bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Diabetes Management Program for African American Women With Type 2 Diabetes
Authors: Keyserllng Thomas C. , Ammerman Alice S. , Samuel-Hodge Carmen D. , Ingram Allyson F. , Skelly Anne H. , Elasy Tom A. , Johnston Larry F. , Cole Anne S. , Henriquez-Rolddn Carlos F. 
Published: April 2008

PURPOSE this paper describes a clinic and community-based diabetes intervention program designed to improve dietary, physical activity, and self-care behaviors of older African American women with type 2 diabetes. It also describes the study to evaluate this program and baseline characteristics of participants. METHODS The New Leaf... Choices for Healthy Living With Diabetes program consists of 4 clinic-based health counselor visits, a community intervention with 12 monthly phone calls from peer counselors, and 3 group sessions. A randomized, controlled trial to evaluate the effectiveness of this intervention is described. RESULTS Seventeen focus groups of African American women were used to assessed the cultural relevance/acceptability of the intervention and measurement instruments. For the randomized trial, 200 African American women with type 2 diabetes were recruited from 7 practices in central North Carolina. Mean age was 59, mean diabetes duration was 10 years, and participants were markedly overweight and physically inactive. CONCLUSIONS Participants found this program to be culturally relevant and acceptable. Its effects on diet, physical activity, and self-care behaviors will be assessed in a randomized trial.
Who Participates in Internet-Based Self-Management Programs? A Study Among Novice Computer Users in a Primary Care Setting
Authors: Fell Edward G. , Glasgow Russell E. , Boles Shawn , McKay H. Garth 
Published: April 2008

PURPOSE the purpose of this study was to evaluate the participation rates and factors associated with nonparticipation among primary care patients who were invited to join an Internet-based self-management research program. METHODS Primary care providers invited their patients with type 2 diabetes to participate in an Internet-based diabetes self-management support program. Research staff contacted these patients by phone to assess their eligibility and interest in participating. Reasons for declining were assessed and demographic/medical status information was collected. RESULTS Of the eligible patients, 60% participated in the program. No significant differences were found between participants and decliners in gender, insulin use, computer familiarity, or computer ownership. There were significant differences in age and years since diagnosis. Participants were slightly younger and had diabetes for a fewer number of years than nonparticipants. Nonparticipation was not related to computer or Internet issues. CONCLUSIONS Most older diabetes patients without previous Internet experience will-takepart in Internet-based self-managment support programs if barriers to participation are addressed.
An Integrative Literature Review of Cardiac Risk Factor Management in Diabetes Education Interventions
Authors: Lacey Kimberly O. , Chyun Deborah A. , Grey Margaret 
Published: April 2008

PURPOSE the purposes of this paper are to (1) review the literature on educational interventions for adults with type 2 diabetes; (2) determine what kinds of interventions have been studied; (3) identify which interventions have included cardiac risk factor management; (4) determine how effective these interventions have been on metabolic control, diabetes-related outcomes, and cardiovascular-related outcomes; and (5) make recommendations for further research on combined interventions designed to promote optimal diabetes and cardiac risk factor management in adults with type 2 diabetes. METHODS Using an integrative literature review approach, 64 studies on diabetes education interventions for adults with diabetes published between 1987 and 1998 were reviewed; 44 met these criteria. RESULTS Few studies included cardiac risk factor management, which should be an integral part of diabetes management. Most studies demonstrated a beneficial effect of education on the management of type 2 diabetes but not cardiovascular risk. CONCLUSIONS Identifying strategies that promote effective disease management for improved diabetes control and reduction of cardiac events in adults with diabetes is essential. Further intervention studies focusing on the combined management of diabetes and cardiac risk factors are warranted.
Using a Primary Nurse Manager to Implement DCCT Recommendations in a Large Pediatric Program
Authors: Ahern Jo Ann , Ramchandani Neesha , Cooper Jake , Himmel Allison , Silver David , Tamborlane William V. 
Published: April 2008

