Diabetes self-management education (DSME) is a critical element of care for all people with diabetes and is necessary in order to improve patient outcomes. The National Standards for DSME are designed to define quality diabetes self-management education and to assist diabetes educators in a variety of settings to provide evidence-based education. Because of the dynamic nature of health care and diabetes-related research, these Standards are reviewed and revised approximately every 5 years by key organizations and federal agencies within the diabetes education community.

A Task Force was jointly convened by the American Association of Diabetes Educators and the American Diabetes Association in the summer of 2006. Additional organizations that were represented included the American Dietetic Association, the Veteran's Health Administration, the Centers for Disease Control and Prevention, the Indian Health Service, and the American Pharmaceutical Association. Members of the Task Force included a person with diabetes; several health services researchers/behaviorists, registered nurses, and registered dietitians; and a pharmacist.

The Task Force was charged with reviewing the current DSME standards for their appropriateness, relevance, and scientific basis. The Standards were then reviewed and revised based on the available evidence and expert consensus. The committee convened on 31 March 2006 and 9 September 2006, and the Standards were approved 25 March 2007.

Diabetes self-management education (DSME) is the ongoing process of facilitating the knowledge, skill, and ability necessary for diabetes self-care. This process incorporates the needs, goals, and life experiences of the person with diabetes and is guided by evidence-based standards. The overall objectives of DSME are to support informed decision-making, self-care behaviors, problem-solving and active collaboration with the health care team and to improve clinical outcomes, health status, and quality of life.

Before the review of the individual Standards, the Task Force identified overriding principles based on existing evidence that would be used to guide the review and revision of the DSME Standards. These are:

  1. Diabetes education is effective for improving clinical outcomes and quality of life, at least in the short-term (1,,,,,7).

  2. DSME has evolved from primarily didactic presentations to more theoretically based empowerment models (3,8).

  3. There is no one “best” education program or approach; however, programs incorporating behavioral and psychosocial strategies demonstrate improved outcomes (9,11). Additional studies show that culturally and age-appropriate programs improve outcomes (12,,,16) and that group education is effective (4,6,7,17,18).

  4. Ongoing support is critical to sustain progress made by participants during the DSME program (3,13,19,20).

  5. Behavioral goal-setting is an effective strategy to support self-management behaviors (21).

Structure

Standard 1.

The DSME entity will have documentation of its organizational structure, mission statement, and goals and will recognize and support quality DSME as an integral component of diabetes care.

Documentation of the DSME organizational structure, mission statement, and goals can lead to efficient and effective provision of services. In the business literature, case studies and case report investigations on successful management strategies emphasize the importance of clear goals and objectives, defined relationships and roles, and managerial support (22,,25). While this concept is relatively new in health care, business and health policy experts and organizations have begun to emphasize written commitments, policies, support, and the importance of outcome variables in quality improvement efforts (22,26,,,,,,,,,,37). The continuous quality improvement literature also stresses the importance of developing policies, procedures, and guidelines (22,26).

Documentation of the organizational structure, mission statement, and goals can lead to efficient and effective provision of DSME. Documentation of an organizational structure that delineates channels of communication and represents institutional commitment to the educational entity is critical for success (38,,,42). According to the Joint Commission on Accreditation of Health Care Organizations (JCAHO) (26), this type of documentation is equally important for small and large health care organizations. Health care and business experts overwhelmingly agree that documentation of the process of providing services is a critical factor in clear communication and provides a solid basis from which to deliver quality diabetes education (22,26,33,35,37). In 2005, JACHO published the Joint Commission International Standards for Disease or Condition-Specific Care, which outlines national standards and performance measurements for diabetes and addresses diabetes self-management education as one of seven critical elements (26).

Standard 2.

The DSME entity shall appoint an advisory group to promote quality. This group shall include representatives from the health professions, people with diabetes, the community, and other stakeholders.

