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.

Diabetes is a chronic disease that is often comorbid with cardiovascular disease, hypertension, kidney disease, and neuropathy. Its management is complex, requiring ongoing clinical management, lifestyle changes, and self-care. This article examines recent literature on telehealth and emerging technological tools for supporting self-management of diabetes and identifies best practices. The authors conducted a PubMed search (January 2008-2012) that was supplemented by review of meeting materials and a scan of the Internet to identify emerging technologies. Fifty-eight papers were reviewed; 12 were selected for greater analysis. This review supports earlier findings that the delivery of diabetes self-management and training (DSME/T) via telehealth is useful, appropriate, and acceptable to patients and providers. Best practices are emerging; not all technology is appropriate for all populations--interactive technology needs to be appropriate to the patient's age, abilities, and sensitivities. Telehealth is scalable and sustainable provided that it adds value, does not add to the provider's workload, and is fairly reimbursed. However, there are multiple barriers (patient, provider, health system) to remotely provided DSME/T. DSME/T delivered via telehealth offers effective, efficient, and affordable ways to reach and support underserved minorities and other people with diabetes and related comorbidities. The new generation of smartphones, apps, and other technologies increase access, and the newest interventions are designed to meet patient needs, do not increase workloads, are highly appropriate, enhance self-management, and are desired by patients.

Hypertension is a prevalent chronic disease that requires ongoing management and self-care. The disease affects 31% of American adults and contributed to or caused the deaths of 348,000 Americans in 2008, fewer than 50% of whom effectively self-managed the disease. However, self-management is complex, with patients requiring ongoing support and easy access to care. Telehealth may help foster the knowledge and skills necessary for those with hypertension to engage in successful self-management. This paper considers the applicability, efficacy, associated risks, and cost-effectiveness of telehealth for individuals and populations with hypertension. Telehealth is a broad term, encompassing telemedicine and mobile health that is used for physician-patient interactions, diagnostics, care delivery, education, information sharing, monitoring, and reminders. Telemedicine may have considerable utility for people diagnosed with hypertension who have poor access or social barriers that constrain access, but potential risks exist. Telehealth technology is evolving rapidly, even in the absence of fully proven cost-effectiveness and efficacy. Considering the cost of inpatient and emergency department care for patients with hypertension, telehealth is a highly attractive alternative, but there are risks to consider. Incorporating telehealth, which is increasingly characterized by mobile health, can increase both the capacity of health care providers and the reach of patient support, clinical management, and self-care. Telehealth studies need improvement; long-term outcome data on cardiovascular events must be obtained, and robust risk analyses and economic studies are needed to prospectively evaluate the safety and cost savings for hypertension self-management.

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Nearly 26 million people diagnosed with diabetes mellitus in the U.S. must actively engage in self-management of the disease. Telehealth is a population-based approach with the potential to optimize resources and increase access to diabetes self-management education/training (DSME/T). We conducted a systematic literature review on diabetes education and telehealth (2009–April 2014) to determine whether remote DSME/T sufficiently improves behavioral, clinical, and economic outcomes and access. Twenty-five out of 213 identified systematic literature reviews or meta-analyses (two on mobile health were identified via a Google search) met our criteria and were fully reviewed; 22 additional studies and reports of diabetes-related technologies and interventions were also identified. Telemedicine has the potential to offer great utility, but guidelines for high research standards must be introduced, adopted, and proactively refined to determine the strengths of this technology for DSME/T, behavioral change, cost-effective care, and improved access in chronic disease self-management.