{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T19:12:13Z","timestamp":1781118733147,"version":"3.54.1"},"reference-count":38,"publisher":"American Diabetes Association","issue":"3","license":[{"start":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T00:00:00Z","timestamp":1775433600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["HS025937"],"award-info":[{"award-number":["HS025937"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To examine how communication patterns within primary care teams are associated with diabetes outcomes, using social network analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>We conducted a cross-sectional study in 23 primary care practices affiliated with institutions in New York and Pennsylvania. All providers and staff were invited to complete a survey measuring communication frequency and modality. We constructed egocentric communication networks for 96 primary care professionals (PCPs), linking survey data to data from electronic health records for 2,617 patients with diabetes. Key network measures included density (proportion of actual to possible connections) and PCP betweenness centrality (extent to which communication was routed through the PCP). Multilevel logistic regression models assessed the association between network measures and composite measure of diabetes control, defined as achieving recommended targets for blood pressure, LDL cholesterol, and HbA1c.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Patients cared for by teams with denser communication networks were more likely to achieve composite diabetes control (odds ratio 1.28; 95% CI 1.04, 1.57) in unadjusted models. This association remained significant when controlling for patient and provider covariates but was attenuated after adjusting for institutional context and patient race and ethnicity. PCP betweenness centrality was not significantly associated with diabetes outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Denser primary care team communication was associated with improved diabetes control, but these effects were attenuated by institution and patient racial composition. Findings suggest team communication may contribute to better outcomes, yet its impact is shaped by practice context and patient population. Larger, multisite studies are warranted to clarify mechanisms and inform strategies for optimizing team-based diabetes care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/doc25-0063","type":"journal-article","created":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T14:01:55Z","timestamp":1775484115000},"page":"366-373","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":0,"title":["Communication in Primary Care Teams and Diabetes Outcomes: A Social Network Analysis"],"prefix":"10.2337","volume":"1","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1942-8683","authenticated-orcid":false,"given":"Grant R.","family":"Martsolf","sequence":"first","affiliation":[{"name":"University of Pittsburgh School of Nursing 1 , Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle","family":"Featherston","sequence":"additional","affiliation":[{"name":"Columbia University School of Nursing 2 , New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Voigt","sequence":"additional","affiliation":[{"name":"Columbia University School of Nursing 2 , New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianfang","family":"Liu","sequence":"additional","affiliation":[{"name":"Columbia University School of Nursing 2 , New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika L.","family":"Moen","sequence":"additional","affiliation":[{"name":"Geisel School of Medicine at Dartmouth 3 , Hanover, NH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lusine","family":"Poghosyan","sequence":"additional","affiliation":[{"name":"Columbia University School of Nursing 2 , New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2026,4,6]]},"reference":[{"key":"2026061014515927200_B1","unstructured":"Centers for Disease Control and\n            Prevention\n          . National Diabetes Statistics Report, 2024. Accessed 29 October 2025. Available from https:\/\/www.cdc.gov\/diabetes\/php\/data-research\/?CDC"},{"key":"2026061014515927200_B2","doi-asserted-by":"crossref","first-page":"10","DOI":"10.2337\/cd22-as01","article-title":"Standards of Medical Care in Diabetes\u20142022 abridged for primary care providers","volume":"40","author":"American Diabetes Association","year":"2022","journal-title":"Clin Diabetes"},{"key":"2026061014515927200_B3","doi-asserted-by":"crossref","first-page":"26","DOI":"10.2337\/dci23-0085","article-title":"Economic costs of diabetes in the U.S. in 2022","volume":"47","author":"Parker","year":"2024","journal-title":"Diabetes Care"},{"key":"2026061014515927200_B4","unstructured":"Centers for Disease Control and Prevention\n          . Diabetes Complications. 