scholarly journals Early Insights From a Digitally Enhanced Diabetes Self-Management Education and Support Program: Single-Arm Nonrandomized Trial

JMIR Diabetes ◽  
10.2196/25295 ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. e25295
Author(s):  
Folasade Wilson-Anumudu ◽  
Ryan Quan ◽  
Cynthia Castro Sweet ◽  
Christian Cerrada ◽  
Jessie Juusola ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Management Education ◽  
Diabetes Education ◽  
Self Management ◽  
Diabetes Distress ◽  
Digital Format ◽  
Nonrandomized Trial ◽  
Digitally Enhanced ◽  
The Impact

Background Translation of diabetes self-management education and support (DSMES) into a digital format can improve access, but few digital programs have demonstrated outcomes using rigorous evaluation metrics. Objective The aim of this study was to evaluate the impact of a digital DSMES program on hemoglobin A1c (HbA1c) for people with type 2 diabetes. Methods A single-arm, nonrandomized trial was performed to evaluate a digital DSMES program that includes remote monitoring and lifestyle change, in addition to comprehensive diabetes education staffed by a diabetes specialist. A sample of 195 participants were recruited using an online research platform (Achievement Studies, Evidation Health Inc). The primary outcome was change in laboratory-tested HbA1c from baseline to 4 months, and secondary outcomes included change in lipids, diabetes distress, and medication adherence. Results At baseline, participants had a mean HbA1c of 8.9% (SD 1.9) and mean BMI of 37.5 kg/m2 (SD 8.3). The average age was 45.1 years (SD 8.9), 70% were women, and 67% were White. At 4-month follow up, the HbA1c decreased by 0.8% (P<.001, 95% CI –1.1 to –0.5) for the total population and decreased by 1.4% (P<.001, 95% CI –1.8 to –0.9) for those with an HbA1c of >9.0% at baseline. Diabetes distress and medication adherence were also significantly improved between baseline and follow up. Conclusions This study provides early evidence that a digitally enhanced DSMES program improves HbA1c and disease self-management outcomes.

scholarly journals Early Insights From a Digitally Enhanced Diabetes Self-Management Education and Support Program: Single-Arm Nonrandomized Trial (Preprint)

2020 ◽  
Author(s):  
Folasade Wilson-Anumudu ◽  
Ryan Quan ◽  
Cynthia Castro Sweet ◽  
Christian Cerrada ◽  
Jessie Juusola ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Management Education ◽  
Diabetes Education ◽  
Self Management ◽  
Diabetes Distress ◽  
Digital Format ◽  
Nonrandomized Trial ◽  
Digitally Enhanced ◽  
The Impact

BACKGROUND Translation of diabetes self-management education and support (DSMES) into a digital format can improve access, but few digital programs have demonstrated outcomes using rigorous evaluation metrics. OBJECTIVE The aim of this study was to evaluate the impact of a digital DSMES program on hemoglobin A<sub>1c</sub> (HbA<sub>1c</sub>) for people with type 2 diabetes. METHODS A single-arm, nonrandomized trial was performed to evaluate a digital DSMES program that includes remote monitoring and lifestyle change, in addition to comprehensive diabetes education staffed by a diabetes specialist. A sample of 195 participants were recruited using an online research platform (Achievement Studies, Evidation Health Inc). The primary outcome was change in laboratory-tested HbA<sub>1c</sub> from baseline to 4 months, and secondary outcomes included change in lipids, diabetes distress, and medication adherence. RESULTS At baseline, participants had a mean HbA<sub>1c</sub> of 8.9% (SD 1.9) and mean BMI of 37.5 kg/m<sup>2</sup> (SD 8.3). The average age was 45.1 years (SD 8.9), 70% were women, and 67% were White. At 4-month follow up, the HbA<sub>1c</sub> decreased by 0.8% (<i>P</i>&lt;.001, 95% CI –1.1 to –0.5) for the total population and decreased by 1.4% (<i>P</i>&lt;.001, 95% CI –1.8 to –0.9) for those with an HbA<sub>1c</sub> of &gt;9.0% at baseline. Diabetes distress and medication adherence were also significantly improved between baseline and follow up. CONCLUSIONS This study provides early evidence that a digitally enhanced DSMES program improves HbA<sub>1c</sub> and disease self-management outcomes.

scholarly journals The Impact of a Community Pharmacy Diabetes Self-Management Education Program on Diabetes Distress

2018 ◽  
Vol 35 (1) ◽  
pp. 3-10 ◽  
Author(s):  
Morgan L. Machen ◽  
Hamilton C. Borden ◽  
Kenneth C. Hohmeier
Keyword(s):  
Community Pharmacy ◽  
Management Education ◽  
Information Age ◽  
Retrospective Chart Review ◽  
Self Management ◽  
Diabetes Distress ◽  
Health History ◽  
Scale Scores ◽  
History Of ◽  
The Impact

