A Diabetes Education Model in Primary Care: Provider and Staff Perspectives

2019 ◽  
Vol 45 (5) ◽  
pp. 498-506 ◽  
Author(s):  
Linda Siminerio ◽  
Megan Hamm ◽  
Justin Kanter ◽  
Flor de Abril Cameron ◽  
Jodi Krall
Keyword(s):  
Primary Care ◽  
Diabetes Management ◽  
Management Education ◽  
Diabetes Education ◽  
Self Management ◽  
Diabetes Educator ◽  
Transportation Scheduling ◽  
Education Model ◽  
Study Completion ◽  
Management Recommendations

Purpose The purpose of this qualitative study was to explore the effectiveness of Glucose to Goal (G2G), a diabetes self-management education and support (DSMES) model for primary care (PC). Methods PC providers and staff were recruited from 5 PC practices participating in the 18-month intervention to participate in focus groups and interviews, which were used to gain insights about their perspectives on DSMES and how G2G was implemented across the intervention. Data were collected by qualitative researchers at baseline, midpoint, and study completion. Results At baseline, PC participants held a favorable view of DSMES and welcomed having a diabetes educator (DE) in their practice. Most participants suggested DEs would be helpful in meeting patients’ nutrition needs but should give therapeutic advice only with a doctor’s oversight. Participants anticipated that having a DE onsite would mitigate transportation, scheduling, communication, and cost barriers. Participant viewpoints about G2G remained unchanged from midpoint to study end, while barriers regarding location and transportation were perceived as being reduced by having a DE in the practice. Despite referral rates remaining low in some practices, many concerns stated at earlier timepoints appeared to have been attenuated by G2G components (eg, bringing the DE onsite, preidentifying patients, and DE ability to communicate and make diabetes management recommendations). Conclusions This study demonstrates that G2G, providing DSMES in PC, appeared to be a welcome service where acceptance of and enthusiasm for the model grew over the course of the intervention.

The Evolving Role of the Diabetes Educator—Changing Patient Behavior in Diabetes Self-management Education

2008 ◽  
Vol 04 (01) ◽  
pp. 29
Author(s):  
Daniel J Blackman
Keyword(s):  
Management Education ◽  
Diabetes Education ◽  
Diabetes Patient ◽  
Self Management ◽  
Diabetes Educator ◽  
Significant Difference ◽  
The Us ◽  
Patients With Diabetes ◽  
Diagnosed Diabetes ◽  
Diabetes Educators

In this day and age of evidence-based practice, we seek to provide interventions that we know will make a significant difference in the lives of our patients. For those of us who specialize in the care of people with diabetes, e.g. endocrinologists and diabetes educators, diabetes self-management education/training (DSME/T) has long been considered an essential intervention, a cornerstone of diabetes care. The government’s Healthy People 2010 objective that 60% of persons with diabetes should receive formal diabetes education supports this logic.1However, for many healthcare professionals outside of the specialty, this belief in the efficacy of DSME/T appears to be less solid, as evidenced by the poor referral rates for education. This disconnect is illustrated by the following findings. Although Medicare covers DSME/T as a benefit for patients with diabetes, only 1% of Medicare beneficiaries received this service in 2004 and 2005.2The Centers for Disease Control and Prevention (CDC) d ta indicate that only 54.3% of people who responded to a survey had ever attended some type of diabetes self-management class.3A 2007 Roper US Diabetes Patient Market Study found that only 26% of nearly 17 million diagnosed diabetes patients in the US had visited a diabetes educator within the past year.4Anecdotal reports from diabetes educators support the notion that with the current type 2 diabetes epidemic facing the US, education programs should be over-run with referrals for DSME/T. This, however, is far from the case for most programs. Most diabetes educators are sorely underutilized, and the rate of recognized diabetes education program closures is staggering, at three per week in the US.5

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 Quality of primary care physicians’ communication of diabetes self-management during medical encounters with persons with diabetes mellitus in a resource-poor country

2018 ◽  
Vol 60 (6) ◽  
pp. 41
Author(s):  
O. S. Ojo ◽  
S. O. Malomo ◽  
A. O. Egunjobi ◽  
A. O.A. Jimoh ◽  
M. O. Olowere
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Diabetes Management ◽  
Management Education ◽  
Poor Country ◽  
Self Management ◽  
Related Factors ◽  
Local Study ◽  
Resource Poor

