Jane G. Smilie

Montana Department of Public Health and Human Services

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Steven D. Helgerson

Montana Department of Public Health and Human Services

Todd S. Harwell

Montana Department of Public Health and Human Services

Dorothy Gohdes

Prevention Group

Kelly Moore

Native Health

Janet M. McDowall

Montana Department of Public Health and Human Services

Michael J. McInerney

University of Oklahoma

Cecilia M. Prela

Centers for Medicare and Medicaid Services

Louise P. Roumagoux

Centers for Medicare and Medicaid Services

Kelly J. Acton

Prevention Group

Debbie Powell-Taylor

Indian Health Service

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Indian Health Service

Montana Department of Public Health and Human Services

University of Washington

National Center for Chronic Disease Prevention and Health Promotion

National Jewish Health

Centers for Medicare and Medicaid Services

Native Health

Vanderbilt University Medical Center

Colorado School of Public Health

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Diabetes screening practices among persons gtoreq45 years of age

Todd S. Harwell Jane G. Smilie Steven D. Helgerson Dorothy Gohdes

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Diabetes screening practices among individuals aged 45 years and older.

Diabetes Care (2000)

Todd S. Harwell Jane G. Smilie Janet M. McDowall Steven D. Helgerson Dorothy Gohdes

10.2337/diacare.23.1.125

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Citations (14)

Smoking cessation and prevention: an urgent public health priority for American Indians in the Northern Plains

Public Health Reports (2002)

Dorothy Gohdes Todd S. Harwell Susan Cummings Kelly Moore Jane G. Smilie

10.1016/s0033-3549(04)50162-0

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Citations (19)

Rural Public Health Structure and Practice and the Role of the Public Health Nurse

Springer eBooks (2018)

Jo Ann Walsh Dotson Jane G. Smilie

Rural Health

Community Health

Public health nursing

10.1891/9780826161710.0028

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Citations (1)

Foot Care Practices, Services and Perceptions of Risk among Medicare Beneficiaries with Diabetes at High and Low Risk for Future Foot Complications

Foot & Ankle International (2001)

Todd S. Harwell Steven D. Helgerson Dorothy Gohdes Michael J. McInerney Louise P. Roumagoux

A cohort of Medicare beneficiaries with diabetes was identified from inpatient and outpatient claims data and their risk for foot complications was estimated based on claims reflecting services for recent foot problems. A telephone survey of a random sample from this cohort was conducted to assess their foot care practices, barriers, and perceptions of risk. Eight percent of respondents reported a history of foot ulcers and 7% a history of lower extremity amputation. Based on claims data, 30% of respondents were at high risk for future foot complications. Compared to those at low risk, those at high risk were more likely to report having an annual foot exam, using protective footwear, and perceiving themselves to be high risk for future foot complications. However, 50% of those with claims indicating a high risk perceived themselves to be at low risk for future foot complications. Overall, 20% of respondents seldom checked their feet daily for sores or irritations. Among this group, 60% felt that it was unimportant and 9% reported they were limited by poor vision or physical problems. Our findings suggest that strategies are needed to improve the delivery of preventive foot care services to older persons with diabetes. Additionally, emphasis is needed to help individuals understand their risk and seek and perform appropriate preventive foot care.

Foot (prosody)

Podiatry

10.1177/107110070102200909

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Citations (25)

Cardiovascular disease and risk factors in Montana American Indians and non-Indians

American Journal of Preventive Medicine (2001)

Todd S. Harwell Dorothy Gohdes Kelly Moore Janet M. McDowall Jane G. Smilie

10.1016/s0749-3797(00)00312-3

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Citations (56)

Direct mail intervention to increase retinal examination rates in Medicare beneficiaries with diabetes.

PubMed (2000)

Cecilia M. Prela Jane G. Smilie Michael J. McInerney Todd S. Harwell Steven D. Helgerson

The objective of this study was to identify the baseline frequency of eye examinations for Medicare beneficiaries with diabetes in Montana and to determine whether a direct mail reminder increased eye examinations. Using Medicare Part A and Medicare Part B claims data, a cohort of Medicare beneficiaries with diabetes was defined. Eye examination claims were identified using billing codes specific for retinal examinations, as well as visits to ophthalmologists and optometrists during which retinal exams were likely to have been performed. A random sample of the identified beneficiaries with diabetes received a letter encouraging regular annual retinal examinations. In the first 3-month period after the mailing, the billed eye examination rate for those to whom letters were sent was 2.2 percentage points greater than the rate for those to whom letters were not sent (19.4% vs 17.2%; relative risk, 1.13; 95% confidence interval, 1.01-1.26). However, 6 months after the letters were sent, there was no longer a significant difference in the rates for these 2 groups (32.9% vs 32.4%; relative risk, 1.02; 95% confidence interval, 0.94-1.10). In this study, direct mail outreach initially influenced the proportion of Medicare beneficiaries receiving an eye examination, but this pattern was not sustained over the 6-month follow-up period.

Eye examination

Outreach

Medicare Part B

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Comparing Self-Reported Measures of Diabetes Care With Similar Measures From a Chart Audit in a Well-Defined Population

American Journal of Medical Quality (2001)

Todd S. Harwell Kelly Moore Mary Madison Debbie Powell-Taylor Pat Lundgren

The objective of this study was to compare self-reported measures of diabetes care with measures derived from medical records in a well-defined population. Diabetes measures were collected through a 1997 Behavioral Risk Factor Surveillance System telephone survey of American Indians living on or near 7 Montana reservations (N = 398) and were compared with data collected from charts of a systematic sample of American Indians with diabetes seen in 1997 at Indian Health Service (IHS) facilities. Survey respondents were more likely to report a duration of diabetes >10 years (44 vs 31%), annual dilated retinal exam (75 vs 59o), and an influenza immunization in the past year (73 vs 57%) compared with estimates from the chart audit. Estimates of pneumococcal immunization (88 vs 42%), annual cholesterol screening (86 vs 69o), and overweight, based on body mass index (67 vs 50%), were significantly higher from the chart audit. No significant differences were found between the survey respondents and the chart audit data for annual foot exams (65 vs 61%), annual blood pressure checks (98 vs 93%), high cholesterol (35 vs 41%), and high blood pressure (54 vs 64%). These findings suggest that self-reported data may over and underestimate specific measures of diabetes care.

Medical record

10.1177/106286060101600102

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Citations (19)