Diabetes Numeracy and Blood Glucose Control: Association With Type of Diabetes and Source of Care

Zaugg, Stephanie D.; Dogbey, Godwin; Collins, Karen; Reynolds, Sharon; Batista, C; Brannan, Grace D.; Shubrook, Jay H.

doi:10.2337/diaclin.32.4.152

Cited by 37 publications

(33 citation statements)

References 9 publications

(20 reference statements)

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“…Numeracy skills, i.e., “the ability to understand and use numbers in daily life”, are used by diabetes patients to assist with self-management tasks such as understanding glucose measurements, calculating medication doses (especially insulin) and interpreting dietary recommendations and nutrition labels [ 60 ]. High performance on a numeracy test developed and tested for diabetes has been found to have a significant correlation with higher diabetes knowledge and higher perceived self-efficacy [ 60 , 61 ] but the association between numeracy skills and glycemic control has not been consistently demonstrated [ 62 , 63 , 64 , 65 ]. In populations which face language barriers, numbers can become the single most important criterion for understanding disease status.…”

Section: Discussionmentioning

confidence: 99%

Patient and Provider Dilemmas of Type 2 Diabetes Self-Management: A Qualitative Study in Socioeconomically Disadvantaged Communities in Stockholm

Aweko

Man

Absetz

et al. 2018

IJERPH

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Studies comparing provider and patient views and experiences of self-management within primary healthcare are particularly scarce in disadvantaged settings. In this qualitative study, patient and provider perceptions of self-management were investigated in five socio-economically disadvantaged communities in Stockholm. Twelve individual interviews and four group interviews were conducted. Semi-structured interview guides included questions on perceptions of diabetes diagnosis, diabetes care services available at primary health care centers, patient and provider interactions, and self-management support. Data was analyzed using thematic analysis. Two overarching themes were identified: adopting and maintaining new routines through practical and appropriate lifestyle choices (patients), and balancing expectations and pre-conceptions of self-management (providers). The themes were characterized by inherent dilemmas representing confusions and conflicts that patients and providers experienced in their daily life or practice. Patients found it difficult to tailor information and lifestyle advice to fit their daily life. Healthcare providers recognized that patients needed support to change behavior, but saw themselves as inadequately equipped to deal with the different cultural and social aspects of self-management. This study highlights patient and provider dilemmas that influence the interaction and collaboration between patients and providers and hinder uptake of self-management advice.

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Section: Discussionmentioning

confidence: 99%

Patient and Provider Dilemmas of Type 2 Diabetes Self-Management: A Qualitative Study in Socioeconomically Disadvantaged Communities in Stockholm

Aweko

Man

Absetz

et al. 2018

IJERPH

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“…4 This presents problems with elevated glucose levels and glycemic variability. Two-thirds of people taking insulin cannot calculate their doses correctly 5,6 even if they know their blood glucose and know how much carbohydrate they are eating. This presents some significant challenges that require tools to help people manage their insulin better.…”

Section: Challenges With MDI Therapymentioning

confidence: 99%

Presenting the Case for Smart Insulin Pens

MacLeod¹

2020

ADCES in Practice

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“…In rural southeastern Ohio, diabetes rates far exceed both the national (19.9% vs. 9.4%) [ 4 , 5 ] and state prevalence (11.0%) [ 6 ]. Here, diabetes patients are more likely to have a delayed diagnosis, limited access to health care, lower health literacy, and lower empowerment [ 7 , 8 ]. Moreover, the Appalachian counties located in southeastern Ohio are designated as economically “distressed,” with nearly a third of residents living below the poverty line [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

A qualitative process evaluation of a diabetes navigation program embedded in an endocrine specialty center in rural Appalachian Ohio

et al. 2018

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BackgroundDiabetes in the United States has reached epidemic proportions and the people of Appalachia have been disproportionately affected by this disease. Strategies that complement standard diabetes care are critically important to mitigate the risk of complications, reduce health expenditures, and improve the quality of life of patients living in rural Appalachia. The purpose of this study was to conduct a qualitative process evaluation of a patient navigation program for diabetes after its first year of implementation.MethodsThe process evaluation assessed how the Diabetes Navigation Program was delivered as well as how it was experienced by the navigators, providers, health administrators, and office staff at an endocrine specialty center in rural Appalachian Ohio. We employed total population sampling to conduct in-depth, face-to-face interviews with all providers, health administrators, staff, and navigators at a Diabetes Endocrine Center. Interviews were transcribed, coded, and analyzed via content and thematic analyses using NVivo 11 software.ResultsSeventeen individuals (providers n = 5, health administrators n = 4, office staff members n = 3, and navigators n = 5) participated in in-depth, face-to-face interviews (age = 44.7 ± 11.6 years, 82.4% female, 94.1% white, 13.3 ± 9.6 years work experience). Fidelity of implementation: The navigation team carried out most of the activities denoted in the Work Plan, therefore the program was implemented somewhat successfully. Qualitative analysis revealed three themes: 1) The navigator addresses sources of health disparities: All participants described the role of the diabetes navigator as someone who is knowledgeable about diabetes and able to identify and address health disparities. 2) The navigators are the eyes in the community and the patients’ homes: Navigators offered providers and clinic staff a rare glimpse into the personal lives of patients, which led to the identification of unrecognized barriers. 3) Difficulties with cross-system integration of services: Differences in the organizational culture and vision of the specialty center and navigation office contributed to systemic barriers.ConclusionsOverall, this process evaluation highlights the importance of coordinating providers, health administrators, medical office staff, and navigators to address barriers to diabetes care. Forthcoming research is needed to document the clinical effectiveness and sustainability of the Diabetes Navigation Program in rural Appalachia.

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Diabetes Numeracy and Blood Glucose Control: Association With Type of Diabetes and Source of Care

Cited by 37 publications

References 9 publications

Patient and Provider Dilemmas of Type 2 Diabetes Self-Management: A Qualitative Study in Socioeconomically Disadvantaged Communities in Stockholm

Patient and Provider Dilemmas of Type 2 Diabetes Self-Management: A Qualitative Study in Socioeconomically Disadvantaged Communities in Stockholm

Presenting the Case for Smart Insulin Pens

A qualitative process evaluation of a diabetes navigation program embedded in an endocrine specialty center in rural Appalachian Ohio

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