ABSTRACT
The purpose of this study was to determine whether a telecommunications diabetes self-management (DSM) intervention would improve health-related outcomes among frontier participants with diabetes. A one-group pre-test/post-test quasi-experimental design with two groups of participants was used. Differences between pre and post-test periods on measures of physical and emotional health, knowledge of diabetes, and self-care behaviors were measured. Overall, participants did better along measures of blood pressure, HbA(1c), self-efficacy, knowledge of diabetes, understanding of DSM, monitoring behaviors, and reported less personal and social disruption from diabetes. Six-month follow-up results showed continued positive outcomes.
Subject(s)
Diabetes Mellitus, Type 1/drug therapy , Diabetes Mellitus, Type 2/drug therapy , Hypoglycemic Agents/administration & dosage , Self Care/standards , Telecommunications/organization & administration , Adaptation, Psychological , Adult , Aged , Attitude to Health , Blood Glucose Self-Monitoring/methods , Diabetes Mellitus, Type 1/diagnosis , Diabetes Mellitus, Type 1/psychology , Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/psychology , Female , Humans , Male , Middle Aged , Patient Compliance/statistics & numerical data , Patient Education as Topic , Program Evaluation , Risk Assessment , Self Care/trends , Self Efficacy , Severity of Illness Index , Treatment Outcome , Young AdultABSTRACT
PURPOSE: Diabetes self-management education (DSME) is an integral component of diabetes care; however, skilled educators and recognized programs are not uniformly available in rural communities. METHODS: To increase access to quality DSME, the Montana Diabetes Control Program and the Montana chapter of the American Association of Diabetes Educators developed a mentoring program with 3 levels: basic, intermediate, and advanced. All participants were assisted by a volunteer certified diabetes educator (CDE) mentor. In addition, the program provided technical support for recognition through the American Diabetes Association and the Indian Health Service. RESULTS: From 2000 to 2005, 90 individuals participated; 76% were nurses and 21% dietitians. Twenty-seven of the 90 enrollees (30%) completed their structured option, and 13 achieved CDE certification. Most provided services in frontier counties (66%). Statewide, the number of CDEs in Montana increased 46% from 52 in 2000 to 76 in 2005. Twenty-five of the 30 facilities that received technical assistance achieved recognition. Statewide, the number of recognized education programs increased from 2 in 2000 to 22 in 2005. Twelve (55%) of these programs were located in frontier counties. CONCLUSIONS: Mentoring and technical support is an effective method to increase personnel skills for DSME and to increase access to quality education programs in rural areas.
