DIABETES EDUCATION MULTIMEDIA FOR VULNERABLE POPULATIONS

对糖尿病患者进行有效的教育有多种障碍，特别是在服务不足的人群中。近年来，计算机技术在患者教育中的应用研究显示出巨大的潜力。然而，对于脆弱的患者在临床环境中使用计算机进行糖尿病教育仍然缺乏知识。这项为期3年的实验研究的主要目标是确定促进研究转化为实践的干预措施的有效性。为了帮助克服教育障碍，将创建一个新的交互式多媒体计算机应用程序，并对其进行评估，以提供糖尿病教育。我们的假设是，这个计算机程序的补充教育将改善糖尿病相关的知识、态度和自我效能，并增加对自我护理的依从性。为了验证这一假设，将根据焦点小组的结果开发一个具有文化敏感性的多媒体计算机程序，以加强糖尿病教育。此外，还将评估计算机程序在临床环境中的效果。为了创建多媒体计算机应用程序，描述自我护理问题的患者证词的视频记录将基于非裔美国人和拉丁裔焦点小组的分析。在此基础上，将根据罗伯特·加涅的学习理论和组件显示理论，开发出英语和西班牙语的软件应用程序。为了在实践中评估这一计划，将在芝加哥地区的多个诊所地点安装个人计算机。在随机对照试验中，临床地点被随机分成使用多媒体的试验组或接受当前标准护理的对照组。将进行患者调查，以评估知识、自我效能和自我护理。将获得糖化血红蛋白水平，以量化补充多媒体教育的临床效果。此外，还将评估患者和工作人员对计算机用于糖尿病教育的满意度。

There are multiple barriers to effective education of diabetic patients, especially in underserved populations. Recent research on the application of computer technology in patient education demonstrates great potential. However, there remains a lack of knowledge regarding the use of computers by vulnerable patients for diabetes education in a clinical setting. The main objective of this 3-year experimental study is to determine the effectiveness of an intervention that promotes translation of research into practice. To help overcome barriers to education, a new, interactive multimedia computer application will be created and evaluated to provide diabetes education. Our hypothesis is that supplemental education with this computer program will improve diabetes-related knowledge, attitudes, and self- efficacy as well as increase compliance with self-care. To test this hypothesis, a culturally sensitive multimedia computer program to enhance diabetes education will be developed based on focus group results. Also, the effects of the computer program in the clinical environment will be evaluated. To create the multimedia computer application, videorecords of patient testimonials describing self-care issues will be based on African- American and Latino focus group analyses. From this, a software application will be developed in English and Spanish following Robert Gagne's learning theories and Component Display Theory. To evaluate this program in practice, personal computers will be installed at multiple clinic sites in the Chicago area. In a randomized controlled trial, the clinic sites are randomized to either an experimental group with multimedia use or a control group, receiving the current standard of care. Patient surveys will be administered to assess knowledge, self-efficacy, and self-care. Glycosylated hemoglobin levels will be obtained to quantify the clinical effects of the supplemental multimedia education. Also, patient and staff satisfaction with computer usage for diabetes education will be evaluated.