Established and new systems (e.g., committees, governing bodies, advisory groups) provide a forum and a mechanism for activities that serve to guide and sustain the DSME entity (30,39,41). Broad participation of organization(s) and community stakeholders, including health professionals, people with diabetes, consumers, and other community interest groups, at the earliest possible moment in the development, ongoing planning, and outcomes evaluation process (22,26,33,35,36,41) can increase knowledge and skills about the local community and enhance collaborations and joint decision-making. The result is a DSME program that is patient-centered, more responsive to consumer-identified needs and the needs to the community, more culturally relevant, and of greater personal interest to consumers (43,,,,,,50).

Standard 3.

The DSME entity will determine the diabetes educational needs of the target population(s) and identify resources necessary to meet these needs.

Clarifying the target population and determining its self-management educational needs serve to focus resources and maximize health benefits (51,53). The assessment process should identify the educational needs of all individuals with diabetes, not just those who frequently attend clinical appointments (51). DSME is a critical component of diabetes treatment (2,54,55), yet the majority of individuals with diabetes do not receive any formal diabetes education (56,57). Thus, identification of access issues is an essential part of the assessment process (58). Demographic variables, such as ethnic background, age, formal educational level, reading ability, and barriers to participation in education, must also be considered to maximize the effectiveness of DSME for the target population (13,,,,,19,43,,,47,59,61).

Standard 4.

A coordinator will be designated to oversee the planning, implementation, and evaluation of diabetes self-management education. The coordinator will have academic or experiential preparation in chronic disease care and education and in program management.

The role of the coordinator is essential to ensure that quality diabetes education is delivered through a coordinated and systematic process. As new and creative methods to deliver education are explored, the coordinator plays a pivotal role in ensuring accountability and continuity of the educational process (23,60,62). The individual serving as the coordinator will be most effective if there is familiarity with the lifelong process of managing a chronic disease (e.g., diabetes) and with program management.

Process

Standard 5.

DSME will be provided by one or more instructors. The instructors will have recent educational and experiential preparation in education and diabetes management or will be a certified diabetes educator. The instructor(s) will obtain regular continuing education in the field of diabetes management and education. At least one of the instructors will be a registered nurse, dietitian, or pharmacist. A mechanism must be in place to ensure that the participant's needs are met if those needs are outside the instructors' scope of practice and expertise.

Diabetes education has traditionally been provided by nurses and dietitians. Nurses have been utilized most often as instructors in the delivery of formal DSME (2,3,5,63,,,67). With the emergence of medical nutrition therapy (66,,,70), registered dietitians became an integral part of the diabetes education team. In more recent years, the role of the diabetes educator has expanded to other disciplines, particularly pharmacists (73,,,,,79). Reviews comparing the effectiveness of different disciplines for education report mixed results (3,5,6). Generally, the literature favors current practice that utilizes the registered nurse, registered dietitian, and the registered pharmacist as the key primary instructors for diabetes education and members of the multidisciplinary team responsible for designing the curriculum and assisting in the delivery of DSME (1,,,,,7,77). In addition to registered nurses, registered dietitians, and pharmacists, a number of studies reflect the ever-changing and evolving health care environment and include other health professionals (e.g., a physician, behaviorist, exercise physiologist, ophthalmologist, optometrist, podiatrist) (48,80,,,84) and, more recently, lay health and community workers (85,,,,,91) and peers (92) to provide information, behavioral support, and links with the health care system as part of DSME.

Expert consensus supports the need for specialized diabetes and educational training beyond academic preparation for the primary instructors on the diabetes team (64,93,,,97). Certification as a diabetes educator by the National Certification Board for Diabetes Educators (NCBDE) is one way a health professional can demonstrate mastery of a specific body of knowledge, and this certification has become an accepted credential in the diabetes community (98). An additional credential that indicates specialized training beyond basic preparation is board certification in advanced Diabetes Management (BC-ADM) offered by the American Nurses Credentialing Center (ANCC), which is available for master's prepared nurses, dietitians, and pharmacists (48,84,99).

