Shared Visits for Health Care Consumers in a Rural Free Clinic Setting


Background: One of every four adults in the United States lives with two or more chronic diseases.  Current care delivery models may not adequately address diabetes or hypertension management challenges. Shared visits may provide more efficient chronic illness care. 

Purpose: The purpose of this advanced practice registered nurse-led study was to conduct a pilot program to test the effectiveness of shared visits for low-income, uninsured, rural health care consumers who have uncontrolled chronic type II diabetes or hypertension and who receive care at a rural free clinic.

Methods:  A convenience sample of two groups of adults with diabetes and one group with hypertension engaged in shared health care visits that included shared education and discussion. Data were analyzed using descriptive and inferential statistics.

Findings: Fifty-three percent of diabetes participants had reduced hemoglobin A1c. A statistically significant difference in systolic blood pressure (p = 0.01) was found for the hypertension group. Seventy-eight percent of participants had lower diastolic pressure.

Conclusion: Shared visits show good potential for better self-management and improved outcomes among rural, low-income, uninsured health care consumers who have uncontrolled chronic type II diabetes or hypertension. 

Keywords: Advanced Practice Registered Nurses; Chronic Disease; Diabetes Mellitus, Type 2; Primary Health Care; Rural Health; Self-care


Authors who publish with this journal agree to the following terms:

  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share (for non-commerical purposes) the work with an acknowledgement of the work's authorship and initial publication in this journal.
  2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).