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

Diabetes Educator Mentorship Program

2014 ◽  
Vol 41 (1) ◽  
pp. 38-42
Author(s):  
Joni K. Beck ◽  
Sheryl E. Traficano
Keyword(s):  
Health Professionals ◽  
Management Education ◽  
Self Management ◽  
Mentorship Program ◽  
Diabetes Educator ◽  
Collaborative Program ◽  
Diabetes Educators

Purpose The purpose of this article is to describe the Diabetes Educator Mentorship Program, communicate mentors’ experiences and perceptions during the first 3 years following implementation, and provide strategies to encourage mentoring. Conclusions Creation of this collaborative program has fostered successful attainment of additional certified diabetes educators who obtained diabetes self-management education and support (DSMES) practice requirement hours through a voluntary Diabetes Educator Mentorship Program. There is a significant need for additional mentors to meet the growing need for mentoring partnerships. Increasing the number of mentors will provide more opportunities to those seeking to gain DSMES experience and will ultimately expand the number of health professionals available to educate those with diabetes or prediabetes.

scholarly journals Diabetes Educators� Insights Regarding Connecting Mobile Phone� and Wearable Tracker�Collected Self-Monitoring Information to a Nationally-Used Electronic Health Record System for Diabetes Education: Descriptive Qualitative Study (Preprint)

2018 ◽  
Author(s):  
Jing Wang ◽  
Chin-Fun Chu ◽  
Chengdong Li ◽  
Laura Hayes ◽  
Linda Siminerio
Keyword(s):  
Mobile Phone ◽  
Management Education ◽  
Diabetes Education ◽  
Health Care Team ◽  
Self Management ◽  
Activity Data ◽  
Self Monitoring ◽  
Diabetes Educators ◽  
Monitoring Information ◽  
Behavioral Goal

BACKGROUND Diabetes educators are integral to a clinical team in providing diabetes self-management education and support; however, current mobile and Web-based self-management tools are not integrated into clinical diabetes care to support diabetes educators’ education efforts. OBJECTIVE The objective of our study was to seek diabetes educators’ insights regarding the development of an interface within the Chronicle Diabetes system, a nationally used electronic health record (EHR) system for diabetes education documentation with behavioral goal-setting functions, to transfer mobile phone- and wearable tracker-collected self-monitoring information from patients to diabetes educators to facilitate behavioral goal monitoring. METHODS A descriptive qualitative study was conducted to seek educators’ perspectives on usability and interface development preferences in developing a connected system. Educators can use the Chronicle Diabetes system to set behavioral goals with their patients. Individual and group interviews were used to seek educators’ preferences for viewing mobile phone- and wearable tracker-collected information on diet, physical activity, and sleep in the Chronicle Diabetes system using open-ended questions. Interview data were transcribed verbatim and analyzed for common themes. RESULTS Five common themes emerged from the discussion. First, educators expressed enthusiasm for and concerns about viewing diet and physical activity data in Chronicle Diabetes system. Second, educators valued viewing detailed dietary macronutrients and activity data; however, they preferred different kinds of details depending on patients’ needs, conditions, and behavioral goals and educators’ training background. Third, all educators liked the integration of mobile phone-collected data into Chronicle Diabetes system and preferably with current EHR systems. Fourth, a need for a health care team and a central EHR system to be formed was realized for educators to share summaries of self-monitoring data with other providers. Fifth, educators desired advanced features for the mobile app and the connected interface that can show self-monitoring data. CONCLUSIONS Flexibility is needed for educators to track the details of mobile phone- and wearable tracker-collected diet and activity information, and the integration of such data into Chronicle Diabetes and EHR systems is valuable for educators to track patients’ behavioral goals, provide diabetes self-management education and support, and share data with other health care team members to faciliate team-based care in clinical practice.

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.

Assessing the Value of Diabetes Education

2009 ◽  
Vol 35 (5) ◽  
pp. 752-760 ◽  
Author(s):  
Ian Duncan ◽  
Christian Birkmeyer ◽  
Sheryl Coughlin ◽  
Qijuan Li ◽  
Dawn Sherr ◽  
...  
Keyword(s):  
Management Education ◽  
Underserved Populations ◽  
Diabetes Education ◽  
Cost Savings ◽  
Self Management ◽  
Financial Outcomes ◽  
Referral Rates ◽  
Referring Physicians ◽  
The Impact ◽  
Diabetes Educators

Purpose The purpose of this study was to evaluate the impact of diabetes self-management education/training (DSME/T) on financial outcomes (cost of patient care). Methods Commercial and Medicare claims payer-derived datasets were used to assess whether patients who participate in diabetes education are more likely to follow recommendations for care than similar patients who do not participate in diabetes education, and if claims of patients who participate in diabetes education are lower than those of similar patients who do not. Results Patients using diabetes education have lower average costs than patients who do not use diabetes education. Physicians exhibit high variation in their referral rates to diabetes education. Conclusions The collaboration between diabetes educators and physicians yields positive clinical quality and cost savings. The analysis indicates that quality can be improved, and cost reduced, by increasing referral rates to diabetes education among low-referring physicians, specifically among men and people in disadvantaged areas. More needs to be done to inform physicians about ways to increase access to diabetes education for underserved populations.

