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

描述(申请人提供)：与美国白人相比，患有2型糖尿病(T2 DM)的非裔美国人(AA)的糖尿病患病率更高，代谢控制更差，并发症和死亡的风险更大。包括糖尿病教育和技能培训在内的自我管理干预措施有效地改善了糖尿病患者的代谢控制。最近的研究结果表明，糖尿病患者，特别是少数民族患者，更喜欢通过电话进行糖尿病教育，而不是小组访问或基于互联网的教育。来自我们小组的初步数据表明，根据文化定制的电话糖尿病教育和技能培训干预是改善患有T2 DM的AA患者代谢控制的有效策略。电话联系、视频会议、个人数字助理和基于网络的系统的使用提供了新的机会，以弥合与卫生保健提供者面对面访问之间在支持糖尿病患者方面的差距。Fora系统是一种价格低廉、现成的 最先进的技术，通过该技术，个人/护理人员和提供者可以就糖尿病自我管理所需的数据进行准确的沟通。该系统由一个易于操作的二合一血糖和血压监测仪组成，该监测仪通过调制解调器将结果上传到安全的网站。提供者(在这种情况下是糖尿病教育者)可以每周查看血糖和血压读数，并使用这些数据来定制糖尿病教育和自我护理技能培训，使用激励增强技术来实现最佳代谢控制。然而，没有大型随机对照试验测试过，使用新技术(如FORA2合1血糖和血压监测仪)向患者提供反馈是否会改善血糖和血压控制，或者使用反馈来量身定制和加强糖尿病教育和技能培训是否有效改善代谢控制。我们提出了一项随机对照研究，以测试使用FORA系统对控制不佳的2型糖尿病患者进行技术强化的糖尿病教育/技能训练(DEDS)干预的有效性。该项目的长期目标是确定有效的战略，以改善代谢控制，从而减少糖尿病并发症和2型糖尿病患者的死亡率。

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.