School of Nursing, Columbia University Medical Center, New York, New York (Dr Heitkemper, Dr Smaldone).
Department of Biomedical Informatics, Columbia University Medical Center, New York, New York (Dr Mamykina).
Diabetes Educ. 2017 Dec;43(6):576-588. doi: 10.1177/0145721717737367. Epub 2017 Oct 23.
Purpose The purpose of this study is to describe the characteristics and technology training needs of underserved adults with type 2 diabetes mellitus (T2DM) who participated in a health information technology (HIT) diabetes self-management education (DSME) intervention. Methods The baseline physiological, psychosocial, and technology use characteristics for 220 adults with poorly controlled T2DM were evaluated. Intervention participants received a 1-time intervention training, which included basic technology help, introduction to the Mobile Diabetes Detective (MoDD) website and text message features, and account activation that included subject-specific tailoring. Four additional on-site sessions for participants needing computer or Internet access or technology support were made available based on need. Data regarding on-site visits for usual care were collected. Data were analyzed using descriptive statistics and bivariate analysis. Results The participants were predominately Hispanic and female with a baseline mean A1C of 10% (86 mmol/mol). Only half of the participants regularly used computers or text messages in daily life. The average introductory MoDD training session lasted 73.6 minutes. Following training, approximately one-third (35%) of intervention participants returned for basic and MoDD-specific technology assistance at their federally qualified health center. The most frequently reported duration for the extra training sessions was 30 to 45 minutes. Conclusions Training and support needs were greater than anticipated. Diabetes educators should assess technology abilities prior to implementing health information technology (HIT) diabetes self-management education (DSME) in underserved adults. Future research must invest resources in technology access, anticipate subject training, and develop new training approaches to ensure HIT DSME use and engagement.
目的 本研究旨在描述参与健康信息技术（HIT）糖尿病自我管理教育（DSME）干预的服务不足的 2 型糖尿病（T2DM）成年人的特点和技术培训需求。
方法 评估了 220 名血糖控制不佳的 T2DM 成年人的基线生理、心理社会和技术使用特征。干预参与者接受了一次性干预培训，其中包括基本技术帮助、移动糖尿病侦探（MoDD）网站和短信功能介绍以及包括特定主题定制的账户激活。根据需要，为需要计算机或互联网访问或技术支持的参与者提供了另外四个现场会议。收集了有关常规护理现场访问的数据。使用描述性统计和双变量分析对数据进行分析。
结果 参与者主要是西班牙裔和女性，基线平均 A1C 为 10%（86 mmol/mol）。只有一半的参与者在日常生活中定期使用计算机或短信。平均入门 MoDD 培训课程持续 73.6 分钟。培训后，大约三分之一（35%）的干预参与者返回其联邦合格的健康中心接受基本和 MoDD 特定技术援助。报告的额外培训课程最频繁的持续时间为 30 至 45 分钟。
结论 培训和支持需求大于预期。糖尿病教育者应在向服务不足的成年人实施健康信息技术（HIT）糖尿病自我管理教育（DSME）之前评估技术能力。未来的研究必须投入资源解决技术获取问题、预测受试者培训需求并开发新的培训方法，以确保 HIT DSME 的使用和参与。
