Technology-Intensified Diabetes Education/Skills Intervention in AAs with DM-2

描述（由申请人提供）：与美国白人相比，非洲裔美国人（AA）患有2型糖尿病（T2DM），糖尿病患病率较高，代谢控制较差，并发症和死亡风险较高。自我管理干预，包括糖尿病教育和技能培训，在改善糖尿病代谢控制方面是有效的。最近的研究结果表明，糖尿病患者，特别是少数民族患者，更喜欢电话授课的糖尿病教育，而不是团体访问或网络教育。我们小组的初步数据表明，针对不同文化背景的电话糖尿病教育和技能培训干预是改善AA合并T2DM患者代谢控制的有效策略。电话联络、视频会议、pda和基于网络的系统的使用为糖尿病患者与卫生保健提供者面对面访问之间的支持鸿沟提供了新的机会。FORA系统是一种廉价的，现成的，

DESCRIPTION (provided by applicant): African Americans (AA) with Type 2 diabetes (T2DM) have higher prevalence of diabetes, poorer metabolic control and greater risk for complications and death compared to White Americans. Self-management interventions that include diabetes education and skills training are effective at improving metabolic control in diabetes. Recent findings indicate that patients with diabetes, especially ethnic minority patients, prefer telephone-delivered diabetes education to group visits or internet-based education. Preliminary data from our group suggest that a culturally-tailored telephone-delivered diabetes education and skills training intervention is an effective strategy to improve metabolic control in AA patients with T2DM. Use of telephone contact, video- conferencing, PDAs and web-based systems offer new opportunities to bridge the gap in support for diabetic patients between face to face visits with their health care providers. The FORA system is an inexpensive, off- the-shelf, state-of-the-art technology whereby a person/caregiver and a provider can communicate accurately on data needed for self-management of diabetes. The system is comprised of an easy to operate 2-in-1 Blood Glucose and Blood Pressure monitor that uploads results to a secure website via a modem. The provider (in this case a diabetes educator) can review the glucose and blood pressure readings weekly and use the data to tailor diabetes education and self-care skills training using motivational enhancement techniques to achieve optimal metabolic control. However, no large RCT has tested whether providing feedback to patients using novel technology like the FORA 2-in-1 Blood Glucose and Blood Pressure monitor leads to improvements in glycemic and blood pressure control or whether using the feedback to tailor and augment diabetes education and skills training are effective at improving metabolic control. We propose a randomized controlled study to test the efficacy of a technology-intensified diabetes education/skills training (TIDES) intervention using the FORA system in AAs with poorly controlled T2DM. The long-term goal of the project is to identify effective strategies to improve metabolic control and hence reduce diabetes complication and mortality rates in AAs with T2DM.