Date of Award

12-2015

Degree Name

Doctor of Philosophy

Department

Interdisciplinary Health Sciences

First Advisor

Dr. Amy Curtis

Second Advisor

Dr. Eric Vangsnes

Third Advisor

Dr. Jean Kerver

Abstract

Diabetes is a debilitating disease and if not managed properly it can lead to multiple complications and even premature death. Diabetes continues to disproportionately affect vulnerable populations. The purpose of this three-paper method dissertation was to examine the implementation of a prediabetes and diabetes programs in a community setting to serve vulnerable populations in addition to understanding future diabetes-related educational needs.

The first paper is an evaluation of a shortened five-week diabetes prevention program for older adults with prediabetes or at a high risk for developing type 2 diabetes mellitus (T2DM). Chang in nutrition knowledge, eating and physical activity behaviors, and weight were the main outcomes of this study. Participants lost a statistically significant amount of weight over the course of six-months and increased their nutrition knowledge significantly. Participants also reported a statistically significant increase in the amount of vegetables intake in addition to their amount of daily vigorous physical activity.

The second paper examined changes in knowledge, weight, and A1c as the main outcomes of a shortened diabetes-self management education (DSME) program called IDEAS. IDEAS was a one-time, four-hour program delivered at a patient-center medical home that served primarily low-income individuals. There was a statistically significant increase in participants’ knowledge on T2DM. Clinical outcomes included weight and A1c. Participants’ weight loss was not statistically significant; however it was clinically relevant. The main outcome of the study was the statistically significant improvement of participants’ A1c levels.

The third paper, examined referral rates to an American Diabetes Association accredited DSME program and hours of attendance this program for patients newly diagnosed with T2DM that attended the same clinic mentioned in paper II. The study found that referral rates to DSME programs were low. In fact, only a little over half of the newly diagnosed patients received a formal referral. Furthermore, almost half of those referred did not attend a DSME program. A main outcome of the study is that patients who attended the one-hour assessment at a DSME program and patients who almost completed the DSME program (8 or more hours) had a statically significant similar improvement in their A1c levels.

Access Setting

Dissertation-Open Access

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