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

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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.