Population Health: The Diabetes Educator’s Evolving Role

2019 ◽  
Vol 45 (4) ◽  
pp. 333-348 ◽  
Author(s):  
Teresa L. Pearson ◽  
Joan Bardsley ◽  
Susan Weiner ◽  
Leslie Kolb
Keyword(s):  
Health Care ◽  
Population Health ◽  
Diabetes Management ◽  
Management Education ◽  
Care Delivery ◽  
Population Level ◽  
Cost Effective ◽  
Self Management ◽  
Quality Initiatives ◽  
Diabetes Educators

Purpose The US health care system’s focus on high-quality, efficient, and cost-effective care has led payers and provider groups to identify new models with a shift toward value-based care. This perspective on clinical practice describes the population health movement and the opportunities for diabetes educators beyond diabetes self-management education, as well as steps to engage in and drive new care models to demonstrate individual, organizational, and payer value. Conclusion Diabetes educators have an opportunity to position themselves as diabetes specialists for diabetes management, education, and population health care delivery. With expertise that extends beyond diabetes self-management education and with a wide variety of skills, diabetes educators recognize that there is a range of personal, social, economic, and environmental factors that influence diabetes health outcomes. Diabetes educators should align with organizational strategic plans and support the population-level performance measures and quality initiatives, thus enhancing the value that diabetes educators bring to health care organizations.

scholarly journals An Effective Model of Diabetes Care and Education: Revising the AADE7 Self-Care Behaviors®

2020 ◽  
Vol 46 (2) ◽  
pp. 139-160 ◽  
Author(s):  
Keyword(s):  
Health Care ◽  
Diabetes Management ◽  
Management Education ◽  
Self Care ◽  
Position Statement ◽  
Health Care Team ◽  
Care Team ◽  
Self Management ◽  
Health Related ◽  
Problem Solve

Purpose The AADE7 Self-Care Behaviors® (AADE7) is a robust framework for self-management of diabetes and other related conditions, such as prediabetes and cardiometabolic diseases. It is the position of the American Association of Diabetes Educators (AADE) that, at the cornerstone of diabetes self-management education and support, the AADE7 is the framework for achieving behavior change that leads to effective self-management through improved behavior and clinical outcome measures. The AADE7 model guides the health care team in effective person-centered collaboration and goal setting to achieve health-related outcomes and improved quality of life. Continued research and evidence are critical to expand this model and broaden its application to other chronic conditions. Given the advances in the science of diabetes management, as well as in diabetes self-management education and support, AADE has evaluated the AADE7 within the framework of these advances, including the digital and dynamic health care landscape. Conclusion This revised position statement blends the updates in research and AADE’s vision and expansion beyond diabetes to refresh the AADE7 framework. This revision reflects the perspectives of all members of the health care team as they problem solve with individuals who are at risk for or who have diabetes and related conditions to achieve healthier outcomes.

scholarly journals An Effective Model of Diabetes Care and Education: The ADCES7 Self-Care Behaviors™

2021 ◽  
Vol 47 (1) ◽  
pp. 30-53
Author(s):  
◽  
Leslie Kolb
Keyword(s):  
Health Care ◽  
Diabetes Care ◽  
Diabetes Management ◽  
Management Education ◽  
Self Care ◽  
Position Statement ◽  
Health Care Team ◽  
Care Team ◽  
Self Management ◽  
Problem Solve

Purpose The ADCES7 Self-Care Behaviors™ (ADCES7) is a robust framework for self-management of diabetes and other related conditions, such as prediabetes and cardiometabolic diseases. It is the position of the Association of Diabetes Care and Education Specialists (ADCES) that at the cornerstone of diabetes self-management education and support, the ADCES7 is the framework for achieving behavior change that leads to effective self-management through improved behavior and clinical outcome measures. The ADCES7 model guides the health care team in effective person-centered collaboration and goal setting to achieve health-related outcomes and improved quality of life. Continued research and evidence are critical to expand this model and broaden its application to other chronic conditions. Given the advances in the science of diabetes management as well as diabetes self-management education and support, ADCES has evaluated the ADCES7 within the framework of these advances, including the digital and dynamic health care landscape. Conclusion This revised position statement blends the updates in research and ADCES’s vision and expansion beyond diabetes to refresh the ADCES7 framework. This revision reflects the perspectives of all members of the health care team as they problem solve with individuals who are at risk for or who have diabetes and related conditions to achieve healthier outcomes.

scholarly journals Effect of Voluntary Participation on Mobile Health Care in Diabetes Management: Randomized Controlled Open-Label Trial

