المؤلفون: Graham Martin, Bernie Stribling, Mike Patterson, Nicky Hudson, Abualbishr Alshreef, Laura J. Gray, Lisa Huddlestone, Simon Dixon, Caroline A. Kristunas, Jessica Turner, Helen Eborall, Agnieszka Glab, Sally Schreder, Alison Northern, Kamlesh Khunti, Melanie J. Davies, Rebecca Pritchard

المساهمون: Gray, Laura J. [0000-0002-9284-9321], Apollo - University of Cambridge Repository, Davies, Melanie J [0000-0002-9987-9371], Alshreef, Abualbishr [0000-0003-2737-1365], Gray, Laura J [0000-0002-9284-9321]

المصدر: BMC Family Practice
BMC Family Practice, Vol 20, Iss 1, Pp 1-15 (2019)

مصطلحات موضوعية: Diabetes self-management, Adult, Male, Service organization, utilization, and delivery of care, Diabetes education, Referral, Cost-Benefit Analysis, 030209 endocrinology & metabolism, law.invention, Interviews as Topic, Study Protocol, 03 medical and health sciences, 0302 clinical medicine, Patient Education as Topic, Randomized controlled trial, Nursing, law, Intervention (counseling), Humans, Medicine, 030212 general & internal medicine, Cluster randomised controlled trial, Anthropology, Cultural, Randomised controlled trial, Glycated Hemoglobin, lcsh:R5-920, Self management, Self-management, Primary Health Care, business.industry, Self-Management, Attendance, Type 2 diabetes, Type 2 Diabetes, Cluster randomised trial, Structured education, Diabetes self management, Diabetes Mellitus, Type 2, Wait-list, Female, Observational study, lcsh:Medicine (General), Family Practice, business, Wait list, Psychosocial

الوصف: Background Approximately 425 million people globally have diabetes, with ~ 90% of these having Type 2 Diabetes Mellitus (T2DM). This is a condition that leads to a poor quality of life and increased risk of serious health complications. Structured self-management education (SSME) has been shown to be effective in improving glycaemic control and patient related outcome measures and to be cost-effective. However, despite the demonstrated benefits, attendance at SSME remains low. An intervention has been developed to embed SSME called the ‘Embedding Package’. The intervention aims to address barriers and enhance enablers to uptake of SSME at patient, healthcare professional and organisational levels. It comprises a marketing strategy, user friendly and effective referral pathways, new roles to champion SSME and a toolkit of resources. Methods A mixed methods study incorporating a wait-list cluster randomised trial and ethnographic study, including 66 UK general practices, will be conducted with two intervention start times (at 0 and 9 months), each followed by an active delivery phase. At 18 months, the intervention will cease to be actively delivered and a 12 month observational follow-up phase will begin. The intervention, the Embedding Package, aims to increase SSME uptake and subsequent improvements in health outcomes, through a clear marketing strategy, user friendly and effective referral pathways, a local clinical champion and an ‘Embedder’ and a toolkit of resources for patients, healthcare professionals and other key stakeholders. The primary aim is, through increasing uptake to and attendance at SSME, to reduce HbA1c in people with T2DM compared with usual care. Secondary objectives include: assessing whether there is an increase in referral to and uptake of SSME and improvements in biomedical and psychosocial outcomes; an assessment of the sustainability of the Embedding Package; contextualising the process of implementation, sustainability of change and the ‘fit’ of the Embedding Package; and an assessment of the cost-effectiveness of the Embedding Package. Discussion This study will assess the effectiveness, cost-effectiveness and sustainability of the Embedding Package, an intervention which aims to improve biomedical and psychosocial outcomes of people with T2DM, through increased referral to and uptake of SSME. Trial registration International Standard Randomised Controlled Trials Number ISRCTN23474120. Assigned 05/04/2018. The study was prospectively registered. On submission of this manuscript practice recruitment is complete, participant recruitment is ongoing and expected to be completed by the end of 2019.

