Patterns and Correlates of Emergency Department Use by Individuals with Diabetes. Diabetes Care. 2004 Jul; 27(7):1748-50.
  • Egede LE. Effect of Depression on Work Loss and Disability Bed Days in Individuals with Diabetes. Diabetes Care. 2004 Jul; 27(7):1751-3.
  • Egede LE Poston ME. Racial/Ethnic Differences in Leisure-Time Physical Activity Levels among Individuals with Diabetes. Diabetes Care. 2004 Oct.; 27(10):2493-2494.
  • Egede LE. Effect of Comorbid Chronic Diseases on Prevalence and Odds of Depression in Adults with Diabetes. Psychosomatic Medicine 2005 Jan-Feb; 67(1):46-51.
  • Egede LE, Dagogo-Jack S. Epidemiology of Type 2 Diabetes: Focus on Ethnic Minorities. Medical Clinics of North America 2005 Sept.; 89(5):949-75.
  • Egede LE, Nietert PJ, Zheng D. Depression and All-Cause and Coronary Heart Disease Mortality among Adults with and without Diabetes. Diabetes Care 2005 Jun; 28(5):1339-45.
  • Egede LE. Effect of Depression on Self-Management Behaviors and Health Outcomes in Adults with Type 2 Diabetes. Current Diabetes Review 2005 November; 1(3):235-43.
  • Garrow D, Egede LE. Association between Complementary and Alternative Medicine Use, Preventive Care Practices, and Use of Conventional Medical Services among Adults with Diabetes. Diabetes Care 2006 Jan; 29:15-9.
  • Egede LE, Michel Y. Medical Mistrust, Diabetes Self-Management, and Glycemic Control in an Indigent Population with Type 2 Diabetes. Diabetes Care 2006 Jan; 29: 131-2.

AHRQ Research Portfolios: Socio-economics of Health Care; Care Management; Training.
AHRQ Goals: Safety and Quality

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