10.2196/19153 ◽  
2020 ◽  
Vol 8 (9) ◽  
pp. e19153 ◽  
Author(s):  
Da Young Lee ◽  
Seung-Hyun Yoo ◽  
Kyong Pil Min ◽  
Cheol-Young Park
Keyword(s):  
Health Care ◽  
Diabetes Management ◽  
Management Education ◽  
Intervention Group ◽  
Self Management ◽  
Voluntary Participation ◽  
Management Skills ◽  
Open Label ◽  
Mobile Health Care ◽  
Open Label Trial

Background The role of mobile health care (mHealth) in glycemic control has been investigated, but its impact on self-management skills and its psychological aspects have not been studied. Objective We evaluated the efficacy of mHealth-based diabetes self-management education and the effect of voluntary participation on its effects. Methods This study was a randomized controlled open-label trial conducted for 6 months at Kangbuk Samsung Hospital. Participants in the control group (n=31) maintained their previous diabetes management strategies. Participants in the intervention group (n=41) additionally received mHealth-based diabetes self-management education through a mobile app and regular individualized feedback from health care professionals. The primary outcome was change in glycated hemoglobin (HbA1c) level over 6 months between the 2 groups (intervention versus control) and within each group (at 6 months versus baseline). The secondary outcomes were changes in body mass index, blood pressure, lipid profile, and questionnaire scores (the Korean version of the Summary of Diabetes Self-Care Activities Questionnaire, an Audit of Diabetes Dependent Quality of Life, the Appraisal of Diabetes Scale, and Problem Areas in Diabetes) over 6 months between groups and within each group. Results A total of 66 participants completed this study. HbA1c (P=.04), total cholesterol level (P=.04), and Problem Areas in Diabetes scores (P=.02) significantly decreased; total diet (P=.03) and self-monitoring of blood glucose level scores (P=.01), based on the Summary of Diabetes Self-Care Activities Questionnaire, markedly increased within the intervention group. These significant changes were observed in self-motivated participants who were recruited voluntarily via advertisements. Conclusions mHealth-based diabetes self-management education was effective at improving glycemic control and diabetes self-management skills and lowering diabetes-related distress in voluntary participants. Trial Registration ClinicalTrials.gov NCT03468283; http://clinicaltrials.gov/ct2/show/NCT03468283

scholarly journals Effect of Voluntary Participation on Mobile Health Care in Diabetes Management: Randomized Controlled Open-Label Trial (Preprint)

2020 ◽  
Author(s):  
Da Young Lee ◽  
Seung-Hyun Yoo ◽  
Kyong Pil Min ◽  
Cheol-Young Park
Keyword(s):  
Health Care ◽  
Diabetes Management ◽  
Management Education ◽  
Intervention Group ◽  
Self Management ◽  
Voluntary Participation ◽  
Management Skills ◽  
Open Label ◽  
Mobile Health Care ◽  
Open Label Trial

BACKGROUND The role of mobile health care (mHealth) in glycemic control has been investigated, but its impact on self-management skills and its psychological aspects have not been studied. OBJECTIVE We evaluated the efficacy of mHealth-based diabetes self-management education and the effect of voluntary participation on its effects. METHODS This study was a randomized controlled open-label trial conducted for 6 months at Kangbuk Samsung Hospital. Participants in the control group (n=31) maintained their previous diabetes management strategies. Participants in the intervention group (n=41) additionally received mHealth-based diabetes self-management education through a mobile app and regular individualized feedback from health care professionals. The primary outcome was change in glycated hemoglobin (HbA<sub>1c</sub>) level over 6 months between the 2 groups (intervention versus control) and within each group (at 6 months versus baseline). The secondary outcomes were changes in body mass index, blood pressure, lipid profile, and questionnaire scores (the Korean version of the Summary of Diabetes Self-Care Activities Questionnaire, an Audit of Diabetes Dependent Quality of Life, the Appraisal of Diabetes Scale, and Problem Areas in Diabetes) over 6 months between groups and within each group. RESULTS A total of 66 participants completed this study. HbA<sub>1c</sub> (<i>P</i>=.04), total cholesterol level (<i>P</i>=.04), and Problem Areas in Diabetes scores (<i>P</i>=.02) significantly decreased; total diet (<i>P</i>=.03) and self-monitoring of blood glucose level scores (<i>P</i>=.01), based on the Summary of Diabetes Self-Care Activities Questionnaire, markedly increased within the intervention group. These significant changes were observed in self-motivated participants who were recruited voluntarily via advertisements. CONCLUSIONS mHealth-based diabetes self-management education was effective at improving glycemic control and diabetes self-management skills and lowering diabetes-related distress in voluntary participants. CLINICALTRIAL ClinicalTrials.gov NCT03468283; http://clinicaltrials.gov/ct2/show/NCT03468283