وصف الملف: application/pdf; text/xml; application/vnd.openxmlformats-officedocument.wordprocessingml.document

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9cf9dbb12bf863354dcacd48b1e6781aTest
https://doi.org/10.1186/s12875-019-1038-0Test

المؤلفون: Davies, Melanie J, Kristunas, Caroline A, Alshreef, Abualbishr, Dixon, Simon, Eborall, Helen, Glab, Agnieszka, Huddlestone, Lisa, Hudson, Nicky, Khunti, Kamlesh, Martin, Graham, Northern, Alison, Patterson, Mike, Pritchard, Rebecca, Schreder, Sally, Stribling, Bernie, Turner, Jessica, Gray, Laura J

مصطلحات موضوعية: Cluster randomised trial, Diabetes education, Diabetes self-management, Randomised controlled trial, Self-management, Structured education, Type 2 diabetes, Wait-list, Adult, Anthropology, Cultural, Cost-Benefit Analysis, Diabetes Mellitus, Type 2, Female, Glycated Hemoglobin, Humans, Interviews as Topic, Male, Patient Education as Topic, Primary Health Care

الوصف: BACKGROUND: Approximately 425 million people globally have diabetes, with ~ 90% of these having Type 2 Diabetes Mellitus (T2DM). This is a condition that leads to a poor quality of life and increased risk of serious health complications. Structured self-management education (SSME) has been shown to be effective in improving glycaemic control and patient related outcome measures and to be cost-effective. However, despite the demonstrated benefits, attendance at SSME remains low. An intervention has been developed to embed SSME called the 'Embedding Package'. The intervention aims to address barriers and enhance enablers to uptake of SSME at patient, healthcare professional and organisational levels. It comprises a marketing strategy, user friendly and effective referral pathways, new roles to champion SSME and a toolkit of resources. METHODS: A mixed methods study incorporating a wait-list cluster randomised trial and ethnographic study, including 66 UK general practices, will be conducted with two intervention start times (at 0 and 9 months), each followed by an active delivery phase. At 18 months, the intervention will cease to be actively delivered and a 12 month observational follow-up phase will begin. The intervention, the Embedding Package, aims to increase SSME uptake and subsequent improvements in health outcomes, through a clear marketing strategy, user friendly and effective referral pathways, a local clinical champion and an 'Embedder' and a toolkit of resources for patients, healthcare professionals and other key stakeholders. The primary aim is, through increasing uptake to and attendance at SSME, to reduce HbA1c in people with T2DM compared with usual care. Secondary objectives include: assessing whether there is an increase in referral to and uptake of SSME and improvements in biomedical and psychosocial outcomes; an assessment of the sustainability of the Embedding Package; contextualising the process of implementation, sustainability of change and the 'fit' of the Embedding Package; and an ...

وصف الملف: Electronic; application/vnd.openxmlformats-officedocument.wordprocessingml.document

العلاقة: https://www.repository.cam.ac.uk/handle/1810/298243Test

الإتاحة: https://doi.org/10.17863/CAM.45297Test
https://www.repository.cam.ac.uk/handle/1810/298243Test

المؤلفون: Nana Folmann Hempler, Mira Petersen

المصدر: BMC Medical Informatics and Decision Making
BMC Medical Informatics and Decision Making, Vol 17, Iss 1, Pp 1-10 (2017)

مصطلحات موضوعية: Diabetes self-management, Adult, Male, Knowledge management, Denmark, Design thinking, Mobile application, 030209 endocrinology & metabolism, Health Informatics, lcsh:Computer applications to medicine. Medical informatics, Health informatics, 03 medical and health sciences, 0302 clinical medicine, Agency (sociology), Diabetes support, Humans, Data Protection Act 1998, Medical Informatics Applications, 030212 general & internal medicine, Goal setting, Aged, Medical education, Self-management, business.industry, Self-Management, Health Policy, Type 2 diabetes, Usability, Qualitative methods, Middle Aged, Mobile Applications, Computer Science Applications, Diabetes Mellitus, Type 2, lcsh:R858-859.7, Female, Erratum, business, Psychology, Qualitative research

الوصف: Background Numerous mobile applications have been developed to support diabetes-self-management. However, the majority of these applications lack a theoretical foundation and the involvement of people with diabetes during development. The aim of this study was to develop and test a mobile application (app) supporting diabetes self-management among people with newly diagnosed type 2 diabetes using design thinking. Methods The app was developed and tested in 2015 using a design-based research approach involving target users (individuals newly diagnosed with type 2 diabetes), research scientists, healthcare professionals, designers, and app developers. The research approach comprised three major phases: inspiration, ideation, and implementation. The first phase included observations of diabetes education and 12 in-depth interviews with users regarding challenges and needs related to living with diabetes. The ideation phrase consisted of four interactive workshops with users focusing on app needs, in which ideas were developed and prioritized. Finally, 14 users tested the app over 4 weeks; they were interviewed about usability and perceptions about the app as a support tool. Results A multifunctional app was useful for people with newly diagnosed type 2 diabetes. The final app comprised five major functions: overview of diabetes activities after diagnosis, recording of health data, reflection games and goal setting, knowledge games and recording of psychological data such as sleep, fatigue, and well-being. Users found the app to be a valuable tool for support, particularly for raising their awareness about their psychological health and for informing and guiding them through the healthcare system after diagnosis. Conclusions The design thinking processes used in the development and implementation of the mobile health app were crucial to creating value for users. More attention should be paid to the training of professionals who introduce health apps. Trial registration: Danish Data Protection Agency: 2012-58-0004. Registered 6 February 2016.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::75d32b1e86baf80c3f955e66fd80739fTest
https://doi.org/10.1186/s12911-017-0493-6Test