DSME has been shown to be most effective when delivered by a multidisciplinary team with a comprehensive plan of care (7,31,52,100,102). Within the multidisciplinary team, team members work interdependently, consult with one another, and have shared objectives (7,103,104). The team should have a collective combination of expertise in the clinical care of diabetes, medical nutrition therapy, educational methodologies, teaching strategies, and the psychosocial and behavioral aspects of diabetes self-management. A referral mechanism should be in place to ensure that the individual with diabetes receives education from those with appropriate training and credentials. It is essential in this collaborative and integrated team approach that individuals with diabetes are viewed as leaders of their team and assume an active role in designing their educational experience (7,20,31,100,102,104).

Standard 6.

A written curriculum reflecting current evidence and practice guidelines, with criteria for evaluating outcomes, will serve as the framework for the DSME entity. Assessed needs of the individual with pre-diabetes and diabetes will determine which of the content areas listed below are to be provided:

  • Describing the diabetes disease process and treatment options

  • Incorporating nutritional management into lifestyle

  • Incorporating physical activity into lifestyle

  • Using medication(s) safely and for maximum therapeutic effectiveness

  • Monitoring blood glucose and other parameters and interpreting and using the results for self-management decision making

  • Preventing, detecting, and treating acute complications

  • Preventing detecting, and treating chronic complications

  • Developing personal strategies to address psychosocial issues and concerns

  • Developing personal strategies to promote health and behavior change

People with diabetes and their families and caregivers have a great deal to learn in order to become effective self-managers of their diabetes. A core group of topics are commonly part of the curriculum taught in comprehensive programs that have demonstrated successful outcomes (1,2,3,6,105,,,109). The curriculum, a coordinated set of courses and educational experiences, includes learning outcomes and effective teaching strategies (110,112). The curriculum is dynamic and needs to reflect current evidence and practice guidelines (112,,,,117). Current educational research reflects the importance of emphasizing practical, problem-solving skills, collaborative care, psychosocial issues, behavior change, and strategies to sustain self-management efforts (31,39,42,48,98,118,,,122).

The content areas delineated above provide instructors with an outline for developing this curriculum. It is important that the content be tailored to match each individual's needs and adapted as necessary for age, type of diabetes (including pre-diabetes and pregnancy), cultural influences, health literacy, and other comorbidities (123,124). The content areas are designed to be applicable in all settings and represent topics that can be developed in basic, intermediate, and advanced levels. Approaches to education that are interactive and patient-centered have been shown to be effective (83,119,121,122,125,127).

These content areas are presented in behavioral terms and thereby exemplify the importance of action-oriented, behavioral goals and objectives (13,21,55,121,123,128,129). Creative, patient-centered experience-based delivery methods are effective for supporting informed decision-making and behavior change and go beyond the acquisition of knowledge.

Standard 7.

An individual assessment and education plan will be developed collaboratively by the participant and instructor(s) to direct the selection of appropriate educational interventions and self-management support strategies. This assessment and education plan and the intervention and outcomes will be documented in the education record.

Multiple studies indicate the importance of individualizing education based on the assessment (1,56,68,131,,,135). The assessment includes information about the individual's relevant medical history, age, cultural influences, health beliefs and attitudes, diabetes knowledge, self-management skills and behaviors, readiness to learn, health literacy level, physical limitations, family support, and financial status (10,,,,,,17,19,131,136,138). The majority of these studies support the importance of attitudes and health beliefs in diabetes care outcomes (1,68,134,135,138,139).

In addition, functional health literacy (FHL) level can affect patients' self-management, communication with clinicians, and diabetes outcomes (140,141). Simple tools exist for measuring FHL as part of an overall assessment process (142,144).

Many people with diabetes experience problems due to medication costs, and asking patients about their ability to afford treatment is important (144). Comorbid chronic illness (e.g., depression and chronic pain) as well as more general psychosocial problems can pose significant barriers to diabetes self-management (104,146,,,,151); considering these issues in the assessment may lead to more effective planning (149,151).