PURPOSE this study was conducted to determine whether recommendations from the Diabetes Control and Complications Trial (DCCT) could be implemented in a large pediatric population using a diabetes clinical nurse specialist program coordinator dedicated to intensive management. METHODS Patients' charts were reviewed to examine HbAic levels from before the results of the DCCT were published and again 1 year after the recommendations were implemented. Patients who met the following criteria (N=124) were enrolled: type 1 diabetes, less than 18 years old, followed at Yale for 1 year prior to the results of the DCCT and 1 year after, and HbA1c level recorded in the medical chart. RESULTS HbA1c levels were significantly lower 1 year after implementing the DCCT protocol; 3 years later these same patients improved even further as evidenced by another decrease in HbAlC levels. The patients were taking more insulin (more Ultralente and regular insulin and less NPH) and had an increased number of injections at both the 1-year and 3-year follow-up points. CONCLUSIONS The DCCT protocol can be implemented in a large population of pediatric patients with the help of a nurse who is dedicated and available to the patients for ongoing adjustments and provides creative ways to overcome the barriers to achieving normoglycemia.
Satisfaction With Automated Telephone Disease Management Calls and Its Relationship to Their Use
Authors: Plette John D. 
Published: April 2008

PURPOSE this paper reports the results of an assessment of automated telephone disease management (ATDM) among patients in 2 randomized trials evaluating ATDM as an adjunct to usual care. METHODS During the 12-month follow-up interview, 256 low-income adults with diabetes from the intervention groups of 2 randomized trials were asked to respond to questions about their satisfaction with the ATDM process. Variation in satisfaction was examined across groups, and satisfaction reports were correlated with the extent to which patients completed ATDM assessments and used them to report glycemic levels or access educational messages. RESULTS Overall, 85% of patients reported that they were satisfied with the ATDM calls, 82% reported that they would be more satisfied with their health care if such calls were available to patients, and 76% reported that they personally would choose to receive such calls in the future. Most patients reported few difficulties completing ATDM assessments and found the calls to be a useful adjunct to their care. Some, however, found the calls intrusive; 16% reported that the calls were a bother. CONCLUSIONS Patients were satisfied with ATDM calls as part of their diabetes care. Satisfaction played some part in determining patients' use of ATDM assessment and health education, although other barriers also contributed to less than optimal usage rates.
Development of a Theory-Based Daily Activity Intervention for Individuals With Type 2 Diabetes
Authors: Tudor-Locke Catrine E. , Myers Anita M. , Rodger N. Wilson 
Published: April 2008

PURPOSE This article describes a theory-driven approach to developing a physical activity intervention for sedentary individuals with type 2 diabetes. METHODS Development of the intervention was based on 6 essential elements of program theory: problem definition, critical inputs, mediating processes, expected outcomes, extraneous factors, and implementation issues. Each element was formulated based on available literature and in collaboration with both intended service deliverers (diabetes educators) and recipients (sedentary persons with type 2 diabetes). RESULTS Diabetes education requires a simple physical activity intervention template that is feasible, acceptable, and effective in a variety of settings. Successful programs are individualized, specific, flexible, and based on walking. Pedometers have potential as self-monitoring and feedback tools. The primary expected outcome is an increase in physical activity, specifically walking. Behavior modification and social support are critical to adoption and adherence. CONCLUSIONS Theory-driven interventions specify what works for whom and under what conditions of delivery. The underlying theoryguides the evaluation, refinement, and clinical replication of an intervention. Recruitment, delivery, and follow-up are realworld implementation issues.
A Community Diabetes Educator Course for the Unemployed in South Auckland, New Zealand
Authors: Tregonning Pamela B. , Simmons David , Fleming Carole 
Published: April 2008

