621-P: Digital Diabetes Education Program Improves Knowledge, Self-Efficacy, and Health Behaviors among People with Type 2 Diabetes

Abstract Background The long-term growth and sustained high prevalence of obesity in the US is likely to increase the burden of Type 2 diabetes. Hispanic individuals are particularly burdened by a larger share of diabetes than non-Hispanic White individuals. Given the existing health disparities facing this population, we aimed to examine the effectiveness and potential cost savings of the Diabetes Education Program (DEP) offered as part of Healthy South Texas, a state-legislated initiative to reduce health disparities in 27 counties in South Texas with a high proportion of Hispanic adults. Methods DEP is an 8-h interactive workshop taught in English and Spanish. After the workshop, participants receive quarterly biometric screenings and continuing education with a health educator for one year. Data were analyzed from 3859 DEP participants with Type 2 diabetes living in South Texas at five time points (baseline, 3-months, 6-months, 9-months, 12-months). The primary outcome variable of interest for study analyses was A1c. A series of independent sample t-tests and linear mixed-model regression analyses were used to identify changes over time. Two methods were then applied to estimate healthcare costs savings associated with A1c reductions among participants. Results The majority of participants were ages 45–64 years (58%), female (60%), Hispanic (66%), and had a high school education or less (75%). At baseline, the average hemoglobin A1c was 8.57%. The most substantial reductions in hemoglobin A1c were identified from baseline to 3-month follow-up (P < 0.001); however, the reduction in A1c remained significant from baseline to 12-month follow-up (P < 0.001). The healthcare cost savings associated with improved A1c for the program was estimated to be between $5.3 to $5.6 million over a two to three year period. Conclusion Findings support the effectiveness of DEP with ongoing follow-up for sustained diabetes risk management. While such interventions foster clinical-community collaboration and can improve patient adherence to recommended lifestyle behaviors, opportunities exist to complement DEP with other resources and services to enhance program benefits. Policy makers and other key stakeholders can assess the lessons learned in this effort to tailor and expand similar initiatives to potentially at-risk populations. Trial registration This community-based intervention is not considered a trial by ICMJE definitions, and has not be registered as such.

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Feasibility, Acceptability, and Impact of a Web-Based Structured Education Program for Type 2 Diabetes: Real-World Study

JMIR Diabetes ◽

10.2196/15744 ◽

2020 ◽

Vol 5 (1) ◽

pp. e15744 ◽

Cited By ~ 1

Author(s):

Shoba Poduval ◽

Louise Marston ◽

Fiona Hamilton ◽

Fiona Stevenson ◽

Elizabeth Murray

Keyword(s):

Type 2 Diabetes ◽

Health Care ◽

Education Program ◽

Self Efficacy ◽

Completion Rates ◽

Web Based ◽

Structured Education ◽

Face To Face ◽

The United Kingdom

Background Structured education for people with type 2 diabetes improves outcomes, but uptake is low globally. In the United Kingdom in 2016, only 8.3% of people who were referred to education programs attended the program. We have developed a Web-based structured education program named Healthy Living for People with type 2 Diabetes (HeLP-Diabetes): Starting Out (HDSO), as an alternative to face-to-face courses. A Web-based program gives people more options for accessing structured education and may help improve overall uptake. Objective The aim was to explore the feasibility and acceptability of delivering a Web-based structured education program (named HeLP-Diabetes: Starting Out) in routine primary health care and its potential impact on self-efficacy and diabetes-related distress. Methods HDSO was delivered as part of routine diabetes services in primary health care in the United Kingdom, having been commissioned by local Clinical Commissioning Groups. Quantitative data were collected on uptake, use of the program, demographic characteristics, self-reported self-efficacy, and diabetes-related distress. A subsample of people with type 2 diabetes and health care professionals were interviewed about acceptability of the program. Results It was feasible to deliver the program, but completion rates were low: of 791 people with type 2 diabetes registered, only 74 (9.0%) completed it. Completers improved their self-efficacy (change in median score 2.5, P=.001) and diabetes-related distress (change in median score 6.0, P=.001). Interview data suggested that the course was acceptable, and that uptake and completion may be related to nonprioritization of structured education. Conclusions The study provides evidence of the feasibility and acceptability of a Web-based structured education. However, uptake and completion rates were low, limiting potential population impact. Further research is needed to improve completion rates, and to determine the relative effectiveness of Web-based versus face-to-face education.

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The relationship between health literacy and knowledge improvement after a multimedia type 2 diabetes education program

Patient Education and Counseling ◽

10.1016/j.pec.2009.04.001 ◽

2009 ◽

Vol 75 (3) ◽

pp. 321-327 ◽

Cited By ~ 71

Author(s):

Namratha R. Kandula ◽

Phyllis A. Nsiah-Kumi ◽

Gregory Makoul ◽

Josh Sager ◽

Charles P. Zei ◽

...

Keyword(s):

Type 2 Diabetes ◽

Health Literacy ◽

Education Program ◽

Diabetes Education ◽

The Relationship

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En Balance: The Contribution of Physical Activity to the Efficacy of Spanish Diabetes Education of Hispanic Americans with Type 2 Diabetes

Journal of Diabetes Research ◽

10.1155/2020/4826704 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Dequina A. Nicholas ◽

Lorena M. Salto ◽

Kristen Lavelle ◽

Joy Wilson ◽

W. Lawrence Beeson ◽

...

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Weight Loss ◽

Glycemic Control ◽

Education Program ◽

Mexican Americans ◽

Diabetes Education ◽

Fasting Blood Glucose ◽

Active Group

Purpose. En Balance, a culturally sensitive diabetes education program, improves glycemic control in Hispanics with type 2 diabetes. The program emphasized diet, physical activity, and other factors important for glycemic control. However, the individual contributions of these education factors are unclear. The purpose of this study is to assess the contribution of physical activity to the success of En Balance in improving the health of Mexican Americans with type 2 diabetes. Methods. A retrospective study was conducted with plasma samples collected pre- and post-3-month study. Samples from 58 (18 males and 40 females) Hispanic subjects with type 2 diabetes were analyzed for the concentration of kynurenines, known to decrease in response to exercise. After three months, health outcomes for the active group (decreased kynurenines) and the rest of the cohort were evaluated by paired Wilcoxon signed-rank test. Results. Half of the subjects had increased kynurenine levels at the end of the educational program. We found that the subjects in the active group with decreased kynurenine concentrations displayed statistically greater improvements in fasting blood glucose, A1C, cholesterol, and triglycerides despite weight loss being higher in the group with increased kynurenine concentrations. Conclusions. En Balance participants with decreased kynurenine levels had significantly improved glycemic control. These data suggest that physical activity significantly contributes to the success of the En Balance education program. This analysis indicates that diabetes public health educators should emphasize the benefit of physical activity on glycemic control even in the absence of major weight loss.

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