24 May 2024. Accessed 29 October 2025. Available from https:\/\/www.cdc.gov\/diabetes\/complications\/index.html"},{"key":"2026061014515927200_B5","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1016\/j.pcd.2020.05.012","article-title":"Multidisciplinary team approach to diabetes. An outlook on providers' and patients' perspectives","volume":"14","author":"Tan","year":"2020","journal-title":"Prim Care Diabetes"},{"key":"2026061014515927200_B6","doi-asserted-by":"crossref","first-page":"e17","DOI":"10.1016\/j.amepre.2019.02.005","article-title":"Team-based care to improve diabetes management: a community guide meta-analysis","volume":"57","author":"Levengood","year":"2019","journal-title":"Am J Prev Med"},{"key":"2026061014515927200_B7","doi-asserted-by":"crossref","first-page":"26335565231165966","DOI":"10.1177\/26335565231165966","article-title":"The multidisciplinary team in diagnosing and treatment of patients with diabetes and comorbidities: a scoping review","volume":"13","author":"Andersen","year":"2023","journal-title":"J Multimorb Comorb"},{"key":"2026061014515927200_B8","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1186\/s12913-024-11062-4","article-title":"Impact of a multi-disciplinary team-based care model for patients living with diabetes on health outcomes: a mixed-methods study","volume":"24","author":"Jacobs","year":"2024","journal-title":"BMC Health Serv Res"},{"key":"2026061014515927200_B9","doi-asserted-by":"crossref","first-page":"150","DOI":"10.32481\/djph.2022.12.033","article-title":"Composition of an ideal medical care team","volume":"8","author":"Harrington","year":"2022","journal-title":"Dela J Public Health"},{"key":"2026061014515927200_B10","doi-asserted-by":"crossref","first-page":"151","DOI":"10.3122\/jabfm.2021.01.200187","article-title":"Interdisciplinary primary care team expertise and diabetes care management","volume":"34","author":"Miller-Rosales","year":"2021","journal-title":"J Am Board Fam Med"},{"key":"2026061014515927200_B11","doi-asserted-by":"crossref","first-page":"4","DOI":"10.3109\/13561820.2010.497750","article-title":"Conflict on interprofessional primary health care teams\u2013can it be resolved?","volume":"25","author":"Brown","year":"2011","journal-title":"J Interprof Care"},{"key":"2026061014515927200_B12","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.healthpol.2009.03.005","article-title":"Social network analysis in primary care: the impact of interactions on prescribing behaviour","volume":"92","author":"Fattore","year":"2009","journal-title":"Health Policy"},{"key":"2026061014515927200_B13","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1111\/jgs.16962","article-title":"Assessing association between team structure and health outcome and cost by social network analysis","volume":"69","author":"Kuo","year":"2021","journal-title":"J Am Geriatr Soc"},{"key":"2026061014515927200_B14","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1370\/afm.1754","article-title":"Effects of primary care team social networks on quality of care and costs for patients with cardiovascular disease","volume":"13","author":"Mundt","year":"2015","journal-title":"Ann Fam Med"},{"key":"2026061014515927200_B15","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1007\/s11606-007-0190-8","article-title":"Factors affecting influential discussions among physicians: a social network analysis of a primary care practice","volume":"22","author":"Keating","year":"2007","journal-title":"J Gen Intern Med"},{"key":"2026061014515927200_B16","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1007\/s11606-017-4247-z","article-title":"Using social network analysis to examine the effect of care management structure on chronic disease management communication within primary care","volume":"33","author":"Holtrop","year":"2018","journal-title":"J Gen Intern Med"},{"key":"2026061014515927200_B17","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1186\/s13643-017-0597-1","article-title":"Use of social network analysis methods to study professional advice and performance among healthcare providers: a systematic review","volume":"6","author":"Sabot","year":"2017","journal-title":"Syst Rev"},{"key":"2026061014515927200_B18","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ijnurstu.2016.01.013","article-title":"Primary care team communication networks, team climate, quality of care, and medical costs for patients with diabetes: a cross-sectional study","volume":"58","author":"Mundt","year":"2016","journal-title":"Int J Nurs Stud"},{"key":"2026061014515927200_B19","unstructured":"Agency for Healthcare Research and Quality\n          . Defining the PCMH,2022. Accessed 29 October 2025. Available from https:\/\/www.ahrq.gov\/ncepcr\/research\/care-coordination\/pcmh\/define.html"},{"key":"2026061014515927200_B20","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1177\/0038038588022001007","article-title":"Social network analysis","volume":"22","author":"Scott","year":"1988","journal-title":"Sociology"},{"key":"2026061014515927200_B21","unstructured":"Qualtrics\n          . Qualtrics LLC, 2020. Accessed 29 October 2025. Available from https:\/\/www.qualtrics.com"},{"key":"2026061014515927200_B22","doi-asserted-by":"crossref","DOI":"10.1002\/9781394260645","volume-title":"Internet, Phone, Mail, and Mixed-Mode Surveys: The Tailored Design