PURPOSE This paper describes an education program that targeted long-term unemployed people from the community and trained them to work as diabetes educators in their own communities in an attempt to address issues of cultural appropriateness. METHODS Government funding was obtained to conduct two 22-week training courses for people who had been selected by their communities. These courses built on participants' existing cultural skills and provided appropriate diabetes training. RESULTS The results indicate that the courses were successful both in creating a cadre of culturally acceptable diabetes educators and providing employment for course participants. CONCLUSIONS Previously unemployed lay people are able to provide diabetes education in the primary prevention and group settings. Such individuals are able to incorporate extensive cultural skills in their work.
Dissemination of Diabetes Care Guidelines: Lessons Learned From Community Health Centers
Authors: Walker Elizabeth A. , Engel Samuel S. , Zybert Patricia A. 
Published: April 2008

PURPOSE This study was conducted to evaluate the impact of a provider problem-based learning (PBL) intervention on screening for complications of diabetes in community health centers. METHODS A successive sampling design was used to compare selected standards of diabetes care delivered preintervention with the care delivered postintervention at 2 community health centers and 1 comparison centers. Two randomly assigned intervention sites received a PBL intervention focused on care guidelines for prevention of diabetes complications, with telephone follow-up over 12 months. Effects of the intervention were determined from an audit of 200 charts from each site. RESULTS The odds of having a glycosylated hemoglobin test more than doubled from preintervention to postintervention, and the odds of having a foot examination more than tripled across centers. Measurement of creatinine and glycosylated hemoglobin were associated; the odds of having one test tripled when the other had been measured. Rates for documentation of patient education were significantly lower at the intervention site where free patient education booklets were distributed. CONCLUSIONS Improvements in diabetes care were not consistent among community health centers. Interventions involving system and policy changes may be more effective in implementing and sustaining improvements than just provider education.
Physician Assistant Students and Diabetes: Evaluation of Attitudes and Beliefs
Authors: Fisk Diane M. , Hayes Risa P. , Barnes Catherine S. , Cook Curtiss B. 
Published: April 2008

PURPOSE Physician assistants are assuming a greater role in patient care in the US health system. The objective of this study was to examine attitudes and beliefs about diabetes among physician assistant trainees. METHODS A survey of 3 currently enrolled classes of physician assistant students was conducted using the Diabetes Attitude Survey (DAS, version 3). An additional question was presented to gather information about the level of hyperglycemia at which students would intensify diabetes therapy. RESULTS On average, students scored high on all subscales, indicating general agreement with the attitudes examined by the DAS. For 3 subscales (seriousness of type 2 diabetes, value of tight glucose control, and patient autonomy), significant differences were seen across year of training. When asked about the level of glucose control at which they would advance therapy, a wide range of responses occurred, with some being out of target. CONCLUSIONS Physician assistant students had favorable attitudes regarding type 2 diabetes. However, deficits appear to exist in understanding when to advance therapy. More studies on physician assistant students' knowledge of diabetes standards of care are required.
Health-Compromising Behavior and Diabetes Mismanagement Among Adolescents and Young Adults With Diabetes
Authors: Hanna Kathleen M. , Guthrle Diana W. 
Published: April 2008

PURPOSE this study examined the relationship between health compromising behavior, age, gender, and diabetes mismanagement. METHODS A total of 107 adolescents and young adults, 12 to 24 years old, with type 1 diabetes were asked to complete a health-compromising behavior scale and a diabetes mismanagement scale. RESULTS Based upon participants' responses, the study population was divided into 2 different groups: those involved in health compromising behavior and those not involved in such behavior. A multiple regression analysis was performed using age, gender, and health-compromising behavior as predictor variables and diabetes mismanagement as the outcome variable. Variables that accounted for significant variance in diabetes mismanagement were being female and being involved in health-compromising behavior. CONCLUSIONS Adolescents and young adults with diabetes appear to be either involved or not involved in health-compromising behavior. Being female and being involved in health-compromising behavior were associated with diabetes mismanagement.
Training Lay Health Educators to Conduct a Church-Based Weight-Loss Program for African American Women
Authors: Quinn Michael T. , McNabb Wylie L. 
Published: April 2008

