Improving Access to Quality Diabetes Education in a Rural State

Abstract

Purpose

Diabetes self-management education (DSME) is an integral component of diabetes care; however, skilled educators and recognized programs are not uniformly available in rural communities.

Methods

To increase access to quality DSME, the Montana Diabetes Control Program and the Montana chapter of the American Association of Diabetes Educators developed a mentoring program with 3 levels: basic, intermediate, and advanced. All participants were assisted by a volunteer certified diabetes educator (CDE) mentor. In addition, the program provided technical support for recognition through the American Diabetes Association and the Indian Health Service.

Results

From 2000 to 2005, 90 individuals participated; 76% were nurses and 21% dietitians. Twenty-seven of the 90 enrollees (30%) completed their structured option, and 13 achieved CDE certification. Most provided services in frontier counties (66%). Statewide, the number of CDEs in Montana increased 46% from 52 in 2000 to 76 in 2005. Twenty-five of the 30 facilities that received technical assistance achieved recognition. Statewide, the number of recognized education programs increased from 2 in 2000 to 22 in 2005. Twelve (55%) of these programs were located in frontier counties.

Conclusions

Mentoring and technical support is an effective method to increase personnel skills for DSME and to increase access to quality education programs in rural areas.

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References

Task Force for Community Preventive Services

. Recommendations for healthcare system and self-management education interventions to reduce morbidity and mortality from diabetes. Am J Prev Med. 2002;22(4 suppl): 10-14.

Balamurgan A

Rivera M

Jack L Jr

Allen K.

Barriers to diabetes self-management education programs in underserved rural Arkansas: implications for program evaluation. Prev Chronic Dis. 2006;3: A15-A15.

Coon P

Zulkowski K.

Adherence to American Diabetes Association standards of care by rural health care providers. Diabetes Care. 2002;25: 2224-2229.

Powell MP

Glover SH

Probst JC

Laditka SB.

Barriers associated with the delivery of Medicare-reimbursed diabetes self-management education. Diabetes Educ. 2005;31: 890-898.

Rosenblatt RA

Baldwin LM

Chen L

et al.

Improving the quality of outpatient care for older patients with diabetes: lessons from a comparison of rural and urban communities. J Fam Pract. 2001;50: 678-680.

Marynluk MD

Bronzini BM

Lorenzi GM.

Quality diabetes self-management education: achieving and maintaining ADA education program recognition. Diabetes Educ. 2004;30: 467-475.

US Department of Commerce

. Census 2000 Summary File (SF 1). Washington, DC: US Department of Commerce, Economic and Statistics Administration, Bureau of the Census; 2000.

Eberhardt MS

Ingram DD

Makuc DM

et al.

Urban and rural health chartbook. Health, United States, 2001. Hyattsville, Md: National Center for Health Statistics, Centers for Disease Control and Prevention, Department of Public Health and Human Services; 2001. Publication No. (PHS) 01-1232-1.

Health Care Financing Administration

. Program memorandum carriers: expanded coverage of diabetes outpatient self-management training. Washington DC: Department of Health and Human Services; 2001.

10.

Johnson EA

Webb WL

McDowall JM

et al.

A field-based approach to support improved diabetes care in rural states. Prev Chronic Dis. 2005;2(4): A08-A08.

11.

Mensing C

Boucher J

Cypress M

et al.

National standards for diabetes self-management education. Diabetes Care. 2005;28(suppl 1): S72-S79.