Periodic reassessment determines attainment of the educational objectives or the need for additional and creative interventions and future reassessment (7,97,100,152). A variety of assessment modalities, including telephone follow-up and other information technologies (e.g., Web-based, automated phone calls), may augment face-to-face assessments (97,99).

While there is little direct evidence on the impact of documentation on patient outcomes, it is required to receive payment for services. In addition, documentation of patient encounters guides the educational process, provides evidence of communication among instructional staff, may prevent duplication of services, and provides information on adherence to guidelines (37,64,100,131,153). Providing information to other members of the patient's health care team through documentation of educational objectives and personal behavioral goals increases the likelihood that all of the members will address these issues with the patient (37,98,153).

The use of evidence-based performance and outcome measures has been adopted by organizations and initiatives such as the Centers for Medicare and Medicaid Services (CMS), the National Committee for Quality Assurance (NCQA), the Diabetes Quality Improvement Project (DQIP), the Health Plan Employer Data and Information Set (HEDIS), the Veterans Administration Health System, and JCAHO (26,154).

Research suggests that the development of standardized procedures for documentation, training health professionals to document appropriately, and the use of structured standardized forms based on current practice guidelines can improve documentation and may ultimately improve quality of care (100,153,155).

Standard 8.

A personalized follow-up plan for ongoing self management support will be developed collaboratively by the participant and instructor(s). The patient's outcomes and goals and the plan for ongoing self management support will be communicated to the referring provider.

While DSME is necessary, it is not sufficient for patients to sustain a lifetime of diabetes self-care (55). Initial improvements in metabolic and other outcomes diminish after ∼6 months (3). To sustain behavior at the level of self-management needed to effectively manage diabetes, most patients need ongoing diabetes self-management support (DSMS).

DSMS is defined as activities to assist the individual with diabetes to implement and sustain the ongoing behaviors needed to manage their illness. The type of support provided can include behavioral, educational, psychosocial, or clinical (13,121,123).

A variety of strategies are available for providing DSMS both within and outside the DSME entity. Some patients benefit from working with a nurse case manager (7,20,98,157). Case management for DSMS can include reminders about needed follow-up care and tests, medication management, education, behavioral goal-setting, and psychosocial support/ connection to community resources.

The effectiveness of providing DSMS through disease-management programs, trained peers and health community workers, community-based programs, use of technology, ongoing education and support groups, and medical nutrition therapy has also been established (7,13,89,,92,101,121,123,158159).

While the primary responsibility for diabetes education belongs to the DSME entity, patients benefit by receiving reinforcement of content and behavioral goals from their entire health care team (100). Additionally, many patients receive DSMS through their provider. Thus, communication is essential to ensure that patients receive the support they need.

Outcomes

Standard 9.

The DSME entity will measure attainment of patient-defined goals and patient outcomes at regular intervals using appropriate measurement techniques to evaluate the effectiveness of the educational intervention.

In addition to program-defined goals and objectives (e.g., learning goals, metabolic, and other health outcomes), the DSME entity needs to assess each patient's personal self-management goals and his/her progress toward those personal goals. The AADE7 self-care behaviors provide a useful framework for assessment and documentation. Diabetes self-management behaviors include physical activity, healthy eating, medication taking, monitoring blood glucose, diabetes self-care related problem solving, reducing risks of acute and chronic complications, and psychosocial aspects of living with diabetes (112,160). Assessments of patient outcomes should occur at appropriate intervals. The interval depends on the outcome itself and the timeframe provided within the selected goals. For some areas, the indicators, measures, and timeframes may be based on guidelines from professional organizations or government agencies. In addition to assessing progress toward personal behavioral goals, a plan needs to be in place to communicate personal goals and progress to other team members.

