Novel Interventions to Increase Uptake of Diabetes Self-Management Support Training within Primary Care

摘要 糖尿病患者的生活可能是具有挑战性的，但糖尿病自我管理教育和支持(DSMES) 众所周知，它可以帮助糖尿病患者(PWDM)学习应对糖尿病患者生活中的不确定性。 不幸的是，在当前的医疗保健环境中，DSMES没有得到充分利用。这是一个多因素的问题 最大的两个问题是没有转介患者的提供者和没有参加DSMES计划的患者。 这些计划和支持这些计划的医护人员有可能改变这种疾病 许多PWDM的病程，包括潜在地改变长期发病率和死亡率。我们正在提议一项 可行性研究，以测试向医疗保健提供者提供的最佳实践建议(BPA)的影响 糖尿病护理和教育专家通过电子健康记录确定PWDM为 符合参加DSMES的资格。我们将确定BPA是否会影响转诊至DSMES的时间以及 预测患者是否被转介到DSMES的因素。我们还建议评估同龄人的影响 支持鼓励PWDM参加DSMES并做出更健康的生活方式选择。我们假设如果 PWDM能够与同样患有糖尿病的同龄人联系，他们可能更有可能参加 DSSMES。最后，我们将定性地评估医疗保健提供者对BPA的使用感觉如何 提醒，探索PWDM如何看待同龄人支持者的效用，以及 他们接受了糖尿病教育。从这些经验教训中，我们将与我们的利益相关者合作，设计一个 大型、务实的随机试验，旨在增加糖尿病的关键部分--丹参酮的摄取 拼图。

Abstract Living with diabetes can be challenging, however Diabetes Self-Management Education and Support (DSMES) is well known to help persons with diabetes (PWDM) learn to cope with the uncertainties of life with diabetes. Unfortunately, DSMES is underutilized in the current health care setting. This is a multifactorial problem with the two largest issues being providers not referring patients and patients not attending the DSMES programs. These programs and the health care workers who support them have the potential to modify the disease course for many PWDM, including potentially modifying long term morbidity and mortality. We are proposing a feasibility study to test the impact of best practice advisories (BPAs) delivered to the health care provider and the diabetes care and education specialists via the electronic health record when a PWDM is identified as qualifying for DSMES. We will determine if the BPAs influence the time to referral for DSMES as well as the factors that predict whether a patient is referred to DSMES. We also propose to assess the impact of a peer support on motivating PWDM to attend DSMES and make healthier lifestyle choices. We hypothesize that if PWDM are able to connect with a peer who is also living with diabetes, they may be more likely to attend DSMES. Finally, we will assess qualitatively how the health care providers felt about the use of the BPA reminders, explore how the PWDM felt about the utility of the peer supporters, and the overall relevance of the diabetes education they received. From these lessons learned we will work with our stakeholders to design a large, pragmatic randomized trial designed to increase the uptake of DSMES, a vital piece of the diabetes puzzle.