The D-Net diabetes self-management program: long-term implementation, outcomes, and generalization results

Glasgow, Russell E.; Boles, Shawn M.; McKay, H Garth; Feil, Edward G.; Barrera, Manuel

doi:10.1016/s0091-7435(02)00056-7

Cited by 242 publications

(274 citation statements)

References 49 publications

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“…In comparison, a similar approach using touch-screen computers in waiting rooms focused on dietary barriers had no effect on A1C or weight (31). Another randomized trial was conducted using tailored diabetes self-management training and support delivered via the Internet (14,32). This study demonstrated no significant change in A1C, though the intervention targeted exercise behavior and not glycemic control.…”

Section: Subject Feedback On Computer Usementioning

confidence: 96%

“…Prior research (12,13) designed to improve diabetes self-management often have not been generalizable beyond local environments. Well-controlled trials frequently included selected motivated subjects and did not adequately address lack of system resources, alterations in clinical flow, and clinical staff having competing obligations (14). In this study, subjects and clinical staff identified key considerations important for adopting computer-based learning in the clinical environment.…”

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confidence: 99%

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Implementation and Evaluation of a Low-Literacy Diabetes Education Computer Multimedia Application

et al. 2005

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OBJECTIVE -To evaluate a clinic-based multimedia intervention for diabetes education targeting individuals with low health literacy levels in a diverse population.RESEARCH DESIGN AND METHODS -Five public clinics in Chicago, Illinois, participated in the study with computer kiosks installed in waiting room areas. Two hundred forty-four subjects with diabetes were randomized to receive either supplemental computer multimedia use (intervention) or standard of care only (control). The intervention includes audio/video sequences to communicate information, provide psychological support, and promote diabetes self-management skills without extensive text or complex navigation. HbA 1c (A1C), BMI, blood pressure, diabetes knowledge, self-efficacy, self-reported medical care, and perceived susceptibility of complications were evaluated at baseline and 1 year. Computer usage patterns and implementation barriers were also examined.RESULTS -Complete 1-year data were available for 183 subjects (75%). Overall, there were no significant differences in change in A1C, weight, blood pressure, knowledge, self-efficacy, or self-reported medical care between intervention and control groups. However, there was an increase in perceived susceptibility to diabetes complications in the intervention group. This effect was greatest among subjects with lower health literacy. Within the intervention group, time spent on the computer was greater for subjects with higher health literacy.CONCLUSIONS -Access to multimedia lessons resulted in an increase in perceived susceptibility to diabetes complications, particularly in subjects with lower health literacy. Despite measures to improve informational access for individuals with lower health literacy, there was relatively less use of the computer among these participants. Diabetes Care 28:1574 -1580, 2005T here is a growing awareness of the impact of low health literacy on diabetes (1,2). Low health literacy poses a major barrier to education and self-management (3). Health literacy directly impacts health outcomes, such as hospitalization risk, particularly in those with chronic diseases (4,5). In one crosssectional study (5) measuring the health literacy level of type 2 diabetic patients, patients with inadequate health literacy were less likely than those with adequate health literacy to achieve tight glycemic control. However, there is limited data from longitudinal studies regarding the impact of health literacy on changes in clinical outcomes over time (2).Despite increasing concern about the impact of low health literacy on diabetes care, there are few proven interventions available that address low health literacy (6). Recent evidence (6,7) suggests that diabetes education improves selfmanagement and glycemic control in those with limited health literacy. Simultaneously, clinicians are faced with less time and resources for disseminating information. Regular attendance in diabetes education classes is disappointingly low, particularly for those with lower socioeconomic status and those who...

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Section: Subject Feedback On Computer Usementioning

confidence: 96%

mentioning

confidence: 99%

Implementation and Evaluation of a Low-Literacy Diabetes Education Computer Multimedia Application

et al. 2005

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“…Physicians, including urologists, who are knowledgeable about e-health will be wellpositioned to guide their patients to relevant websites. 16,18,19 There are limitations to our study. Our patient population is small, with a patient base from a single urologist.…”

Section: Discussionmentioning

confidence: 90%

“…16 Future studies will examine ways to make the Internet more attractive and accessible to all. A study to assess the relevance of electronic-health (e-health) in their practice among urologists in rural areas could be performed.…”

Section: Discussionmentioning

confidence: 99%

Patterns of computer and Internet usage among urology patients in two rural Northern Ontario communities

Abara

Narushima

Abara³

2013

CUAJ

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Introduction: We wanted to determine if the Internet can be used as a potential health promotion tool among urology patients in Northern Ontario. We identified patients' computer and Internet access and use patterns in Kirkland Lake and Kapuskasing, Ontario. Materials and Methods:This study was reviewed and approved by the ethics boards of the Kapuskasing and Kirkland Lake hospitals and Brock University. Data were collected by hand-written questionnaires in English and French. We performed a descriptive analysis of the data obtained. Results:Out of the 137 questionnaires distributed and collected, we achieved a 95% response rate (7 questionnaires were incomplete). There were 67 men (52 %) and 63 women (48%) ranging in age from 24 to 84 (mean 56). Languages spoken were English (57%), French (38%) and other (5%). We divided the responses into 3 groups: non-Internet users, those with a computer but no Internet access and Internet users. Internet and non-Internet users were studied. Our results indicated that younger respondents, those with higher education and higher paying jobs, used the computer and Internet more often. The main reason behind their Internet was to seek health information for themselves, family and friends. Conclusion:About half of the respondents (55%) used the Internet to access health information. Patients' reactions toward online communication with their family physician were mixed. One limitation of this study is the small sample size, which inhibits making far-reaching conclusions. Our results demonstrate that individual empowerment, access to health information and access to services via emerging technologies are important issues for urology patients in rural Northern Ontario.

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“…Fell et al (2000) found that younger diabetic patients showed increased interest in interactive Internet interventions, but older patients increased participation only when barriers to access were addressed. Glasgow et al (2003) The use of the Internet by patients is also challenging the basis of the patient-physician relationship. There are studies suggesting that some physicians may react negatively to the demands of patients that use the Internet as a source of information and education (Broom, 2005).…”

Section: Background and Significancementioning

confidence: 99%

The Impact of ICT on Health Promotion: A Randomized Experiment with Diabetic Patients

Balsa

Gandelman

2010

SSRN Journal

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Standard-Nutzungsbedingungen:Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden.Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen.Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. Abstract * This paper summarizes randomized experiment to study the effects of an Internetbased intervention on type 2 diabetes patients in Montevideo, Uruguay. The intervention consisted of a specially designed website and an electronic social network where participants were able to navigate freely, download materials, and interact with other diabetics and with specialists. No significant impact was found on participants' knowledge, behavior, or health outcomes. It was also found that only a minority of patients logged on to the website, and most were only reached by email and mobile text (SMS). Participation in the website is correlated with patients' characteristics, such as gender, marital status, and education. Terms of use: Documents inJEL classifications: I1, O31, C93

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The D-Net diabetes self-management program: long-term implementation, outcomes, and generalization results

Cited by 242 publications

References 49 publications

Implementation and Evaluation of a Low-Literacy Diabetes Education Computer Multimedia Application

Implementation and Evaluation of a Low-Literacy Diabetes Education Computer Multimedia Application

Patterns of computer and Internet usage among urology patients in two rural Northern Ontario communities

The Impact of ICT on Health Promotion: A Randomized Experiment with Diabetic Patients

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