The AADE Outcome Standards for Diabetes Education specify self-management behavior as the key outcome (112,160). Knowledge is an outcome to the degree that it is actionable (i.e., knowledge that can be translated into self-management behavior). In turn, effective self-management is one (but not the only) contributor to longer-term, higher-order outcomes such as clinical status (e.g., control of glycemia, blood pressure, and cholesterol), health status (e.g., avoidance of complications), and subjective quality of life. Thus, patient self-management behaviors are at the core of the outcomes evaluation.

Standard 10.

The DSME entity will measure the effectiveness of the education process and determine opportunities for improvement using a written continuous quality improvement plan that describes and documents a systematic review of the entities' process and outcome data.

Diabetes education must be responsive to advances in knowledge, treatment strategies, educational strategies, psychosocial interventions, and the changing health care environment. Continuous quality improvement (CQI) is an iterative, planned process (161) that leads to improvement in the delivery of patient education (162). The CQI plan should define quality based on and consistent with the organization's mission, vision, and strategic plan and include identifying and prioritizing improvement opportunities (163). Once improvement projects are identified and selected, the plan should incorporate timelines and important milestones including data collection, analysis, and presentation of results (163). Outcome measures indicate the result of a process (i.e., whether changes are actually leading to improvement), while process measures provide information about what caused those results (163164). Process measures are often targeted to those processes that typically impact the most important outcomes. Measuring both process and outcomes helps to ensure that change is successful without causing additional problems in the system (164).

The previous version of the “National Standards for Diabetes Self-Management Education” was originally published in Diabetes Care 23:682–689, 2000. This version received final approval in March 2007.

Work on this article was supported in part by grant nos. NIH5P60 DK20572 and 1 R18 0K062323 from the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health.

The Task Force gratefully acknowledges the assistance and support of Paulina Duker, MPH, APRN-BC, CDE, and Nathanial Clark, MD, CDE, of the American Diabetes Association; Lori Porter, MBA, RD, CAE, of the American Association of Diabetes Educators; and Karmeen Kulkarni, MS, RD, BC-ADM, Past President, Health Care and Education of the American Diabetes Association; Malinda Peeples, MS, RN, CDE, Past President of the American Association of Diabetes Educators; and Carole' Mensing, RN, MA, CDE, for their insights and helpful suggestions.

We also gratefully acknowledge the work of the previous Task Force for the National Standards for DSME: Carole' Mensing, RN, MA, CDE; Jackie Boucher, MS, RD, LD, CDE; Marjorie Cypress, MS, C-ANP, CDE; Katie Weinger, EdD, RN; Kathryn Mulcahy, MSN, RN, CDE; Patricia Barta, RN, MPH, CDE; Gwen Hosey, MS, ARNP, CDE; Wendy Kopher, RN, C, CDE, HTP; Andrea Lasichak, MS, RD, CDE; Betty Lamb, RN, MSN; Mavourneen Mangan, RN, MS, ANP, C, CDE; Jan Norman, RD, CDE; Jon Tanja, BS, MS, RPH; Linda Yauk, MS, RD, LD, CDE; Kimberlydawn Wisdom, MD, MS; and Cynthia Adams, PhD

