Objective: To provide a comprehensive evaluation of a grant-funded pilot diabetes care program. Rural adult patients living with poorly controlled diabetes were targeted for care. Design and Sample:Retrospective study using a purposive sample of patients at select primary care sites with a glycated hemoglobin (A1C) greater than 8%. Interventions included nurse care management, telemedicine endocrinology consults, as well as diabetes self-management education (DSME), to enhance disease management and prevention of complications.Measures: Pre/post labs, DSME test scores, hospital claims data, satisfaction surveys, and a focus group were evaluated. Results: Fifty-nine adults, 21-76 years of age, participated. Interventions demonstrated statistically significant reduction in A1C (10.10 vs. 9.27; p value = 0.002); DSME test score improvement (76.23 vs. 96.04; p < 0.05) and reduced hospital utilization (Emergency Department use 0.86 vs. 0.40; p value = 0.04; inpatient admissions 0.09 vs. 0.02; p value = 0.02). Patients and providers indicated strong satisfaction with the program components. Less hospital utilization reduced emergency department costs by 51.4% and inpatient costs by 96%. A rural community advisory network indicated satisfaction in delivery of program activities and outcome measures.Conclusions: This rural model shows potential for improving diabetes control, access to specialty care through telemedicine, and reduction of health care utilization costs.

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The purposes of this secondary analysis of data from the National Health and Nutrition Examination Survey (NHANES) III Household Adult Data File (1988-1994) were to describe and compare exercise practices and preferences of adult Caucasians, African Americans, and Hispanics with diabetes and to relate that information to diabetes treatment modalities. The research questions were: (a) What proportion of ethnically diverse adults with diabetes do and do not exercise? (b) What are the preferred types of exercise by ethnicity, gender, and age? and (c) What are the relationships among exercise participation, exercise preference, and treatment of diabetes by ethnic group? More than one third of the total sample reported no exercise within the last month. There were no significant differences in amount of exercise by ethnic group. Gardening and walking were the preferred forms of exercise across age, gender, ethnicity, and treatment.

Children of both sexes and 4 racial/ethnic groups provided a broad range of services to adults with diabetes with little preparation. Diabetes educators should consider if and how they can assess and include child caregivers in diabetes education.

This study examined the relationship between using computer-adaptive quizzing (CAQ) and first-time National Council Licensure Examination (NCLEX) success. A retrospective, descriptive, correlational design was used to analyze the relationship between use of a CAQ program and first-time NCLEX results of 194 baccalaureate graduates. Chi-square analysis suggested that there was an association between using the software and NCLEX success (p < .001, df = 1), with 16 percent of those without access compared to 1 percent with access being unsuccessful on the licensure exam. Results support using CAQ as formative preparation for the NCLEX.