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.

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

Factors Predicting Adequate Glycemic Control after Participation in Diabetes Self-Management Education and Support Program: The Role of Behavioral Change

2021 ◽  
Vol 104 (3) ◽  
pp. 410-417
Keyword(s):  
Glycemic Control ◽  
Management Education ◽  
Goal Achievement ◽  
Self Management ◽  
Initial Visit ◽  
Baseline Hba1c ◽  
Insulin Use ◽  
Diabetes Educators ◽  
Behavioral Goal

Objective: To explore the predictors of achieving adequate glycemic control at a 6-months follow-up in patients with type 2 diabetes (T2D) who participated in the diabetes self-management education and support (DSMES) program. Materials and Methods: A retrospective cohort study of T2D patients who completed the DSMES program (an initial visit and a 3-month follow-up) at Ramathibodi Hospital between 2014 and 2017 was conducted. Behavioral goals were set at the initial visit and whether these were achieved by the patients was assessed at a 3-month follow-up. Diabetes history, baseline, and 6-month hemoglobin A1C (HbA1c) values were collected. Multiple logistic regression analyses were performed to determine independent predictors of adequate glycemic control at 6-month, defined as HbA1c of less than 7% or less than 7.5% in those younger than 65 years or those 65 years or older, respectively. Results: Ninety-two patients were included, with a mean (SD) age 60.7 (10.9) years, an average diabetes duration of 9.1 (9.5) years and 51.1% were using insulin. Seventy-six patients (82.6%) reported that they achieved behavioral goals as set at the initial visit, and 56.5% had adequate glycemic control at 6-month. Multiple regression analysis adjusting for age, baseline HbA1c, and insulin use revealed that behavioral goal achievement at three months was independently associated with HbA1c achievement at six months (OR 3.473, 95% CI 1.005 to 12.001), while higher baseline HbA1c was associated with a lower likelihood of achieving adequate glycemic control (OR 0.727, 95% CI 0.540 to 0.979). Conclusion: Behavioral goal achievement was an independent predictor of adequate glycemic control in participants of the DSMES programs, suggesting that adherence to behavioral changes can improve clinical outcomes. Goal setting skills should be adopted by diabetes educators and incorporated as a key part of DSMES process. Keywords: Factors predicting glycemic control, Diabetes self-management education, Behavioral goal achievement, Diabetic educators

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.

scholarly journals Connecting Smartphone and Wearable Fitness Tracker Data with a Nationally Used Electronic Health Record System for Diabetes Education to Facilitate Behavioral Goal Monitoring in Diabetes Care: Protocol for a Pragmatic Multi-Site Randomized Trial (Preprint)

2018 ◽  
Author(s):  
Jing Wang ◽  
Deidra Carroll Coleman ◽  
Justin Kanter ◽  
Brad Ummer ◽  
Linda Siminerio
Keyword(s):  
Electronic Health Record ◽  
Diabetes Education ◽  
Electronic Health Record System ◽  
Health Record ◽  
Record System ◽  
Self Monitoring ◽  
Electronic Health ◽  
Fitness Tracker ◽  
Diabetes Educators ◽  
Behavioral Goal

BACKGROUND Mobile and wearable technology have been shown to be effective in improving diabetes self-management; however, integrating data from these technologies into clinical diabetes care to facilitate behavioral goal monitoring has not been explored. OBJECTIVE The objective of this paper is to report on a study protocol for a pragmatic multi-site trial along with the intervention components, including the detailed connected health interface. This interface was developed to integrate patient self-monitoring data collected from a wearable fitness tracker and its companion smartphone app to an electronic health record system for diabetes self-management education and support (DSMES) to facilitate behavioral goal monitoring. METHODS A 3-month multi-site pragmatic clinical trial was conducted with eligible patients with diabetes mellitus from DSMES programs. The Chronicle Diabetes system is currently freely available to diabetes educators through American Diabetes Association–recognized DSMES programs to set patient nutrition and physical activity goals. To integrate the goal-setting and self-monitoring intervention into the DSMES process, a connected interface in the Chronicle Diabetes system was developed. With the connected interface, patient self-monitoring information collected from smartphones and wearable fitness trackers can facilitate educators’ monitoring of patients’ adherence to their goals. Feasibility outcomes of the 3-month trial included hemoglobin A1c levels, weight, and the usability of the connected system. RESULTS An interface designed to connect data from a wearable fitness tracker with a companion smartphone app for nutrition and physical activity self-monitoring into a diabetes education electronic health record system was successfully developed to enable diabetes educators to facilitate goal setting and monitoring. A total of 60 eligible patients with type 2 diabetes mellitus were randomized into either group 1) standard diabetes education or 2) standard education enhanced with the connected system. Data collection for the 3-month pragmatic trial is completed. Data analysis is in progress. CONCLUSIONS If results of the pragmatic multi-site clinical trial show preliminary efficacy and usability of the connected system, a large-scale implementation trial will be conducted. CLINICALTRIAL ClinicalTrials.gov NCT02664233; https://clinicaltrials.gov/ct2/show/NCT02664233 (Archived by WebCite at http://www.webcitation.org/6yDEwXHo5)

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.

scholarly journals EVALUATION OF DIABETES SELF-MANAGEMENT EDUCATION IN PATIENTS WITH CONCOMITANT CHRONIC KIDNEY DISEASE

2020 ◽  
Vol 73 (10) ◽  
pp. 2170-2174
Author(s):  
Oleksii M. Korzh
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Management Training ◽  
Cross Sectional Study ◽  
Self Management ◽  
Average Score ◽  
Cross Sectional ◽  
Self Monitoring ◽  
Diabetes Educators

The aim: Was to evaluate the quality of DSME provided by primary care physicians to people with diabetes mellitus. Materials and methods: A descriptive cross-sectional study was conducted among 120 primary care physicians. The quality of diabetes self-management training provided by physicians was assessed on a personal scale of 39 Likert questions obtained from the American Association of Diabetes Educators in seven areas of diabetes self-monitoring. The Cronbach’s reliability coefficient for each domain / subscale was ≥ 0.7. The data were analyzed using an independent selective t-test and one-way ANOVA. Results: More than half of the doctors provided “inadequate quality” of diabetes self-management in all areas. Doctors had the highest average score in the domain of “drug intake” (4.46 ± 0.61). Average scores in the “problem-solving domain” (3.52 ± 0.63) and “ being active domain” (3.46 ± 0.75) were low. The quality of DSME provided by physicians was not related to any of the characteristics of the physician. Conclusions: The quality of doctors’ communication on DSME in this study was suboptimal. Most adequately informed cases of diabetic behavior associated with self-management have been associated with reduced risk factors and an orientation towards disease. Thus, training of primary care physicians in diabetic self-management is recommended because of the key role that these doctors play in managing diabetes.

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.

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