PURPOSE Community-based lay health educators have been utilized in a range of settings and with a variety of health issues. However, little has been published about the specifics of training lay health educators to effectively deliver community-based programs. This paper describes the training used to prepare volunteer, church-based lay health educators to conduct a community-based weight-loss program, and the evaluation of that training. METHODS After recruitment through their respective churches, volunteer lay health educators were given structured training in how to conduct the PATHWAYS weight-loss program. Program sessions were observed to monitor program delivery, and participation rates and weight loss were evaluated. RESULTS The lay health educators were highly consistent in their delivery of the program content. Participant attendance was high and virtually all of the participants completed the program. Participant weight loss averaged 8.3 pounds, which correlated with session attendance. CONCLUSIONS Given training appropriate to the structure of the program and specific to the targeted health behavior, lay health educators can reliably and effectively administer even rather complex programs.
Current Computer Use by Diabetes Educators
Authors: Lewls Deborah 
Published: April 2008

PURPOSE the purpose of this study was to ascertain diabetes educators' current use of computer technologies. METHODS The study population -consisted of 279 randomly selected certified diabetes educators, all of whom were members of the American Association of Diabetes Educators. Participants were asked to complete the Attitudes Toward Patient Education Technology instrument. RESULTS Descriptive findings showed that most educators (89.6%) have access to computers and use them primarily for word processing (43%). Nearly 30% of participants had never accessed the Internet, and no significant difference was noted when this variable was categorized by age. In addition, age and gender were not significant predictors of computer use, although age was significantly related to computer ownership. Patient access and organizational issues were the primary barriers to computer use in patient education. CONCLUSIONS These findings provide further understanding of diabetes educators' computer use and integration of computer technology in the patient education process.
Sequencing Diet and Exercise Programs for African American Women With Diabetes
Authors: Nothwehr Faryle K. , Guare John , Marrero David G. , Hoon Helena 
Published: April 2008

PURPOSE This study was designed to compare the effects of 2 programs that present diet and exercise components in a different sequence. METHODS At an urban YMCA, African American women with type 2 diabetes, aged 30 to 65, were randomly assigned to either 10 weekly sessions about healthy eating followed by 6 weekly sessions about exercise or to the reverse sequence. Sessions consisted of small group discussions and physical activity or food tasting. Primary outcomes were attendance, percent of calories consumed from fat, fruit and vegetable intake, and minutes of exercise per week. Measures were taken at baseline, and 4 and 12 months after the program. RESULTS The only group difference found at the 12-month follow-up was in diastolic blood pressure. Time effects for both groups combined included an increase in minutes of activity, an increase in vegetable intake, and a decrease in percent of calories consumed from fat. CONCLUSIONS This study does not provide definitive evidence of which sequence may be best to bring about behavior change. The effects of sequencing difficult behavioral changes such as diet modification and establishing an exercise habit deserve further study.
The Role of the Certified Diabetes Educator in Telephone Counseling
Authors: Hayes Joy T. , Boucher Jackie L. , Pronk Nicolaas P. , Qehling Eve , Spencer Mary , Waslaski Janelle 
Published: April 2008

PURPOSE this paper describes a telephone-based, outcomesfocused approach to diabetes education provided by certified diabetes educators (CDEs). METHODS Random chart audits were conducted to evaluate the scope of practice and effectiveness of telephone-based interventions provided by CDEs to people with diabetes. Four case studies and a sample prevention case are used to illustrate the role of telephone-based CDEs in providing diabetes education. RESULTS Counseling provided by CDEs helped to identify potential barriers and strategies for making lifestyle behavioral changes. CONCLUSIONS Telephone-based counseling is a brief, effective, ongoing intervention that gives patients with diabetes immediate access to CDEs who provide education to support lifestyle behavioral changes.
Patient Priorities and Needs for Diabetes Care Among Urban African American Adults
Authors: Batts Marian L. , Gary Tiffany L. , Huss Karen , Hill Martha N. , Bone Lee , Brancati Frederick L. 
Published: April 2008

