A diabetes education multimedia program in the waiting room setting

Abstract

IntroductionThis study evaluated the impact of a waiting room-administered, low-literacy, computer multimedia diabetes education program on patient self-management and provider intensification of therapy.MethodsIn this randomized, controlled trial, 129 participants either viewed a computer multimedia education program (intervention group) or read an educational brochure (control group) while in the waiting room. Participants were uninsured, primarily ethnic minority adults with type 2 diabetes receiving care from a county clinic in Chicago, Illinois. Wilcoxon test, t-test, and linear mixed model analyses evaluated changes in diabetes knowledge, self-efficacy, behaviors, medications prescribed, hemoglobin A1c (HbA1c), and blood pressure levels over 3 months.ResultsDuring the study period, there was an increase in the number of oral diabetes medications prescribed over three months to multimedia users compared with those in the control group (P=0.017). HbA1c declined by 1.5 in the multimedia group versus 0.8 in the control group (P=0.06). There were no differences between groups in changes in blood pressure levels, self-efficacy, and most diabetes-related behaviors. Self-reported exercise increased in the control group compared with the multimedia group (0.9 days/week vs. 0.1 days/week, P=0.016).ConclusionMultimedia users received a greater intensification of diabetes therapy, but demonstrated no difference in self-management in comparison with those receiving educational brochures. The availability of a computer multimedia program in the waiting room appears to be a novel and acceptable approach in providing diabetes education for underserved populations.

The use of technology to promote physical activity in Type 2 diabetes management: a systematic review

“…Both CD‐ROMs found a significant increase ( P < 0.001) in physical activity; however, one found that as moderate activity increased (33%) lifestyle activity decreased (14.9%). The computer‐learning intervention found a significant small increase (3%, P < 0.05), but a larger increase in the control (26.45%), which the authors attributed to self‐rating of physical activity.…”

“…The number of participants who actively engaged in the intervention exceeded 80% in seven studies: four web‐based , two mobile phone and one CD‐ROM . When decreasing to 70%, five more were deemed to have an acceptable participation rate: three web‐based , one CD‐ROM and the computer learning based . Two web‐based interventions showed a steep decline in use over time .…”

“…Of eight studies that assessed changes in HbA 1c [14,[16][17][18]20,21,24,25], four found significant decreases: two mobile phone interventions [20,21] and two web-based interventions [16,25]. Average decreases in HbA 1c were 22 mmol/mol (2.0%, P < 0.05) [20] and 11 mmol/mol (1.1%, P < 0.001) [21] in the mobile phone interventions and 1 mmol/mol (0.6%, P < 0.05) [16] and 7 mmol/mol (0.6%, P < 0.05) [25] for the web-based interventions.…”

The effectiveness of multimedia education for patients with type 2 diabetes mellitus

“…This finding is congruent with that reported by Khan et al . (), which showed no differences in HbA1c levels between the multimedia and brochure groups 3 months subsequent to the intervention. However, only 25% of the participants in Khan et al .…”

“…However, only 25% of the participants in Khan et al . 's () study received insulin therapy, which differed significantly from the participant composition of our study, since all patients were receiving insulin therapy. Therefore, it is not possible to make a meaningful comparison between these two studies.…”