Integration of Hybrid Model Diabetes Self-Management Education and Support at Primary Health Care During COVID-19 Pandemic: Protocol Paper of DIAJAPRI Health Coaching Study

IntroductionCOVID -19 pandemic has threatened the optimal achievement on type-2 diabetes mellitus (T2DM) target in primary health care (PHC), due to our priority in COVID-19 management, limited access of patients to PHC and their lifestyle changes as the impact of social restrictions. Therefore, the empowerment of capability of patients on diabetes self-care is required through optimal education and support. The use of telehealth in T2DM management has benefits on improving outcomes of patients. We aim to assess the role of telehealth diabetes self-management education (DSME) versus hybrid (telehealth and face-to-face method) diabetes self-management education and support (DSMES) to improve T2DM outcomes in PHC during COVID-19 pandemic. Methods and analysisThis study is an open label randomized-controlled trial that will be conducted in 10 PHCs in Jakarta, Indonesia, involving patients with T2DM. Subjects are classified into 2 groups: DSME group and DSMES group. Intervention will be given every 2 weeks. DSME group will receive 1 educational video every 2 weeks discussing topics about diabetes self-management, while DSMES group will receive 1 educational video and undergo 1 coaching session every 2 weeks. All interventions will be conducted by trained health workers of PHC, who are physicians, nurses, and nutritionists. Our primary outcome is the change of HbA1C level and our secondary outcomes are the changes of nutritional intake, physical activity, quality of life, anthropometric parameter, fasting blood glucose, lipid profile, inflammatory markers, and progression of diabetes complications at 3 and 6 months after intervention compare to the baseline. Ethics and disseminationThis study protocol has been approved by the Health Research Ethics Committee University of Indonesia. Subjects agree to participate will be given written informed consent prior to data collection. Findings from this study will be published in peer-reviewed journals and presented at conferences. Trial Registrationhttp://www.clinicalstrials.gov with identifier number NCT05090488. SummaryO_ST_ABSStrengths and limitations of the studyC_ST_ABSO_LIThis study evaluates the role of hybrid DSMES, which is useful in areas with limited access or on lockdowns. C_LIO_LIThis study will evaluates the implementation of hybrid DSMES, its benefits, difficulties, and obstacles. C_LIO_LIWe uses validated questionnaire instruments and routinely collected clinical data. C_LIO_LIBecause all of our interventions will be conducted by PHCs health workers, our results depend on the ability and adherence of PHCs health workers. C_LI

Adaptation of internet-based multiple mini-interviews in a limited-resource medical school during the coronavirus disease 2019 pandemic / 한국의학교육

The coronavirus disease 2019 pandemic has affected many aspects of life, including medical education. The selection of students using multiple mini-interviews (MMI) should be adapted promptly as internet-based MMI (iMMI) in the current setting. The current transition from MMI to iMMI is supported by experience in conducting conventional MMI in previous years; hence, the station and assessor preparation could be completed without significant issues. The greater challenges to the use of iMMI are due to technical issues, including poor internet connections and adaptations necessary for assessing candidates’ nonverbal expressions. This paper aims to describe the experience of conducting iMMI in the current pandemic situation, with further highlights on contextual challenges in a limited-resource setting.

Adaptation of internet-based multiple mini-interviews in a limited-resource medical school during the coronavirus disease 2019 pandemic / 한국의학교육

The coronavirus disease 2019 pandemic has affected many aspects of life, including medical education. The selection of students using multiple mini-interviews (MMI) should be adapted promptly as internet-based MMI (iMMI) in the current setting. The current transition from MMI to iMMI is supported by experience in conducting conventional MMI in previous years; hence, the station and assessor preparation could be completed without significant issues. The greater challenges to the use of iMMI are due to technical issues, including poor internet connections and adaptations necessary for assessing candidates’ nonverbal expressions. This paper aims to describe the experience of conducting iMMI in the current pandemic situation, with further highlights on contextual challenges in a limited-resource setting.