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 A preliminary study on diabetes self-management education and glycemic control among patients with diabetes mellitus

2019 ◽  
Vol 9 (9) ◽  
pp. 98 ◽  
Author(s):  
Kisokanth G. ◽  
Indrakumar J. ◽  
Prathapan S. ◽  
Joseph J. ◽  
Ilankoon I.M.P.S.
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Management Education ◽  
Self Management ◽  
Rank Test ◽  
Diabetic Patients ◽  
Effective Measure ◽  
Before And After ◽  
Patients With Diabetes ◽  
Preliminary Study

This study was aimed to assess the effectiveness of diabetes self-management education (DSME) in the improvement of glycemic control among patients with type 2 Diabetes Mellitus (T2DM) in Batticaloa District, Sri Lanka. The study was a prospective interventional study and conducted as a preliminary study at medical clinic, Base hospital, Kaluwanchikudy, Batticaloa. Thirty patients with T2DM were included based on inclusion and exclusion criteria. A structured individual diabetes self-management education for 10 hours (one hour per week) was delivered to diabetic patients by the trained Nurse Health Educator. Glycosylate hemoglobin (HbA1c) was assessed as a main outcome measure and Fasting Blood Sugar (FBS), Body Mass Index (BMI) of each patient were also measured and recorded before and after the intervention. The respondent rate was 96.7% (n = 29). Majority of them were females (n = 25, 86.2%). A Wilcoxon signed rank test showed that DSME had a statistically significant reduction in HbA1c [8.60 (IQR 2.60) vs. 7.40 (IQR 2.10), p = .000] and FBS level [159.00 (IQR 77.50) vs. 134.00 (IQR 40.50), p = .002] at 3 months of intervention. The mean BMI at baseline was higher compared to 3 months of intervention [24.88 (SD ± 3.06) vs. 24.19 (SD ± 2.79)] which was statistically significant (p = .000). Majority of participants (n = 22, 75.9%) had improved their HbA1c level by ≥ 0.5% in 3 months. The diabetes self-management education is an effective measure in improving glycemic control and other clinical parameters among patients with T2DM. Thus, DSME needs to be implemented among clinic patients with T2DM for the better outcome and the preventions of complications.

Reliability and Validity A Quick Review

2007 ◽  
Vol 33 (5) ◽  
pp. 775-780 ◽  
Author(s):  
Karen Fitzner
Keyword(s):  
Construct Validity ◽  
External Validity ◽  
Diabetes Education ◽  
Reliability And Validity ◽  
Management Training ◽  
Self Management ◽  
Validity Testing ◽  
Education Practice ◽  
Rigorous Testing ◽  
Diabetes Educators

The purpose of this article is to provide a brief review of reliability and validity testing. These concepts are important to researchers who are choosing techniques and/or developing tools that will be applied and evaluated in diabetes education practice. Several types of reliability and validity testing are defined, and an easy-to-use check sheet is provided for research purposes. Following testing for the basic aspects of reliability and validity such as face and construct validity, a tool may be appropriate for use in practice settings. Those conducting comprehensive outcomes evaluations, however, may desire additional validation such as testing for external validity. Diabetes educators can and should incorporate rigorous testing for these important aspects when conducting assessments of techniques and tools relating to diabetes self-management training.

Do Diabetes Self-Management Education (DSME) Programs Merit more Consideration in the Indian Setting?

2012 ◽  
Vol 2 (3) ◽  
pp. 77-81
Author(s):  
Vijairam Selvaraj
Keyword(s):  
Diabetes Mellitus ◽  
Management Education ◽  
Lifestyle Changes ◽  
Self Management ◽  
Health Educators ◽  
Resource Limited ◽  
Indian Setting ◽  
Diabetes Educators ◽  
Management Behaviors

Many individuals in India are nowadays either being diagnosed early with type 2 diabetes or lack optimal control of their diabetes. Reducing the burden and impact of diabetes mellitus in India is a major priority among the healthcare system. Diabetes educators, through DPP models, have shown to reduce the risk of developing diabetes among pre-diabetics through lifestyle changes. Among diabetics, DSME is seen as an essential intervention and as a cornerstone of diabetes care. Short-lived benefits and presence of barriers & challenges limit the inclusion of sufficient numbers of health educators or trained individuals in resource limited Indian settings to educate high risk individuals and improve self-management behaviors.

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.

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