1.
Brown
SA
:
Interventions to promote diabetes self-management: state of the science
.
Diabetes Educ
25
(
6 Suppl.
):
52
61
,
1999
2.
Norris
SL
,
Engelgau
MM
,
Naranyan
KMV
:
Effectiveness of self-management training in type 2 diabetes: a systematic review of randomized controlled trials
.
Diabetes Care
24
:
561
587
,
2001
3.
Norris
SL
,
Lau
J
,
Smith
SJ
,
Schmid
CH
,
Engelgau
MM
:
Self-management education for adults with type 2 diabetes: a meta-analysis on the effect on glycemic control
.
Diabetes Care
25
:
1159
1171
,
2002
4.
Norris
SL
:
Self-management education in type 2 diabetes
.
Practical Diabetology
22
:
713
,
2003
5.
Gary
TL
,
Genkinger
JM
,
Guallar
E
,
Peyrot
M
,
Brancati
FL
:
Meta-analysis of randomized educational and behavioral interventions in type 2 diabetes
.
Diabetes Educ
29
:
488
501
,
2003
6.
Deakin
T
,
McShane
CE
,
Cade
JE
, et al
.
Review: group based education in self-management strategies improves outcomes in type 2 diabetes mellitus
.
Cochrane Database Syst Rev
(
2
):
CD003417
,
2005
7.
Renders
CM
,
Valk
GD
,
Griffin
SJ
,
Wagner
EH
,
Eijk van
JThM
,
Assendelft
WJJ
:
Interventions to improve the management of diabetes in primary care, outpatient, and community settings: a systematic review
.
Diabetes Care
24
:
1821
1833
,
2001
8.
Funnell
MM
,
Anderson
RM
:
Patient empowerment: a look back, a look ahead
.
Diabetes Educ
29
:
454
464
,
2003
9.
Roter
DL
,
Hall
JA
,
Merisca
R
,
Nordstrom
B
,
Cretin
D
,
Svarstad
B
:
Effectiveness of interventions to improve patient compliance: a meta-analysis
.
Medical Care
36
:
1138
1161
,
1998
10.
Barlow
J
,
Wright
C
,
Sheasby
J
, et al
:
Self-management approaches for people with chronic conditions: a review
.
Patient Education and Counseling
48
:
177
187
,
2002
11.
Skinner
TC
,
Cradock
S
,
Arundel
F
,
Graham
W
:
Lifestyle and behavior: four theories and a philosophy: self-management education for individuals newly diagnosed with type 2 diabetes
.
Diabetes Spectrum
16
:
75
80
,
2003
12.
Brown
SA
,
Hanis
CL
:
Culturally competent diabetes education for Mexican Americans: the Starr County Study
.
Diabetes Educ
25
:
226
236
,
1999
13.
Anderson
RM
,
Funnell
MM
,
Nowankwo
R
, et al
:
Evaluating a problem based empowerment program for African Americans with diabetes: results of a randomized controlled trial
.
Ethnicity and Disease
15
:
671
678
,
2005
14.
Sarkisian
CA
,
Brown
AF
,
Norris
CK
,
Wintz
RL
,
Mangione
CM
:
A systematic review of diabetes self-care interventions for older, African American or Latino adults
.
Diabetes Educ
28
:
467
47915
,
2003
15.
Chodosh
J
,
Morton
SC
,
Mojica
W
,
Maglione
M
,
Suttorp
MJ
,
Hilton
L
,
Rhodes
S
,
Shekelle
P
:
Meta-analysis: chronic disease self-management programs for older adults
.
Ann Intern Med
143
:
427
438
,
2005
16.
Anderson-Loftin
W
,
Barnett
S
,
Bunn
P
, et al
:
A. Soul food light: culturally competent diabetes education
.
Diabetes Educ
31
:
555
563
,
2005
17.
Mensing
CR
,
Norris
SL
:
Group education in diabetes: effectiveness and implementation
.
Diabetes Spectrum
16
:
96
103
,
2003
18.
Rickheim
PL
,
Weaver
TK
,
Flader
JL
,
Kendall
DM
:
Assessment of group versus individual education: a randomized study
.
Diabetes Care
25
:
269
274
,
2002
19.
Brown
SA
,
Blozis
SA
,
Kouzekanani
K
,
Garcia
AA
,
Winchell
M
,
Hanis
CL
:
Dosage effects of diabetes self-management education for Mexican Americans
