Intervention to Enhance Numeracy in Diabetes (IntEND)
Condition: Diabetes
MeSH terms: Diabetes Mellitus
Study type: Interventional

Summary: 
      The objective of this project is to test two interventions designed to improve
      diabetes-related numeracy. Numeracy is the ability to understand and use numbers. People with
      diabetes use numbers in a variety of ways in managing their condition (e.g., understanding
      blood sugar values, counting carbohydrates, taking medications at the right dose and time).
      As part of this project, the investigators developed and pilot tested two interventions to
      improve diabetes-related numeracy: (1) a series of in-person education classes and (2) a
      one-time, online diabetes education class. The investigators will look to see whether
      participants in the education classes show improvements in their diabetes-related numeracy
      skills, self-care behavior and attitudes, and clinical outcomes (i.e., body mass index, blood
      pressure, blood sugar [A1c]).
    

Detailed description: 
      Sixty-five American Indians with diabetes were enrolled. Each participant was randomly
      assigned to 1 of 3 study arms: (1) the in-person education group, (2) the online education
      group, and (3) a control group. The in-person intervention group attended four class sessions
      addressing numeracy skills used in the management of diabetes (e.g., counting carbohydrates).
      The online education group completed a single online module providing training on
      diabetes-related numeracy skills. The control group received written diabetes educational
      materials. The investigators collected data at baseline, then again immediately after
      intervention participation (in-person or online classes), and one final time about three
      months after the conclusion of the intervention. The investigators will conduct analyses to
      determine if intervention participants experienced positive changes in diabetes numeracy (the
      primary outcome) as well as several secondary outcome measures following intervention.
      Secondary outcomes include: diabetes knowledge, self-efficacy, outcome expectancies,
      readiness to change, self-care behavior, and clinical outcomes (i.e., body mass index, blood
      pressure, blood sugar [A1c]) . The investigators also will assess whether change in numeracy
      predicts change in these secondary outcomes.
    

Intervention name(s): In-Person Diabetes Numeracy Education; Online Diabetes Numeracy Education
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Participants randomized to the in-person education group attended four group classes, each addressing a specific set of diabetes self-care skills (i.e., understanding and using blood glucose numbers, counting carbohydrates, taking medications at the right dose and time). So that each class included a stable group of 8 and 16 participants, we ran classes in "cohorts" of 8-16 people. A participant always attended classes with his/her cohort.; Participants randomized to the online education group attended a single session, at which he/she completed a computerized education module that addressed understanding blood sugar values and using them to examine the impact of food, exercise, and medicines on blood sugar.
Other intervention name(s): Intervention to Enhance Numeracy in Diabetes (IntEND); Electronic Diabetes Numeracy Intervention (e-DNI)
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: numeracy; health literacy