Internet Diabetes Self Management Evaluation

描述（由申请人提供）： 这项拟议的研究将把基于证据的小组糖尿病教育翻译到互联网上，并评估其有用性。这项研究涉及700名2型糖尿病患者，分为三组。研究参与者将被随机分配到1）常规护理，2）为期六周的互动糖尿病自我管理计划（IDSMP），无强化，或3）IDSMP与电子邮件讨论小组强化。这将产生一个由两个随机试验组成的研究设计，每个试验持续两年，成本效益分析，以及一个探索性研究，以确定成功的调解人和调解人。 该研究有四个目标：1）在两年的随机对照试验中开发、实施和评估互联网糖尿病自我管理程序（IDSMP）与常规护理对照，2）在两年的随机试验中比较有和没有电子邮件讨论组强化的IDSMP的效果，3）进行IDSMP与常规护理相比的成本效益分析，4）在6个月和2年时，对IDSMP各部分的使用情况以及使用情况、行为变化、自我效能和患者特征的变化与干预效果（健康状况和卫生保健利用）的关系进行过程评估。评估影响的结果包括健康状况（健康相关的生活质量，总非HDL胆固醇指数，血红蛋白A1c）和医疗保健利用。 这项研究是一系列自我管理研究的延续，旨在帮助满足患者和医疗保健系统对有效、高效和相关的医疗服务的需求。2010年健康人计划的目标是让60%的糖尿病患者接受正规的糖尿病教育。目前，只有大约25%的2型糖尿病患者接受这样的教育。如果成功，这项研究将有助于实现2010年健康人群糖尿病教育的目标。

DESCRIPTION (provided by applicant): The proposed study will translate evidenced-based small-group diabetes education onto the Internet and evaluate its usefulness. This study, involving 700 people with type 2 diabetes, has three arms. Study participants will be randomized to 1) usual care, 2) a six-week Interact Diabetes Self Management Program (IDSMP) without reinforcement, or 3) the IDSMP with e-mail discussing group reinforcement. This will yield a research design consisting of two randomized trials, each lasting two years, cost benefit analyses, and an exploratory study to determine mediators and moderators of success. The study has four aims to: 1) develop, implement and evaluate in a two-year randomized controlled trial an Internet Diabetes Self-Management Program (IDSMP) versus usual care controls), 2) compare in a two-year randomized trial the effects of the IDSMP with and without e-mail discussion group reinforcement, 3) conduct cost benefit analysis of the IDSMP compared to usual care, and the IDSMP without reinforcement and with reinforcement, 4) conduct a process evaluation of the use of the sections of the IDSMP and how usage, changes in behaviors, changes in self-efficacy and patient characteristics, are associated with intervention effects (health status and health care utilization) at six months and two years. Outcomes for evaluating impact include health status (health related quality of life, total non-HDL cholesterol index, hemoglobin A1c) and health care utilization. This study is the continuation of a series of self-management studies to assist in meeting the needs of both patients and the health care system for health services that are effective, efficient and relevant. Healthy People 2010 has set an objective of having sixty percent of all people with diabetes receive formal diabetes education. At the present time only about twenty-five percent of people with type 2 diabetes receive such education. If successful, this study will help achieve the Healthy People 2010 objective for diabetes education.