.
Diabetes Care
28
:
527
532
,
2005
20.
Polonsky
WH
,
Earles
J
,
Smith
S
,
Pease
DJ
,
Macmillan
M
,
Christensen
R
,
Taylor
T
,
Dickert
J
,
Jackson
RA
:
Integrating medical management with diabetes self-management training: a randomized control trial of the Diabetes Outpatient Intensive Treatment Program
.
Diabetes Care
26
:
3094
3053
,
2003
21.
Bodenheimer
T
,
MacGregor
K
,
Sharifi
C
:
Helping Patients Manage Their Chronic Conditions
.
Oakland, CA
,
California Healthcare Foundation
,
2005
22.
Deming
WE
:
Out of the Crisis
.
Cambridge, MA
,
Massachusetts Institute of Technology
,
2000
23.
Drucker
PF
:
The objectives of a business (Chapter 7); Managing service institutions for performance in management tasks, responsibilities, practices (Chapter 14)
. In
The Practice of Management
.
New York
,
Harper & Row
,
1993
24.
Drucker
PF
:
Management: Tasks, Responsibilities, Practices
.
New York
,
Harperbusiness
,
1993
25.
Garvin
DA
:
The processes of organization and management
.
Sloan Manage Rev
(Summer):
30
50
,
1998
26.
Joint Commission on Accreditation of Healthcare Organizations
:
Joint Commission International Standards for Disease or Condition-Specific Care
. 1st ed.
Oakbrook Terrace. IL
,
Joint Accreditation on Healthcare Organizations
,
2005
27.
Berwick
DM
:
A primer on leading the improvement of systems
.
BMJ
312
:
619
622
,
1996
28.
Clemmer
TP
,
Spuhler
VJ
,
Berwick
DM
,
Nolan
TW
:
Cooperation: the foundation of improvement
.
Annals Internal Medicine
128
:
1004
1009
,
1998
29.
Courtney
L
,
Gordon
M
,
Romer
L
:
A clinical path for adult diabetes
.
The Diabetes Educator
23
:
664
671
,
1997
30.
Glasgow
RE
,
Hiss
RG
,
Anderson
RM
,
Friedman
NM
,
Hayward
RA
,
Marrero
DG
,
Taylor
CB
,
Vinicor
F
:
Report of the Health Care Delivery Work Group
.
Diabetes Care
24
:
124
130
,
2001
31.
Wagner
EH
,
Austin
BT
,
Von Korff
M
:
Organizing care for patients with chronic illness
.
Milllbank Quarterly
74
:
511
544
,
1996
32.
Community Health Improvement Partners
:
From the board room to the community room: a health improvement collaboration that's working
.
Journal of Quality Improvement
24
:
549
564
,
1998
33.
Kiefe
CI
,
Allison
JJ
,
Willais
OD
,
Person
SD
,
Weaver
MT
,
Weissman
NW
:
Improving quality improvement using achievable benchmarks for physician feedback
.
JAMA
285
:
2871
2879
,
2001
34.
Solberg
LI
,
Reger
LA
,
Pearson
TL
,
Cherney
LM
,
O'Connor
PJ
,
Freeman
SL
,
Lasch
SL
,
Bishop
DB
:
Using continuous quality improvement to improve diabetes care in populations: the IDEAL model
.
J Qual Improv
23
:
531
591
,
1997
35.
O'Connor
PJ
,
Rush
WA
,
Peterson
J
,
Morben
P
,
Cherney
L
,
Keogh
C
,
Lasch
S
:
Continuous quality improvement can improve glycemic control for HMO patients with diabetes
.
Archives Family Medicine
5
:
502
506
,
1996
36.
Wagner
EH
,
Davis
C
,
Schaefer
J
,
Von Korff
M
,
Austin
B
:
A survey of leading chronic disease management programs: are they consistent with the literature?
Journal of Nursing Care Quality
16
:
67
80
,
2002
37.
Von Korff
M
,
Gruman
J
,
Schaefer
J
,
Curry
SJ
,
Wagner
EH
:
Collaborative management of chronic illness
.
Ann Intern Med
127
:
1097
1102
,
1997
38.
Fox
CH
,
Mahoney
MC
:
Improving diabetes preventative care in a family practice residency program: a case study in continuous quality improvement
.
Family Medicine
30
:
441
445
,
1998
