Shared Health Appointments and Reciprocal Enhanced Support

Inclusion Criteria:

Veterans enrolled into diabetes Shared Medical Appointments (SMAs) at participating sites,
and a random subset of those meeting criteria for diabetes SMAs who have not yet
participated:

   - Veteran receiving care at a participating VA Medical Center

   - Meets at least one of the following criteria in the past 2 years;

      - at least 1 VA hospitalization with a diabetes-related International
      Classification Of Diseases-9 (ICD-9) code,

      - at least 2 VA outpatient visits with a diabetes-related ICD-9 code, or

      - At least 1 VA prescription for a glucose control medication (insulin or oral
      agent) or monitoring supplies

   - Poor glycemic control, indicated by a HbA1c in the past 6 months or:

      - at least 7.5% if age <70, or

      - at least 8% if age 70+

   - Has a current address and telephone number listed in VA databases

   - Is competent to provide informed consent

   - Can communicate in English and by telephone

   - Able to participate in an outpatient program

Exclusion Criteria:

For no intervention control group:

   - Active substance abuse disorder (smoking cigarettes is not an exclusion)

   - Serious psychiatric illness (bipolar disorder, dementia, schizophrenia, or personality
   disorders)

   - Terminally ill

   - Prisoner