BACKGROUND
In southeastern Appalachian Ohio, the prevalence of diabetes is 19.9%, nearly than double the national average of 10.5%. Here, people with diabetes are more likely to have a delayed diagnosis, limited access to healthcare, and lower health literacy. Despite the high rates of diabetes in the region, the availability of endocrinologists and certified diabetes care and education specialists is limited. Therefore, innovative strategies to address the growing diabetes care demands are needed. One approach is to train the primary care workforce in new and emerging therapies for type 2 diabetes to meet the increasing demands and complexity of diabetes care.
OBJECTIVE
The purpose of this study was to evaluate the effectiveness of a virtual reality training program designed to improve cultural self-efficacy and diabetes attitudes.
METHODS
Healthcare providers and administrators were recruited from large health care systems, private practices, university-owned hospitals or clinics, Federally Qualified Health Centers, local health departments, and AmeriCorps. Providers and administrators participated in a 3-hour virtual reality training program consisting of 360-degree videos produced in a professional cinematic manner (cine-VR). Questionnaires measuring cultural self-efficacy, diabetes attitudes, and presence in cine-VR were administered to providers and administrators before and after the program.
RESULTS
A total of 69 participants (mean age=42.2±13.7 years, 85.5% (n=59) identified as female, 82.6% (n=57) identified as white, 85.5% (n=59) providers, 17.3% (n=17) nurses) completed the study. Following the training, we observed positive improvements in all four of the cultural self-efficacy subscales: “Cognitive” (mean change = -1.29, t-value= -9.309, P<.001); “Practical” (mean change = -1.85, t-value= -9.319, P<.001); and “Affective” (mean change = -.75, t= value= -7.067, P<.001). We observed the largest magnitude of change with the “Practical” subscale, with a Cohen’s d of 1.16 indicating a very large effect. In addition, we observed positive improvements in all five of the diabetes attitudes subscales: “Need for special training” (mean change= -0.21, t-value= -6.154, P<.001); “Seriousness of type 2 diabetes” (mean change = -.34, t-value= -8.114, P<.001); “Value of tight glucose control” (mean change = -.13, t-value= -3.029, P=.001); “Psychosocial impact of diabetes” (mean change = -.33, t-value= -6.610, P<.001); and “Attitude toward patient autonomy” (mean change = -.17, t-value= -3.889, P<.001). We observed the largest magnitude of change with the “Psychosocial impact of diabetes” subscale, with a Cohen’s d of 0.87 indicating a large effect. We observed only one significant correlation between presence in cine-VR (i.e., Interface Quality) and a positive change score (“Affective” self-efficacy r=.285, P=.026).
CONCLUSIONS
Our findings support the notion that cine-VR education is an innovative approach to improve cultural self-efficacy and diabetes attitudes among healthcare providers and administrators. The long-term impact of the cine-VR education on cultural self-efficacy and diabetes attitudes needs to be determined.
CLINICALTRIAL
Not applicable
Effects of conventional neurological treatment and a virtual reality training program on eye-hand coordination in children with cerebral palsy