Background: Negative psychosocial implications stemming from the presence of diabetes, known as diabetes distress, place people with diabetes at twice the likelihood of having clinical depression than those who do not have the disease. While many community pharmacies have incorporated diabetes self-management education (DSME) programs into their practices, there are no known studies that evaluate the impact that this model may have on diabetes distress. Objective: The purpose of this study is to evaluate the impact that a community pharmacy DSME program has on diabetes distress. Methods: Retrospective chart review for pre- and post-DSME Problem Areas in Diabetes scale scores, pertinent health history (type and duration of diabetes, A1C, and medications), and demographic information (age, gender) of patients who completed Blount Discount Pharmacy’s DSME program. Data were analyzed using descriptive and inferential statistics. Results: Of the 17 charts that were reviewed, there was an overall decrease in Problem Areas in Diabetes scale scores from baseline ( P = .029). Greater reduction was observed in patients with a long-standing history of diabetes compared with those who were diagnosed with diabetes within the previous 12 months of DSME. Conclusions: The findings suggest that a community pharmacy DSME program may reduce diabetes distress and warrant future study.

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.

scholarly journals 83 A Medication Self-Management Intervention to Improve Medication Adherence For Older People with Multimorbidity: A Pilot Study

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
C Yang ◽  
Z Hui ◽  
S Zhu ◽  
X Wang ◽  
G Tang ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Pilot Study ◽  
Older People ◽  
Intervention Group ◽  
Self Management ◽  
Control Group ◽  
Medication Knowledge ◽  
Management Intervention ◽  
Patient Reported

Abstract Introduction Medication self-management support has been recognised as an essential element in primary health care to promote medication adherence and health outcomes for older people with chronic conditions. A patient-centred intervention empowering patients and supporting medication self-management activities could benefit older people. This pilot study tested a newly developed medication self-management intervention for improving medication adherence among older people with multimorbidity. Method This was a two-arm randomised controlled trial. Older people with multimorbidity were recruited from a community healthcare centre in Changsha, China. Participants were randomly allocated to either a control group receiving usual care (n = 14), or to an intervention group receiving three face-to-face medication self-management sessions and two follow-up phone calls over six weeks, targeting behavioural determinants of adherence from the Information-Motivation-Behavioural skills model (n = 14). Feasibility was assessed through recruitment and retention rates, outcome measures collection, and intervention implementation. Follow-up data were measured at six weeks after baseline using patient-reported outcomes including medication adherence, medication self-management capabilities, treatment experiences, and quality of life. Preliminary effectiveness of the intervention was explored using generalised estimating equations. Results Of the 72 approached participants, 28 (38.89%) were eligible for study participation. In the intervention group, 13 participants (92.86%) completed follow-up and 10 (71.42%) completed all intervention sessions. Ten participants (71.42%) in the control group completed follow-up. The intervention was found to be acceptable by participants and the intervention nurse. Comparing with the control group, participants in the intervention group showed significant improvements in medication adherence (β = 0.26, 95%CI 0.12, 0.40, P &lt; 0.001), medication knowledge (β = 4.43, 95%CI 1.11, 7.75, P = 0.009), and perceived necessity of medications (β = −2.84, 95%CI -5.67, −0.01, P = 0.049) at follow-up. Conclusions The nurse-led medication self-management intervention is feasible and acceptable among older people with multimorbidity. Preliminary results showed that the intervention may improve patients’ medication knowledge and beliefs and thus lead to improved adherence.

Digital Divide

2016 ◽  
pp. 94-101
Author(s):  
Geoff Kaufman ◽  
Mary Flanagan
Keyword(s):  
Public Health ◽  
Systems Thinking ◽  
Cognitive Processes ◽  
Digital Game ◽  
Digital Platforms ◽  
Digital Version ◽  
Digital Format ◽  
Growing Body ◽  
The Impact

With a growing body of work demonstrating the power of games to transform players' attitudes, behaviors, and cognitions, it is crucial to understand the potentially divergent experiences and outcomes afforded by digital and non-digital platforms. In a recent study, we found that transferring a public health game from a non-digital to a digital format profoundly impacted players' behaviors and the game's impact. Specifically, players of the digital version of the game, despite it being a nearly identical translation, exhibited a more rapid play pace and discussed strategies and consequences less frequently and with less depth. As a result of this discrepancy, players of the non-digital version of the game exhibited significantly higher post-game systems thinking performance and more positive valuations of vaccination, whereas players of the digital game did not. We propose several explanations for this finding, including follow-up work demonstrating the impact of platform on basic cognitive processes, that elucidate critical distinctions between digital and non-digital experiences.

