Nurse Faculty Scholars - Diabetes

An Overview of the Genomics of Metabolic Syndrome

kdeming — Tue, 26 Mar 2013 16:23:38 +0000

Published Date:

Sat, 2012-09-08 (All day)

This article provides a brief overview of the diagnostic criteria and genomic risk factors for the components of metabolic syndrome (MetS).

Purpose: This article provides a brief overview of the diagnostic criteria and genomic risk factors for the components of metabolic syndrome (MetS).

Organizing Constructs: Contributions of cardiovascular, obesity, and diabetes genomic risk factors to the development of MetS as reported in the literature have been reviewed.

Low Health Literacy: Overview, Assessment, and Steps Toward Providing High-Quality Diabetes Care

lsharp — Fri, 17 Dec 2010 14:36:51 +0000

Published Date:

Wed, 2010-12-01 (All day)

Although hypotheses about the link between literacy and health outcomes were published in the 1980s,1 the potential consequences of limited literacy in U.S. health care settings was brought to the attention of the larger clinical and health policy communities by a study published in 1995. In this landmark study, researchers revealed dramatic statistics: up to two-thirds of patients seen in public hospitals in the United States were unable to comprehend key health information such as how to take a medication or schedule a follow-up appointment.2 Hundreds of studies have since explored how patients' ability to read and comprehend the written information encountered in health care settings is independently associated with a variety of poorer health outcomes.

Because low literacy is more common among vulnerable populations (racial and ethnic minorities, elderly people, patients with chronic conditions, and those seeking care in public systems), it likely contributes to the disproportionate burden of disease-related problems among disadvantaged and vulnerable populations.3 In fact, when literacy is considered, the role of race in health disparities decreases dramatically.4,5

With an estimated 40% of adults in the United States having less-than-functional literacy,6 addressing health literacy has moved to the forefront of several policy agendas aimed at improving health care quality and outcomes.

Goal setting in diabetes self-management: taking the baby steps to success.

nfs — Tue, 28 Sep 2010 14:21:25 +0000

Published Date:

Sun, 2009-11-01 (All day)

OBJECTIVE: To evaluate the usefulness of a diabetes self-management guide and a brief counseling intervention in helping patients set and achieve their behavioral goals.

METHODS: We conducted a quasi-experimental study using a one group pretest posttest design to assess the effectiveness of a goal setting intervention along with a self-management guide. English- and Spanish-speaking patients with diabetes had one in-person session and two telephone follow-up calls with a non-clinical provider over a 12-16-week period. At each call and at the end of the study, we assessed success in achieving behavioral goals and problem solving toward those goals. Satisfaction with the self-management guide was assessed at the end of the study.

RESULTS: We enrolled 250 patients across three sites and 229 patients completed the study. Most patients chose to set goals in diet and exercise domains. 93% of patients achieved at least one behavioral goal during the study and 73% achieved at least two behavioral goals. Many patients exhibited problem solving behavior to achieve their goals. We found no significant differences in reported achievement of behavior goals by literacy or language. Patients were very satisfied with the guide.

CONCLUSIONS: A brief goal setting intervention along with a diabetes self-management guide helped patients set and achieve healthy behavioral goals.

PRACTICE IMPLICATIONS: Non-clinical providers can successfully help a diverse range of patients with diabetes set and achieve behavioral goals.

OBJECTIVE: To evaluate the usefulness of a diabetes self-management guide and a brief counseling intervention in helping patients set and achieve their behavioral goals.

Design, Feasibility, and Acceptability of an Intervention Using Personal Digital Assistant-based Self-monitoring in Managing Type 2 Diabetes

nfs — Wed, 26 Aug 2009 16:29:49 +0000

Published Date:

Wed, 2008-04-30 (All day)

BACKGROUND: The information processing demands associated with behavioral self-management of diabetes are extensive. Pairing personal digital assistant (PDA)-based self-monitoring with a behavioral self-management intervention may improve adherence and patient outcomes. METHODS: ENHANCE is a randomized controlled trial to test an intervention designed to improve regimen adherence in adults with type 2 diabetes. The intervention, based on Social Cognitive Theory (SCT), is paired with PDA-based self-monitoring. In this paper we describe the: (a) manner in which PDA-based self-monitoring is integrated within the SCT-based intervention, (b) feasibility and acceptability of PDA-based dietary self-monitoring, and (c) issues encountered in teaching participants to self-monitor using a PDA. RESULTS: During the first 30 months of this 5-year study, 232 participants were screened and 151 were randomized. To date, 6 cohorts have completed the study. The retention rate is 85% (n=129). Of those randomized to the intervention (n=74) and completing the study (n=61), 88% reported understanding the usefulness of PDA-monitoring, 85% reported ease in entering foods into the device, 70% reported ease in interpreting feedback graphs, and 82% indicated that they would continue to use the PDA for self-monitoring after the study concluded. Assuming 3 meals per day, participants entered an average of 58% of their meals in their PDA, and 43% were entered assuming 4 meals per day. If we eliminate from the analysis those individuals who entered less than 10% of their expected meals (n=12), the average rate of self-monitoring was 69% assuming 3 meals per day, and 52% assuming 4 meals per day. CONCLUSIONS: PDA-based dietary monitoring is perceived by participants to be useful and acceptable. The approach used to instruct participants in use of the PDA and lessons learned are discussed. PDA technology shows promise as a tool for assisting those with type 2 diabetes in their efforts to manage their disease.