Background: Most of the Nigerian studies on the determinants of diabetes self-management have focused on patient-related factors. There is no previous local study that examined the quality of diabetes self-management education provided by primary care physicians to people with diabetes mellitus.Methods: A descriptive cross-sectional study was conducted among 105 primary care physicians during a workshop. The quality of diabetes self-management education provided by the physicians was assessed using a self-designed scale of 39 Likert questions derived from American Association of Diabetes Educators seven domains of diabetes self-management. Cronbach’s reliability coefficient of each domain/subscale was ≥ 0.7. The data was analysed using the independent sample t-test and one-way ANOVA.Results: Over half of the physicians provided ‘inadequate quality’ diabetes self-management education in all the domains. Physicians had the highest mean score in the ‘taking medication’ domain (4.35 ± 0.59). The mean scores in the ‘problemsolving domain’ (3.63 ± 0.74) and the ‘being active domain’ (3.57 ± 0.71) were low. The quality of diabetes self-management education provided by the physicians was not associated with any of the physician characteristics.Conclusion: The quality of physicians’ communication of diabetes self-management was suboptimal in this study. The majority of the adequately communicated diabetes self-management behaviours were risk factors reduction related and disease-centred. Thus, training of primary care physicians on diabetes self-management education is recommended because of the key role these physicians play in diabetes management in resource-poor countries.

scholarly journals Translating Research into Practice: Impact of an Interprofessional Diabetes Education Model on Patient Health Outcomes

2014 ◽  
Vol 4 (2) ◽  
Author(s):  
Olayinka O. Shiyanbola ◽  
Becky Randall ◽  
Cristina Lammers ◽  
Karly A. Hegge ◽  
Michelle Anderson
Keyword(s):  
Health Promotion ◽  
Clinical Outcomes ◽  
Diabetes Management ◽  
Diabetes Education ◽  
Health Behaviours ◽  
Self Management ◽  
Health Promotion Program ◽  
Diabetes Knowledge ◽  
Foot Care ◽  
Eye Care

Background: Patient education programs encouraging diabetes self-management can improve clinical outcomes and lessen diabetes complications. This study implemented an innovative interprofessional student-led diabetes self-management and health promotion program for an underserved population and demonstrated an improvement in participant clinical outcomes and students’ understanding of interprofessional aspects of diabetes care.Methods and Findings: This community-based program was implemented at two sites that serve medically underserved individuals. Students from five health career professions led educational sessions designed to demonstrate critical components of diabetes self-management. The six-month longitudinal program covered topics within the Alphabet Strategy, including Advice, Blood pressure, Cholesterol, Diabetes control, Dental care, Diet, Eye care, Foot care, and Guardian drugs. Participants completed surveys evaluating diabetes knowledge, understanding of diabetes care, and health behaviours. Clinical values were collected before and after the program. Student surveys assessed their understanding of diabetes self-management. Upon completion of the program, all assessments were repeated to determine if there were improvements in outcomes. Thirty-eight participants and thirty students completed the study. There were significant improvements in participants’ diabetes knowledge, understanding of diabetes management, and clinical outcomes. There were significant improvements in the students’ ability to educate patients about foot care, eye care, and guardian drugs, as well as increased awareness of the role of each health profession in diabetes care.Conclusions: This interprofessional health promotion model showed significant improvements in patient and student outcomes. This innovative student-led program could be implemented in other settings and for the management of other chronic diseases.

Efficacy of a self-management education programme on patients with type 2 diabetes in primary care: A randomised controlled trial

2019 ◽  
Vol 13 (2) ◽  
pp. 122-133 ◽  
Author(s):  
Estibaliz Gamboa Moreno ◽  
Maider Mateo-Abad ◽  
Lourdes Ochoa de Retana García ◽  
Kalliopi Vrotsou ◽  
Emma del Campo Pena ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Randomised Controlled Trial ◽  
Management Education ◽  
Controlled Trial ◽  
Education Programme ◽  
Self Management ◽  
Randomised Controlled

Enhancing Access to Diabetes Self-management Education in Primary Care

2016 ◽  
Vol 42 (5) ◽  
pp. 635-645 ◽  
Author(s):  
Maureen E. Chomko ◽  
Peggy S. Odegard ◽  
Alison B. Evert
Keyword(s):  
Primary Care ◽  
Management Education ◽  
Self Management

scholarly journals Exploring the interpersonal collaboration during the integration of diabetes teams into primary care.