المؤلفون: Minling Chen, Y. Chen, Rui Li, Yinan Liu, Wanghong Xu, Russell L. Rothman, Xiaoyu Liu, Yujie Yan, Hong Fang, Yu Jiang, Junling Gao, Wei Wang, Fangjia Zhou, Qinghua Xia, Peng Zhou, Xiao Na Liu

المصدر: Trials

مصطلحات موضوعية: Diabetes self-management, Blood Glucose, Male, Research design, Health Knowledge, Attitudes, Practice, Time Factors, Cost effectiveness, Cost-Benefit Analysis, Health Behavior, Medicine (miscellaneous), Literacy, law.invention, Study Protocol, Clinical Protocols, Randomized controlled trial, law, Pharmacology (medical), Community Health Services, media_common, Aged, 80 and over, Cost-utility, Self-management, Health Care Costs, Middle Aged, Self-management behaviors, Treatment Outcome, Research Design, Female, Self-efficacy, Adult, medicine.medical_specialty, Adolescent, media_common.quotation_subject, Health literacy, Young Adult, Asian People, Patient Education as Topic, Diabetes Mellitus, medicine, Humans, Aged, Glycemic, Glycated Hemoglobin, business.industry, Numeracy, Health Literacy, Self Care, Hemoglobin A1c, Family medicine, Physical therapy, Cost-effectiveness, business, Biomarkers

الوصف: Background Diabetes self-management often involves the interpretation and application of oral, written, or quantitative information. Numerous diabetes patients in China have limited health literacy, which likely leads to poorer clinical outcomes. This study is designed to examine the efficacy and cost-effectiveness of addressing health literacy to improve self-management skills and glycemic control in Chinese diabetes patients. Methods/design This is a cluster randomized controlled trial (RCT) conducted in 20 community healthcare sites in Shanghai, China. Overall, 800 diabetes patients will be randomized into intervention and control arms and will have a baseline hemoglobin A1c (HbA1c) assay and undergo a baseline survey which includes measures of health literacy and diabetes numeracy using revised Chinese versions of the Health Literacy Management Scale and Diabetes Numeracy Test Scale. During the 1-year period of intervention, while the control group will receive usual care, the intervention group will be supplemented with a comprehensive health literacy strategy which includes i) training healthcare providers in effective health communication skills that address issues related to low literacy, and ii) use of an interactive Diabetes Education Toolkit to improve patient understanding and behaviors. Assessments will be conducted at both patient and healthcare provider levels, and will take place upon admission and after 3, 6, 12, and 24 months of intervention. The primary outcome will be the improvement in HbA1c between Intervention group and Control group patients. Secondary outcomes at the patient level will include improvement in i) clinical outcomes (blood pressure, fasting lipids, body mass index, weight, smoking status), ii) patient reported self-management behaviors, and iii) patient-reported self-efficacy. Outcomes at the provider level will include: i) provider satisfaction and ii) intensity and type of care provided. The effects of the intervention will be examined in multivariable general linear models. Both cost-effectiveness and cost-utility analyses will be performed. Discussion The main strengths of this study are its large sample size and RCT design, involvement of both patients and healthcare providers, and the long term follow-up (24-months). This project will help to demonstrate the value of addressing health literacy and health communication to improve self-management and clinical outcomes among Chinese diabetes patients. Trial registration ISRCTN76130594, Registration date: Sept 22, 2014. Electronic supplementary material The online version of this article (doi:10.1186/1745-6215-15-498) contains supplementary material, which is available to authorized users.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5dd42fb838fb495c3cddfb491ba2dd99Test
https://doi.org/10.1186/1745-6215-15-498Test