Method.","author":"Dillman","year":"2014"},{"key":"2026061014515927200_B23","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1177\/1525822X13518168","article-title":"A mixed methods approach to network data collection","volume":"26","author":"Rice","year":"2014","journal-title":"Field Methods"},{"key":"2026061014515927200_B24","article-title":"Creating Patient-Centered Team-Based Primary Care","author":"Schottenfeld","year":"2016"},{"key":"2026061014515927200_B25","doi-asserted-by":"crossref","DOI":"10.1017\/9781316443255","volume-title":"Egocentric Network Analysis: Foundations, Methods, and Models.","author":"Perry","year":"2018"},{"key":"2026061014515927200_B26","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1017\/CBO9780511815478","volume-title":"Social Network Analysis: Methods and Applications.","author":"Wasserman","year":"1994"},{"key":"2026061014515927200_B27","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1177\/1077558714557079","article-title":"Social networks of professionals in health care organizations: a review","volume":"71","author":"Tasselli","year":"2014","journal-title":"Med Care Res Rev"},{"key":"2026061014515927200_B28","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1080\/13561820.2018.1538942","article-title":"Primary care networks and team effectiveness: the case of a large-scale quality improvement disparity reduction program","volume":"33","author":"Spitzer-Shohat","year":"2019","journal-title":"J Interprof Care"},{"key":"2026061014515927200_B29","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.socnet.2004.11.007","article-title":"Ego network betweenness","volume":"27","author":"Everett","year":"2005","journal-title":"Soc Networks"},{"key":"2026061014515927200_B30","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1097\/BCR.0000000000000218","article-title":"The social network of a burn unit team","volume":"36","author":"Shoham","year":"2015","journal-title":"J Burn Care Res"},{"key":"2026061014515927200_B31","first-page":"2135","article-title":"Local dynamics of collaboration for maternal, newborn and child health: a social network analysis of healthcare providers and their managers in Gert Sibande District, South Africa","volume":"11","author":"Mukinda","year":"2022","journal-title":"Int J Health Policy Manag"},{"key":"2026061014515927200_B32","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.socnet.2022.09.004","article-title":"Random sampling of alters from networks: a promising direction in egocentric network research","volume":"72","author":"Peng","year":"2023","journal-title":"Soc Networks"},{"key":"2026061014515927200_B33","unstructured":"National Institute of Diabetes and Digestive and Kidney Diseases\n          . Managing Diabetes. Accessed 29 October 2025. Available from https:\/\/www.niddk.nih.gov\/health-information\/diabetes\/overview\/managing-diabetes#abcs"},{"key":"2026061014515927200_B34","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1177\/1077558713485134","article-title":"Multistakeholder perspectives on composite measures of ambulatory care quality: a qualitative descriptive study","volume":"70","author":"Martsolf","year":"2013","journal-title":"Med Care Res Rev"},{"key":"2026061014515927200_B35","first-page":"e202-7","article-title":"Using \u201croll-up\u201d measures in health care quality reports: perspectives of report sponsors and national alliances","volume":"23","author":"Cerully","year":"2017","journal-title":"Am J Manag Care"},{"key":"2026061014515927200_B36","unstructured":"Aleppo\n              G\n            \n          . Updated 2023 ADA Standards of Care,2022. Accessed 29 October 2025. Available from https:\/\/www.cardiometabolichealth.org\/updated-2023-ada-standards-of-care\/"},{"key":"2026061014515927200_B37","doi-asserted-by":"crossref","first-page":"S5","DOI":"10.2337\/dc23-Srev","article-title":"Summary of revisions: Standards of Care in Diabetes\u20142023","volume":"46","author":"ElSayed","year":"2023","journal-title":"Diabetes Care"},{"key":"2026061014515927200_B38","doi-asserted-by":"crossref","first-page":"S128","DOI":"10.2337\/dc25-S006","article-title":"6. Glycemic goals and hypoglycemia: Standards of Care in Diabetes\u20142025","volume":"48","author":"ElSayed","year":"2025","journal-title":"Diabetes Care"}],"container-title":["Diabetes Obesity and Cardiometabolic CARE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/diabetesjournals.org\/docm-care\/article-pdf\/1\/3\/366\/861123\/docm250063.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/docm-care\/article-pdf\/1\/3\/366\/861123\/docm250063.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T18:52:12Z","timestamp":1781117532000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/docm-care\/article\/1\/3\/366\/164681\/Communication-in-Primary-Care-Teams-and-Diabetes"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,6]]},"references-count":38,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,4,6]]},"published-print":{"date-parts":[[2026,5,1]]}},"URL":"https:\/\/doi.org\/10.2337\/doc25-0063","relation":{},"ISSN":["3067-3518","3067-3534"],"issn-type":[{"value":"3067-3518","type":"print"},{"value":"3067-3534","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,6]]}}}