2021 ◽  
Author(s):  
Enza Gucciardi ◽  
Sherry Espin ◽  
Antonia Morganti ◽  
Linda Dorado
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Diabetes Management ◽  
Interprofessional Collaboration ◽  
Diabetes Education ◽  
Knowledge Exchange ◽  
Management Training ◽  
New Ways Of Working ◽  
Positive Effects ◽  
Diabetes Educators

Background Specialised diabetes teams, specifically certified nurse and dietitian diabetes educator teams, are being integrated part-time into primary care to provide better care and support for Canadians living with diabetes. This practice model is being implemented throughout Canada in an effort to increase patient access to diabetes education, self-management training, and support. Interprofessional collaboration can have positive effects on both health processes and patient health outcomes, but few studies have explored how health professionals are introduced to and transition into this kind of interprofessional work. Method Data from 18 interviews with diabetes educators, 16 primary care physicians, 23 educators’ reflective journals, and 10 quarterly debriefing sessions were coded and analysed using a directed content analysis approach, facilitated by NVIVO software. Results Four major themes emerged related to challenges faced, strategies adopted, and benefits observed during this transition into interprofessional collaboration between diabetes educators and primary care physicians: (a) negotiating space, place, and role; (b) fostering working relationships; (c) performing collectively; and (d) enhancing knowledge exchange. Conclusions Our findings provide insight into how healthcare professionals who have not traditionally worked together in primary care are collaborating to integrate health services essential for diabetes management. Based on the experiences and personal reflections of participants, establishing new ways of working requires negotiating space and place to practice, role clarification, and frequent and effective modes of formal and informal communication to nurture the development of trust and mutual respect, which are vital to success.

Patients’ Experiences of Diabetes Self-Management Education According to Health-Literacy Levels

2019 ◽  
Vol 29 (5) ◽  
pp. 285-292 ◽  
Author(s):  
Suhyun Kim ◽  
Yeoungsuk Song ◽  
Jihyun Park ◽  
Sonja Utz
Keyword(s):  
Health Literacy ◽  
Diabetes Management ◽  
Management Education ◽  
University Hospital ◽  
Self Management ◽  
Lifestyle Modifications ◽  
Low Health Literacy ◽  
Patients With Diabetes ◽  
Conventional Content Analysis ◽  
High Health Literacy

Diabetes self-management is an important part of patient care for those with diabetes. The purpose of this study was to explore patients’ experiences with diabetes self-management education and how these experiences differed by health-literacy levels. A descriptive qualitative design was conducted. In 2016, 20 patients with diabetes who took a formal diabetes self-management course at a university hospital in South Korea were interviewed. A conventional content analysis was conducted. Patients with low health-literacy misunderstood diabetes management, showed passive attitudes towards seeking information, and had difficulty obtaining detailed information. Patients with high health-literacy wanted systematic, in-depth, individualized counselling on lifestyle modifications and medications. Patients’ experiences with diabetes self-management education revealed differences in their health-literacy dimensions. In addition to practising health-literacy precautions, the content and delivery of diabetes self-management education need to be accommodated according to patients’ health-literacy levels to obtain better outcomes.

scholarly journals Building a Virtual Environment for Diabetes Self-Management Education and Support

2013 ◽  
Vol 5 (3) ◽  
pp. 68-80 ◽  
Author(s):  
Constance Johnson ◽  
Kevin Feenan ◽  
Glenn Setliff ◽  
Katherine Pereira ◽  
Nancy Hassell ◽  
...  
Keyword(s):  
Virtual Environment ◽  
Second Life ◽  
Social Cognitive ◽  
Cognitive Theory ◽  
Management Education ◽  
Diabetes Education ◽  
Self Management ◽  
Key Aspects ◽  
Health Applications

The authors developed an immersive diabetes community to provide diabetes self-management education and support for adults with type 2 diabetes. In this article the authors describe the procedures used to develop this virtual environment (VE). Second Life Impacts Diabetes Education & Self-Management (SLIDES), the VE for our diabetes community was built in Second Life. Social Cognitive Theory, behavioral principles and key aspects of virtual environments related to usability were applied in the development in this VE. Collaboration between researchers, clinicians and information technology (IT) specialists occurred throughout the development process. An interactive community was successfully built and utilized to provide diabetes self-management education and support. VEs for health applications may be innovative and enticing, yet it must be kept in mind that there are substantial effort, expertise, and usability factors that must be considered in the development of these environments for health care consumers.

Sign in / Sign up

Export Citation Format

Share Document