The Importance of End-User Feedback

Pamlico County is a rural county located in Eastern North Carolina. Photo Credit: Ken Lund. No changes were made to the photo. The original photo can be accessed here.

My project entails developing and piloting a diabetes management program for patients at Hope Clinic in Pamlico County, North Carolina. Progress to date has included developing a proposal for the pilot program, which my team and I completed Fall semester 2020. In recent weeks, we received buy-in from stakeholders at Hope Clinic on the proposal and the go-ahead to continue planning and implementing the pilot program.

The next phase of the project has been reaching out to patients. I developed a survey to distribute to a sample of patients to gauge their interest in various elements of the pilot program that my team and I proposed. We developed the pilot program based on a thorough literature review and interviews with experts and innovators who have experience with diabetes management, and more broadly chronic care management, programs. However, the patient population is the most important to get input from before we can finalize the pilot proposal.

This piece of the project has been challenging, as there have been logistical barriers to overcome to distribute the survey. With technological barriers, such as limited access to broadband internet in the county, my team and I ultimately decided the best way to connect with patients would be via phone calls. This month we will be working on calling a sample of the patients, randomly selected in line with the overall demographics of patients at Hope Clinic.

The patient survey is crucial because the pilot will only be useful for patients if it’s in line with their needs and the activities that they are interested in participating in. The survey closes with the question ‘Is there anything that you would like to see in your community that could improve your health or quality of life?’ connecting directly with people that will engage with this program is crucial. I am not a resident of Pamlico County, nor do I have a chronic health condition that requires ongoing care. While the pilot program was developed based on research and talking to stakeholders who have developed similar programs in other locations, getting the input from those who would be using the program is crucial.

If all goes as planned, the patient survey will be complete by the end of the month and the pilot program can be refined and finalized. Once finalized, the program will be rolled out in three different phases based on level of effort and funding required to start the phase. There are two more urgent elements of the pilot that my team and I want to pursue as soon as possible.

The first element includes increasing opportunities for physical fitness for patients, as well as their families and friends, to engage in in the community. As Spring approaches and the weather is nicer, this is soon to be the perfect time for outdoor, socially-distanced fitness classes. We are in contact with various fitness instructors in the area to arrange outdoor classes and take advantage of this optimal timing.

The second element includes coordinating access to food resources for individuals experiencing food insecurity. Food insecurity has increased nationwide as a result of the COVID-19 pandemic and the rise in unemployment that we saw nationwide as a result. At the close of 2020, North Carolina Central University (NCCU) studied the effect of COVID-19 on lost income and increased food insecurity in North Carolina. The study found an increasing number of North Carolinians are relying on friends, family, and charity resources for food.

This element of the pilot is also timely due to a recent closure of one of the county’s grocery stores. The Piggly Wiggly in Grantsboro closed at the end of February after sales plummeted last year. Residents of Pamlico may now have less access to fresh foods in the county, particularly in the particular city the Piggly Wiggly was located in.

The local church network is extensive in Pamlico. As such, this element of the pilot involves reaching out to the local churches that operate food pantries and helping to coordinate services to get food to the patients who need is. Another element involves troubleshooting transportation. There is extremely limited public transportation available in the county, and limited ride-sharing options. We are considering options for distributing gas cards or connecting patients to volunteer drivers to access food pantries that they are typically not able to access.

Arianna Farmer is a second-year Master of Public Policy candidate. She studied global health and social policy as an undergraduate at Northwestern University. Arianna is interested in implementing policy changes to increase equitable health outcomes at the state and local levels, particularly in underserved communities. She hopes to better understand health disparities in rural communities and develop innovative models to address those disparities.

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