Internet Diabetes Self Management Evaluation

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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.