Intervention Mediators in a Randomized Controlled Trial to Increase Physical Activity and Fatigue Self-management Behaviors Among Adults With Multiple Sclerosis

2019 ◽  
Author(s):  
Matthew Plow ◽  
Robert W Motl ◽  
Marcia Finlayson ◽  
Francois Bethoux
Keyword(s):  
Physical Activity ◽  
Multiple Sclerosis ◽  
Goal Setting ◽  
Self Efficacy ◽  
Outcome Expectations ◽  
Step Count ◽  
Self Management ◽  
Post Test ◽  
The Impact

Abstract Background People with multiple sclerosis (MS) often experience fatigue, which is aggravated by inactivity. Identifying mediators of changes in physical activity (PA) and fatigue self-management (FSM) behaviors could optimize future interventions that reduce the impact of MS fatigue. Purpose To examine the effects of telephone-delivered interventions on Social Cognitive Theory constructs and test whether these constructs mediated secondary outcomes of PA and FSM behaviors. Methods Participants with MS (n = 208; Mean age = 52.1; Female = 84.6%) were randomized into contact–control intervention (CC), PA-only intervention, and PA+FSM intervention. Step count (Actigraphy) and FSM behaviors as well as self-efficacy, outcome expectations, and goal setting for PA and FSM were measured at baseline, post-test (12 weeks), and follow-up (24 weeks). Path analyses using bias-corrected bootstrapped 95% confidence intervals (CI) determined whether constructs at post-test mediated behaviors at follow-up when adjusting for baseline measures. Results Path analysis indicated that PA-only (β = 0.50, p < .001) and PA+FSM interventions (β = 0.42, p < .010) had an effect on goal setting for PA, and that PA + FSM intervention had an effect on self-efficacy for FSM (β = 0.48, p = .011) and outcome expectations for FSM (β = 0.42, p = .029). Goal setting for PA at post-test mediated the effects of PA-only (β = 159.45, CI = 5.399, 371.996) and PA + FSM interventions (β = 133.17, CI = 3.104, 355.349) on step count at follow-up. Outcome expectations for FSM at post-test mediated the effects of PA + FSM intervention on FSM behaviors at follow-up (β = 0.02, CI = 0.001, 0.058). Conclusions Goal setting for PA and outcome expectations for FSM may be important constructs to target in telephone-delivered interventions designed to reduce the impact of MS fatigue. Trial registration Clinicaltrials.gov (NCT01572714)

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.

scholarly journals P101 ‘Best Foot Forward Workshops’: a novel supported self-management approach for foot health

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Sue Connett ◽  
Colin Beevor ◽  
Sam Ward ◽  
Ernest Wong ◽  
Lindsey Cherry
Keyword(s):  
Service Use ◽  
Self Management ◽  
Management Approach ◽  
Education Session ◽  
Foot Health ◽  
Notification System ◽  
Clinical Models ◽  
The Impact ◽  
Clinical Appointment

Abstract Background Rheumatic foot health challenges can be multiple and wide-ranging, leading to reduced mobility or quality of life. However, the provision of foot health services is disparate. There is a need to innovate new approaches to personalised foot health care outside of traditional clinical models of service delivery. A new healthcare model was co-designed by patients, academics and clinicians from secondary and primary care Trusts, to support self-management. Part of this model included the development of ‘best foot forward’ workshops. There is a need to: minimise the impact of the demonstrated gap between what service users need or want and what services are providing; reduce waiting times; empower self-management; improve MDT availability for those in need; reduce the number of appointments needed to get resolution; reduce service costs; maintain patient satisfaction. Methods The team co-designed a series of foot health workshops, at 8-week intervals. The novel workshop design extended beyond a traditional patient education session and consisted of: 1. an education session about anatomy and physiology for the lower limb, 2. social networking time, 3. a themed education session, 4. opportunity for group discussion, 5. opportunity for individual question and answer with a health professional, 6. Access to direct request for follow-up appointment. Electronic invitations were sent to all patients registered within a single rheumatology department enrolled on the electronic notification system. Posters advertising the workshops were displayed in waiting areas. After three workshops data regarding patient attendance, satisfaction, and health service use up to four weeks after the workshop was collected. Results Nineteen, 22 and 30 patients attended the workshops respectively. Seven people attended multiple workshops. All patients reported having an unmet foot health need and would have otherwise sought a clinical appointment. Allowing for session preparation time (approx. 3 hours per session) 20 hours of clinical time was saved; the clinical waiting list was reduced by 12 sessions (6 weeks). Three patients (4%) requested one follow-up clinical appointment immediately after the workshop. No patients requested additional appointments in the four weeks after each workshop; enabling patient led review saved 71 further appointments. Patients reported content, venue and satisfactions scores of 9.6, 8.7 and 9.6/10 respectively. Conclusion Further research is needed to confirm that patients’ needs are being fully met, in addition to enabling supported self-management and improving clinical outcomes. There is potential for these workshops to be co-ordinated and facilitated by expert patient partners. The role of group interaction as a therapeutic mechanism to aid supported self-management is worthy of further study. Best foot forward workshops could represent a viable supported self-management alternative to traditional clinical models for people with rheumatic conditions. Disclosures S. Connett None. C. Beevor None. S. Ward None. E. Wong None. L. Cherry None.

Capacity of Diabetes Education Programs to Provide Both Diabetes Self-management Education and to Implement Diabetes Prevention Services

2011 ◽  
Vol 17 (3) ◽  
pp. 242-247 ◽  
Author(s):  
Marcene K. Butcher ◽  
Karl K. Vanderwood ◽  
Taryn O. Hall ◽  
Dorothy Gohdes ◽  
Steven D. Helgerson ◽  
...  
Keyword(s):  
Diabetes Prevention ◽  
Management Education ◽  
Diabetes Education ◽  
Self Management ◽  
Education Programs ◽  
Prevention Services

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

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