PURPOSE this study was conducted to determine diabetes care priorities and needs in a group of urban African American adults with type 2 diabetes mellitus. METHODS One hundred nineteen African American adults with type 2 diabetes, aged 35 to 75, received behavioral/educational interventions from a nurse case manager, a community health worker, or both. Priorities and needs were assessed during 3 intervention visits. RESULTS The most frequently reported priorities for diabetes care were glucose self-monitoring (61%), medication adherence (47%), and healthy eating (36%). The most frequently addressed diabetes needs were glucose self-monitoring and medication adherence. Most of the intervention visits (77%) addressed nondiabetes-related health issues such as cardiovascular disease (36%) and social issues such as family responsibilities (30%). CONCLUSIONS Participants' self-reported priorities for diabetes care directly reflected the diabetes needs addressed. Needs beyond the focus of traditional diabetes care (social issues and insurance) are important to address in urban African Americans with type 2 diabetes. Interventions designed to address comprehensive health and social needs should be included in treatment and educational plans for this population.
Accuracy of Self-Monitoring of Blood Glucose: Impact on Diabetes Management Decisions During Pregnancy
Authors: Henry M. Joann , Major Carol A. , Reinsch Sibylle 
Published: April 2008

PURPOSE This study tested the hypothesis that the accuracy of self-monitoring of blood glucose (SMBG) values of patients with diabetes during pregnancy deviates substantially from reference values. METHODS The patients' glucose values were measured on 6 different SMBG meters; reference values were from the HemoCue B Glucose Analyzer. Over a 5-year period, 1973 comparisons between SMBG values and reference values were recorded during clinic visits and used for this study. Data were analyzed for percent of values that varied more than ±10.5% and ±15.5% from the reference value. Out-of-range data at each variance level were analyzed to determine the impact on medical management if decisions were based solely on SMBG values. RESULTS One third of SMBG readings deviated significantly, which could adversely affect treatment for half of these patients if diabetes management was based on SMBG values. At the 10.5% deviation level, 34% of SMBG meter readings were out of range; 54% of these would have implied erroneous treatment. At the 15.5% deviation level, 18% were out of range; 63% of these would have implied erroneous management. CONCLUSIONS The accuracy of home meters should be verified at regular intervals, and SMBG values should not be the sole criterion for diabetes management during pregnancy.
Tablet-Breaking Ability of Older Persons With Type 2 Diabetes Mellitus
Authors: Wilson Margaret-Mary G. , Kaiser Fran E. , Morley John E. 
Published: April 2008

PURPOSE the purpose of this study was to assess the ability of older persons with type 2 diabetes to accurately break in half 2 different formulations of micronized glyburide tablets. METHODS Thirty persons with type 2 diabetes, over age 70, were recruited from the St Louis University geriatric clinics. Participants were randomly assigned to 2 groups. Group A broke 30 Glynase Prestabs and 30 generic tablets using 2 different manual tablet-breaking methods. Group B broke 15 Glynase Prestabs and 15 generic tablets without instructions. Visual analog scales were used to assess pain and difficulty of tablet breaking. RESULTS A higher percentage of successful tablet breaking was reported with Glynase Prestabs (80%) compared with the generic tablets (33%). Mean pain scores for breaking Glynase Prestabs were 0.1 (Group A) and 0.9 (Group B). Higher pain scores were obtained for the generic tablets (2.1 for Group A, 3.2 for Group B). Glynase Prestabs were easier to break in both groups, and the resultant half tablets showed less variance from the expected theoretical weight (50% of whole parent tablet weight). CONCLUSIONS Older adults broke Glynase Prestabs more accurately and with less difficulty than generic micronized glyburide tablets. This variation in ease of tablet breaking and accuracy between different tablet formulations affect bioavailability and patient compliance.