Importance of Self-care Behaviors in Diabetes Management

2005 ◽  
Vol 00 (01) ◽  
pp. 16 ◽  
Author(s):  
Mary M Austin
Keyword(s):  
Patient Outcomes ◽  
Significant Contribution ◽  
Diabetes Management ◽  
American Association ◽  
Management Education ◽  
Diabetes Education ◽  
National Standards ◽  
Self Management ◽  
Program Outcomes ◽  
Diabetes Educators

Diabetes educators are healthcare professionals such as nurses, dietitians, pharmacists, exercise specialists, physicians, and social workers, who specialize in diabetes education and who make a significant contribution to the care and management of persons with diabetes. The specialty of diabetes education has advanced to be based increasingly on evidence and focussed on achieving desired outcomes.The emphasis on outcomes-based interventions comes from both the National Standards for Diabetes Self-Management Education,1which emphasizes program outcomes, and the Standards for Outcomes Measurement of Diabetes Self-Management Education2of the American Association of Diabetes Educators, which focusses on individual patient outcomes as well as the reporting of aggregate patient data.

The 2017 Diabetes Educator and the Diabetes Self-Management Education National Practice Survey

2018 ◽  
Vol 44 (3) ◽  
pp. 260-268 ◽  
Author(s):  
Joanne Rinker ◽  
Jane K. Dickinson ◽  
Michelle L. Litchman ◽  
Ann S. Williams ◽  
Leslie E. Kolb ◽  
...  
Keyword(s):  
At Risk ◽  
Diabetes Management ◽  
American Association ◽  
Management Education ◽  
The United States ◽  
Self Management ◽  
Practice Survey ◽  
Diabetes Educator ◽  
Diabetes Educators ◽  
National Practice

Purpose The American Association of Diabetes Educators conducts the National Practice Survey (NPS) biennially to document current practice in diabetes education in the United States. The purpose of the study is to obtain insight about factors influencing the work of the diabetes educator. Method The 2017 NPS was comprised of 100 questions covering diabetes educator demographics, profile populations of people with diabetes, practice information, program accreditation, program curriculum, staffing, education delivery methods, data collection, and reporting. The basic survey consisted of 22 questions using branch logic, from which respondents were then directed to questions tailored to their particular practice setting, enabling them to answer only a relevant subset of the remaining questions. The web-based survey was sent to approximately 32 000 individuals who were either members of the American Association of Diabetes Educators (AADE) or Certified Diabetes Educators (CDE) with the National Certification Board for Diabetes Educators (NCBDE) but not AADE members. Weekly reminder e-mails were sent to recipients who had not yet responded. The outreach efforts resulted in the survey being completed by 4696 individuals, a 17% response rate yielding 95% confidence that these responses are within ±5% accuracy. Results Diabetes Self-Management Education and Support (DSMES) continues to be a field dominated by women (95%). Diabetes educators represent a diverse health care profession, with educators indicating most commonly that their primary discipline is nursing (48%), nutrition (38%), and pharmacy (7%). When asked about credentials, 82.6% indicated that they held a CDE, 3.8% held the Board Certified-Advanced Diabetes Management (BC-ADM) credential, and 16.5% held neither the CDE nor the BC-ADM. Nearly 75% characterized their role as a diabetes educator as providing direct patient care. DSMES continued to be provided in a varied array of settings to educationally, socioeconomically, and racially diverse patient populations. DSMES was delivered using a number of different educational strategies. Diabetes educators have direct influence in care and services that people with diabetes receive. Conclusions The results of the 2017 NPS demonstrate that diabetes educators are meeting the needs of varied populations in various practice settings. They are working with individuals with type 1 and type 2 diabetes, those at risk for diabetes, and women with gestational diabetes and are involved in recommending, implementing, and providing key referrals and recommendations for diabetes care, including insulin initiation, titration, medication adjustments, recommendations on devices, and technology. Identified areas for improvement include needs for increased racial and ethnic diversity in the workforce, recruiting young professionals, drawing practice approaches from related disciplines (eg, mental health and disability rehabilitation), and encouraging tracking of more areas of outcomes data. Diabetes educators are playing an increasingly central role within multidisciplinary care teams with people at risk for diabetes, those who have diabetes, and those with other chronic conditions.

scholarly journals Innovation Pathways in the NHS: An Introductory Review

2021 ◽  
Author(s):  
Anmol Arora ◽  
Andrew Wright ◽  
Mark Cheng ◽  
Zahra Khwaja ◽  
Matthew Seah
Keyword(s):  
Health Care ◽  
National Health ◽  
Health Care Professionals ◽  
New Technologies ◽  
Care Delivery ◽  
Cost Effective ◽  
Care Models ◽  
Set Up ◽  
The Uk ◽  
Introductory Review

