ABSTRACT
This study evaluated paraprofessional-led diabetes self-management coaching (DSMC) among 94 clients with type 2 diabetes recruited from a Community Care Access Centre in Ontario, Canada. Subjects were randomized to standard care or standard care plus coaching. Measures included the Diabetes Self-Efficacy Scale (DSES), Insulin Management Diabetes Self-Efficacy Scale (IMDSES), and Hospital Anxiety and Depression Scale (HADS). Both groups showed improvement in DSES (6.6 + 1.5 vs. 7.2 + 1.5, p < .001) and IMDSES (113.5 + 20.6 vs. 125.7 + 22.3, p < .001); there were no between-groups differences. There were no between-groups differences in anxiety (p > .05 for all) or depression scores (p > .05 for all), or anxiety (p > .05 for all) or depression (p > .05 for all) categories at baseline, postintervention, or follow-up. While all subjects demonstrated significant improvements in self-efficacy measures, there is no evidence to support paraprofessional-led DSMC as an intervention which conveys additional benefits over standard care.
Subject(s)
Community Health Services/methods , Diabetes Mellitus, Type 2/psychology , Mentoring/methods , Self-Management/methods , Aged , Analysis of Variance , Anxiety/etiology , Anxiety/psychology , Community Health Services/statistics & numerical data , Depression/etiology , Depression/psychology , Diabetes Mellitus, Type 2/therapy , Female , Humans , Male , Mentoring/standards , Mentoring/statistics & numerical data , Middle Aged , Ontario , Psychometrics/instrumentation , Psychometrics/methods , Psychometrics/statistics & numerical data , Self Efficacy , Self-Management/statistics & numerical data , Statistics, NonparametricABSTRACT
Access to education, communication, and support is essential for achieving and maintaining a skilled healthcare workforce. Delivering affordable and accessible continuing education for healthcare providers in rural, remote, and isolated First Nation communities is challenging due to barriers such as geography, isolation, costs, and staff shortages. The innovative use of technology, such as on-line courses and webinars, will be presented as a highly effective approach to increase access to continuing education for healthcare providers in these settings. A case study will be presented demonstrating how a national, not-for-profit health care organization has partnered with healthcare providers in these communities to support care at the local level through various technology-based knowledge exchange activities.
