Web-based Training of Peers to Deliver Diabetes Self-Management Support (DSMS)

摘要 本提案的具体目的是测试开发、利用和评估基于Web的 为非裔美国人量身定做的糖尿病自我管理支持(DSM)培训计划 社区。有效的自我管理是改善糖尿病预后、避免并发症以及 降低成本。在许多非洲国家中，持续的自我管理尤其具有挑战性。 美国人。糖尿病自我管理教育(DSME)是为了解决自我管理方面的这一关键差距而发展起来的 管理支持。当在文化上量身定做时，DSME在非裔美国人中可能特别有效 社区。然而，DSME的影响并不持久。持续的糖尿病自我管理支持 (Dsms)在DSME已被使用后，以维持DSME的积极效应。同行导师(训练有素的门外汉 成功管理自己的糖尿病的人)是一种负担得起的有效方式 DSM。同伴导师目前是面对面培训的，这极大地限制了能够 由于这类培训缺乏可扩充性，因此需要接受培训。因此，我们建议开发和评估一个 基于Web的DSM培训取代面对面培训的同行导师培训。 为实现第一阶段的具体目标，我们将开展四项工作： 任务1：组织焦点小组：我们将进行两个焦点小组，每组6名糖尿病患者 以及两个焦点小组，每个小组有6名糖尿病同伴导师。我们的目标是了解如何将 非洲裔美国人-将面对面的培训材料定制为有效的基于网络的计划。 任务2：为同行导师开发DSM培训计划原型：12个基于网络的电子学习模块 评估将基于唐等人开发并被证明有效的模块来创建。(2011)。 任务3：对24名受试者进行同伴培训效果评估。招聘30名糖尿病同伴导师候选人 完成基于网络的培训和评估；占20%的自然减员。要达到的培训标准： 超过80%的导师必须通过所有个人合格标准：1)&>80%的糖尿病 知识测试，糖尿病知识问卷80分，糖尿病知识问卷平均分4分 了解管理实践量表；(2)6个以赋权为基础的小插曲中的3个+2，至少+1个 关于剩下的3个小插曲；(3)自我效能感调查；(4)目标设定模拟及格；以及 A(5)积极倾听观察量表改编版的平均分&GT；4。 任务4.评估同行导师提供的DSM的可行性：一项双臂随机临床试验将 评估在非裔美国人DSME后使用经过网络培训的同行导师提供DSM的可行性 社区。可行性测试：我们预计HbA1c下降1%的差异将在6个月内持续。 第二阶段计划：为多个多元化群体开发一套类似的产品，并进行大型多臂 随机临床试验，以测试同行交付的DSM的有效性，以支持该产品的商业化。

ABSTRACT The Specific Aim of this proposal is to test the feasibility of developing, utilizing, and evaluating a web-based diabetes self-management support (DSMS) training program that is culturally tailored for the African American community. Effective self-management is the key to improving diabetes outcomes, avoiding complications, and reducing costs. Ongoing maintenance of self-management is particularly challenging among many African- Americans. Diabetes self-management education (DSME) was developed to address this critical gap in self- management support. When culturally tailored, DSME can be particularly effective in African American communities. However, the impact of DSME is not long lasting. Ongoing diabetes self-management support (DSMS) after DSME has been used to sustain the positive effects of DSME. Peer mentors (trained lay individuals successfully managing their own diabetes) are an affordable and effective means of delivering DSMS. Peer mentors are currently trained in-person, which greatly limits the number of peer mentors that can be trained due to lack of scalability of such training. Thus we propose the development and evaluation of a web-based DSMS training of peer mentors in lieu of in-person training. To achieve our Phase I Specific Aim, we will carry out four Tasks: Task 1: Conduct focus groups: We will conduct two focus groups with 6 uncontrolled diabetes patients each and two focus groups with 6 diabetes peer mentors each. The goal is to understand how to translate the African American-tailored in-person training material into an effective web-based program. Task 2: Develop DSMS Training Program Prototype for Peer Mentors: 12 web-based, e-Learning modules and assessments will be created based on the modules developed and proven effective by Tang et al. (2011). Task 3. Evaluate Peer Training Efficacy with 24 Subjects. Recruit 30 diabetes peer mentor candidates to complete the web-based training and evaluations; accounting for 20% attrition. Training Criteria to be Met: More than 80% of mentors must pass all of the individual passing criteria: 1) >80% score on the Diabetes Knowledge Test, >80% score on the Diabetes Knowledge Questionnaire, and mean score of >4 on the Understanding Management Practice scale; (2) +2 on 3 of the 6 empowerment-based vignettes and at least +1 on the remaining 3 vignettes; (3) >4 on Self-Efficacy Survey; (4) passing score in Goal-Setting Simulation; and a (5) mean score >4 on an adapted version of the Active Listening Observation Scale. Task 4. Evaluate Feasibility of DSMS Delivered by Peer Mentors: A two-arm randomized clinical trial will assess the feasibility of using web-trained peer mentors to deliver DSMS after DSME in the African American community. Test of Feasibility: We expect a 1% difference in HbA1c reduction to be sustained at 6 months. Phase II Plans: Develop a set of similar products for multiple diversity groups and conduct a large multi-arm randomized clinical trial to test efficacy of peer-delivered DSMS to support commercialization of the product.