AbstractHealthcare as an industry is recognised as one of the most innovative. Despite heavy regulation, there is substantial scope for new technologies and care models to not only boost patient outcomes but to do so at reduced cost to healthcare systems and consumers. Promoting innovation within national health systems such as the National Health Service (NHS) in the United Kingdom (UK) has been set as a key target for health care professionals and policy makers. However, while the UK has a world-class biomedical research industry, several reports in the last twenty years have highlighted the difficulties faced by the NHS in encouraging and adopting innovations, with the journey from idea to implementation of health technology often taking years and being very expensive, with a high failure rate. This has led to the establishment of several innovation pathways within and around the NHS, to encourage the invention, development and implementation of cost-effective technologies that improve health care delivery. These pathways span local, regional and national health infrastructure. They operate at different stages of the innovation pipeline, with their scope and work defined by location, technology area or industry sector, based on the specific problem identified when they were set up. In this introductory review, we outline each of the major innovation pathways operating at local, regional and national levels across the NHS, including their history, governance, operating procedures and areas of expertise. The extent to which innovation pathways address current challenges faced by innovators is discussed, as well as areas for improvement and future study.

scholarly journals Using population health surveys to provide information on access to and use of quality primary health care

2006 ◽  
Vol 30 (4) ◽  
pp. 485 ◽  
Author(s):  
Elizabeth J Comino ◽  
Oshana Hermiz ◽  
Jeff Flack ◽  
Elizabeth Harris ◽  
Gawaine Powell Davies ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Population Health ◽  
Health Survey ◽  
Health Surveys ◽  
Diabetes Management ◽  
Relevant Information ◽  
Population Based ◽  
Primary Health ◽  
Data Collections

Objective: Currently, primary health care (PHC) is under-represented in health statistics due to the lack of a comprehensive PHC data collection. This research explores the utility of population health surveys to address questions relating to access to and use of PHC, using diabetes as an example. Methods: Drawing on published material relating to diabetes management, we developed a conceptual framework of access to and use of quality PHC. Using this framework we examined three recent population-based health surveys ? the 2001 National Health Survey, 2002?03 NSW Health Survey, and AusDiab ? to identify relevant information collection. Results: We identified seven domains comprising aspects of quality PHC for people with diabetes. For each domain we proposed associated indicators. In critiquing the three population health surveys in relation to these indicators, we identified strengths and weaknesses of the data collections. Conclusion: This approach could inform the development of questions and extension of population health surveys to provide a better understanding of access to and use of quality PHC in Australia. The additional information would complement other data collections with a communitybased perspective and contribute to the develop- ment of PHC policy.

scholarly journals DENTAL HYGIENISTS AS ESSENTIAL MEMBERS OF THE HEALTH CARE TEAM

2018 ◽  
Vol 1 (2) ◽  
pp. 73
Author(s):  
Jacqueline Juhl
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Care Delivery ◽  
Cost Effective ◽  
Economic Loss ◽  
The United States ◽  
Health Care Team ◽  
Care Team ◽  
Oral Disease ◽  
Dental Hygienists

Despite the advances in dental sciences, innovative oral health programs, and efforts dedicated by oral health professionals,globally, unmet oral disease, and the economic loss it causes, is growing. In the present, oral health care delivery systemsurgently need improvement. The introduction of dental hygienists as essential members of the health care team can contributeto improved and cost-effective health care outcomes. This paper provides definitions of dental hygienists from both, aninternational and the United States (U.S.) and describes their education, functions, and contributions to the health care team.

A Principled Approach to Essential Health-Care Delivery System Reforms

2017 ◽  
pp. 159-201
Author(s):  
Gunnar Almgren
Keyword(s):  
Health Care ◽  
Population Health ◽  
Health Care System ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Right To Health Care ◽  
Competing Interests ◽  
Political Feasibility ◽  
Future Health Care ◽  
Care System

The basic premise of this chapter is that we have at our disposal a wealth of evidence-based knowledge of critical health care delivery strategies that would, if implemented on a large scale, yield both a social right to health care for all citizens and favorable population health care outcomes at lower cost. This chapter provides a synthesis of this knowledge, and then identifies a limited set of very specific health care system delivery reforms that meet three evaluative criteria: equity, sustainability, and political feasibility. Equity refers to the extent to which any particular health care system delivery reform achieves a fair balance between the competing interests of different segments of the patient population and society at large. Sustainability refers to the extent to which a health care system delivery reform initiative yields favorable impacts on population health while realizing large reductions in immediate and future health care costs. Finally, political feasibility refers to the likelihood of a given health care system delivery reform in view of the competing interests of different stakeholder groups affected. This chapter offers a principled and empirically justified blueprint for the most promising health care system delivery reforms towards the fulfillment of these three ends.

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