Continuity of Care and Lifestyle Intervention Programs for Spanish-Speaking Immigrants Without Health Insurance at a Free Clinic in Rhode Island

PEER REVIEWED

From January 2016 through June 2019, prior to evaluation period, 805 participants enrolled in BTG; of these, 22 participants elected to continue in BTG program. From October 2019 through October 2021, 1,150 new patients visited the Neighborhood Health Station and main clinic; those with chronic disease or with prediabetes/diabetes or overweight/obesity were flagged; of these, 494 were informed of and consented to participate in BTG program. From July 2019 through June 2021, 516 participants enrolled in BTG and scheduled quarterly visits; of these, 45 were excluded: 41 participants did not return for any follow-up visits and 4 participants transferred to a traditional health insurance plan. The final analytic sample had 471 participants.

Figure 1.
Flow of participants in the Clínica Esperanza/Hope Clinic Bridging the [Health Equity] Gap program, Providence, Rhode Island, 2019–2022.

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Figure 2.
Timeline for the Clínica Esperanza/Hope Clinic Bridging the [Health Equity] Gap program in Providence, Rhode Island, for the evaluation period, July 1, 2019, to July 1, 2022. Names of programs reflect funding sources. Abbreviations: NVS, Navegante Vida Sana; WWVS, Wisewoman Vida Sana.

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Figure 3.
Venn diagram for the distribution of chronic conditions among participants in the Clínica Esperanza/Hope Clinic Bridging the [Health Equity] Gap program in Providence, Rhode Island, for the evaluation period, July 1, 2019, to July 1, 2022. All values are number of participants.

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This line graph shows a downward trend in glucose measurements over 12 calendar quarters (2019–2022) starting at approximately 150 mg/dL and ending at approximately 113 mg/dL. Three measures fell outside the CI, in Quarter 3 of 2019 (1st calendar quarter of program), in Quarter 3 of 2021 (9th calendar quarter of program), and in Quarter 1 of 2022 (11th calendar quarter of program).

Figure 4.
Mean blood glucose measurements among participants (N = 471) in the Clínica Esperanza/Hope Clinic Bridging the [Health Equity] Gap Program, Providence, Rhode Island, July 2019–July 2022. All visits (baseline and follow-up) were used in calculation of means. The regression excluded outliers found during the Delta (August 2021) and Omicron (January 2022) waves of COVID-19. Shading indicates 95% CIs.

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This line graph shows a downward trend in mean glycosylated hemoglobin A1c (HbA1c) measurements over 12 calendar quarters (2019–2022) starting at approximately 6.7% and ending at 6.2%. The first 2 measures, in the second half of 2019, both fell outside the CI, as did the measure in the third quarter of 2021.

Figure 5.
Mean glycosylated hemoglobin A_1c (HbA_1c) measurements among participants (N = 471) in the Clínica Esperanza/Hope Clinic Bridging the [Health Equity] Gap Program, Providence, Rhode Island, July 2019–July 2022. All visits (baseline and follow-up) were used in calculation of means. The regression excluded the outlier found during the Omicron (January 2022) wave of COVID-19. Shading indicates 95% CIs.

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