Making a Difference With Interactive Technology: Considerations in Using and Evaluating Computerized Aids for Diabetes Self-Management Education

Glasgow, Russell E.; Bull, Sheana

doi:10.2337/diaspect.14.2.99

Cited by 38 publications

(18 citation statements)

References 21 publications

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“…Interactive computer technology will be used increasingly in future research and practice (12,33). It is possible that greater benefit could be obtained through using interactive technology to address lifestyle change issues such as physical activity and nutrition counseling that are not often dealt with sufficiently in primary care (11,12,(33)(34)(35) …”

Section: Methodsmentioning

confidence: 99%

“…We report a "practical clinical trial" (10) to improve diabetes care, characterized by a clinically relevant intervention, a diverse sample of patients recruited from heterogeneous practices, and end point data on a broad range of outcomes (10,11). Our purpose is to describe outcomes important to patients, clinicians, and policy makers derived from typical community settings.…”

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confidence: 99%

“…Our purpose is to describe outcomes important to patients, clinicians, and policy makers derived from typical community settings. The intervention used interactive computer technology to assist both patients and clinicians in emphasizing patient-centered communication and improved quality of care and to provide immediate feedback of personally tailored information and recommendations (11)(12)(13). Our CD-ROM-assisted Diabetes Priority Program was evaluated against a stringent randomized control condition for its effectiveness in improving both laboratory assay and more patient-centered aspects of care recommended by the National Committee on Quality Assurance/American Diabetes Association Provider Recognition Program (PRP) (14,15).…”

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confidence: 99%

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Randomized Effectiveness Trial of a Computer-Assisted Intervention to Improve Diabetes Care

et al. 2005

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OBJECTIVE -There is a well-documented gap between diabetes care guidelines and the services received by patients in most health care settings. This report presents 12-month follow-up results from a computer-assisted, patient-centered intervention to improve the level of recommended services patients received from a variety of primary care settings.RESEARCH DESIGN AND METHODS -A total of 886 patients with type 2 diabetes under the care of 52 primary care physicians participated in the Diabetes Priority Program. Physicians were stratified and randomized to intervention or control conditions and evaluated on two primary outcomes: number of recommended laboratory screenings and recommended patient-centered care activities completed from the National Committee on Quality Assurance/ American Diabetes Association Provider Recognition Program (PRP). Secondary outcomes were evaluated using the Problem Areas in Diabetes 2 quality of life scale, lipid and HbA 1c levels, and the Patient Health Questionnaire-9 depression scale. RESULTS -The program was well implemented and significantly improved both the number of laboratory assays and patient-centered aspects of diabetes care patients received compared with those in the control condition. There was overall improvement on secondary outcomes of lipids, HbA 1c , quality of life, and depression scores; between-condition differences were not significant.CONCLUSIONS -Staff in small, mixed-payer primary care offices can consistently implement a patient-centered intervention to improve PRP measures of quality of diabetes care. Alternative explanations for why these process improvements did not lead to improved outcomes, and suggested directions for future research are discussed.

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Section: Methodsmentioning

confidence: 99%

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confidence: 99%

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Randomized Effectiveness Trial of a Computer-Assisted Intervention to Improve Diabetes Care

et al. 2005

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“…Common approaches to providing this additional self-management support include telephonebased counseling (7)(8)(9)(10)(11)(12), group medical visits (13)(14)(15)(16)(17)(18)(19)(20)(21), and, increasingly, computer or internetbased programs (22)(23)(24)(25)(26)(27)(28)(29)(30). Efficacy studies of self-management support have shown improvements in patient satisfaction, healthy behaviors, self-efficacy, and, in some cases, utilization and clinical outcomes (31)(32)(33).…”

Section: Introductionmentioning

confidence: 99%

Preferences for self-management support: Findings from a survey of diabetes patients in safety-net health systems

Sarkar

Piette

Gonzales

et al. 2008

Patient Education and Counseling

131

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Objectives-We sought to identify interest in different modes of self-management support among diabetes patients cared for in public hospitals, and to assess whether demographic or disease-specific factors were associated with patient preferences. We explored the possible role of a perceived communication need in influencing interest in self-management support.Methods-Telephone survey of a random sample of 796 English and Spanish-speaking diabetes patients (esponse rate 47%) recruited from 4 urban US public hospital systems. In multivariate models, we measured the association of race/ ethnicity, primary language, self-reported health literacy, self-efficacy, and diabetes-related factors on patients' interest in three self-management support strategies (telephone support, group medical visits, and internet -based support). We explored the extent to which patients believed that better communication with providers would improve their diabetes control, and whether this perception altered the relationship between patient factors and selfmanagement support acceptance. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. CI 0.33-0.93). African-Americans were more interested than Whites in all 3 self-management support strategies. Patients with limited self-reported health literacy were more likely to be interested in telephone support than those not reporting literacy deficits. Forty percent reported that their diabetes would be better controlled if they communicated better with their health care provider. This perceived communication benefit was independently associated with interest in self-management support (p<0.001), but its inclusion in models did not alter the strengths of the main associations between patient characteristics and self-management support preferences. NIH Public AccessConclusion-Many diabetes patients in safety-net settings report an interest in receiving selfmanagement support, but preferences for modes of delivery of self-management support vary by race/ethnicity, language proficiency, and self-reported health literacy.Practice Implications-Public health systems should consider offering a range of selfmanagement support services to meet the needs of their diverse patient populations. More broad dissemination and implementation of self-management support may help address the unmet need for better provider communication among diabetes patients in these settings.

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“…A number of modalities can be incorporated to achieve these activities, such as computer interactive software or tailored print materials, and telephone support can be used to efficiently accomplish intervention components. [45][46][47] These principles or guidelines can be integrated into most practices. The integration that will work best in a specific setting is probably best determined through a series of rapid cycle improvement tests (mini studies where new conditions and strategies are completed with a few patients and compared with standard care).…”

Section: Recommended Assessment and Brief Intervention Activitiesmentioning

confidence: 99%

Physical Activity Promotion Through Primary Care

Estabrooks

Glasgow

Dzewaltowski³

2003

JAMA

143

119

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Making a Difference With Interactive Technology: Considerations in Using and Evaluating Computerized Aids for Diabetes Self-Management Education

Cited by 38 publications

References 21 publications

Randomized Effectiveness Trial of a Computer-Assisted Intervention to Improve Diabetes Care

Randomized Effectiveness Trial of a Computer-Assisted Intervention to Improve Diabetes Care

Preferences for self-management support: Findings from a survey of diabetes patients in safety-net health systems

Physical Activity Promotion Through Primary Care

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