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

描述（由申请人提供）：与白色美国人相比，患有2型糖尿病（T2 DM）的非洲裔美国人（AA）的糖尿病患病率更高，代谢控制较差，并发症和死亡风险更大。包括糖尿病教育和技能培训在内的自我管理干预措施可有效改善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，更喜欢电话提供的糖尿病教育，以小组访问或基于互联网的教育。我们小组的初步数据表明，文化定制的电话提供的糖尿病教育和技能培训干预是一种有效的策略，以改善AA患者的T2 DM代谢控制。电话联系、视频会议、PDA和基于网络的系统的使用提供了新的机会，以弥合糖尿病患者与其医疗保健提供者面对面访问之间的支持差距。FORA系统是一种便宜的，现成的， 个人/护理者和提供者可以准确地就糖尿病自我管理所需的数据进行通信的最新技术。该系统由一个易于操作的2合1血糖和血压监测仪组成，可通过调制解调器将结果上传到安全网站。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是否提供反馈给患者使用新技术，如FORA 2合1血糖和血压监测仪导致血糖和血压控制的改善，或是否使用反馈来定制和加强糖尿病教育和技能培训是有效的改善代谢控制。我们提出了一项随机对照研究，以测试技术强化的糖尿病教育/技能培训（TIDES）干预的有效性，使用FORA系统在AA与控制不佳的T2 DM。该项目的长期目标是确定有效的策略，以改善代谢控制，从而降低T2 DM AA患者的糖尿病并发症和死亡率。

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.