39.
Siminerio
L
,
Piatt
G
,
Emerson
S
,
Ruppert
K
,
Saul
M
,
Solano
F
,
Stewart
A
,
Zgibor
J
:
Deploying the chronic care model to implement and sustain diabetes self-management training programs
.
Diabetes Educ
32
:
1
8
,
2006
40.
Siminerio
LM
,
Zgibor
JC
,
Solano
FX
:
Implementing the chronic care model for improvements in diabetes practice and outcomes in primary care: The University of Pittsburgh Medical Center Experience
.
Clinical Diabetes
22
:
54
58
,
2003
41.
Heins
JM
,
Nord
Wr
,
Cameron
M
:
Establishing and sustaining state-of-the-art diabetes education programs: research and recommendations
.
Diabetes Educ
18
:
501
598
,
1992
42.
Mangan
M
:
Diabetes self-management education programs in the Veterans Health Administration
.
Diabetes Educ
23
:
687
695
,
1997
43.
Griffin
JA
,
Gilliland
Ss
,
Perez
G
,
Helitzer
D
,
Carter
JS.
:
Participants satisfaction with culturally appropriate diabetes education program: the Native American diabetes education program in a northwest Indian tribe
.
Diabetes Educ
25
:
351
363
,
1999
44.
Hiss
RG
:
Barriers to care in non-insulin-dependent diabetes mellitus: the Michigan experience
.
Ann Intern Med
124
:
146
148
,
1996
45.
Simmons
D
,
Voyle
J
,
Swinburn
B
,
O'Dea
K
:
Community-based approaches for the primary prevention of non-insulin-dependent diabetes mellitus
.
Diabet Med
14
:
519
526
,
1997
46.
Gamm
LD
:
Advancing community health through community health partnerships
.
J Healthcare Management
43
:
51
67
,
1998
47.
Snoek
FJ
:
Quality of life: a closer look at measuring patients' well-being
.
Diabetes Spectrum
13
:
24
28
,
2000
48.
Piatt
G
,
Brooks
MM
,
Orchard
TJ
,
Kortykowski
M
,
Emerson
S
,
Siminerio
L
,
Simmons
D
,
Ahmad
U
,
Soner
TJ
,
Zgibor
JC
:
Translating the chronic care model into the community
.
Diabetes Care
29
:
811
816
,
2006
49.
Harris
SB
,
Zinman
B
:
Primary prevention of type 2 diabetes in high-risk populations
.
Diabetes Care
23
:
87
881
,
2000
50.
Rothman
J
:
Approaches to community intervention
. In
Strategies of Community Intervention
. 5th ed.
Itasca, IL
,
F. Peacock
,
2001
, p.
26
63
51.
O'Connor
PJ
,
Pronk
NP
:
Integrating population health concepts, clinical guidelines, and ambulatory medical care systems to improve diabetes care
.
J Ambulatory Care Manager
21
:
67
73
,
1998
52.
Wagner
EH
:
The role of patient care teams in chronic disease management
.
Br Med J
320
:
569
572
,
2000
53.
Hiss
RG
,
Gillard
ML
,
Armbruster
BA
,
McClure
LA
:
Comprehensive evaluation of community-based diabetic patients
.
Diabetes Care
24
:
690
694
,
2001
54.
Jack
L
:
Diabetes Self-Management Education Research: An international review of intervention methods, theories, community partners and outcomes
.
Disease Management and Health Outcomes
11
:
415
428
,
2003
55.
Piette
JD
,
Glasgow
R
:
Strategies for improving behavioral health outcomes among patients with diabetes: self-management, education
. In
Evidence-Based Diabetes Care
.
Gerstein
HC
,
Haynes
RB
Eds.
Ontario, Canada
,
BC Decker Publishers
2001
, p.
207
251
56.
Coonrod
BA
,
Betschart
J
,
Harris
MI
:
Frequency and determinants of diabetes patient education among adults in the U.S. population
.
Diabetes Care
17
:
852
858
,
1994
57.
Pearson
J
,
Mensing
C
,
Anderson
R
:
Medicare reimbursement and diabetes self-management training: national survey results
.
Diabetes Educ
30
:
914
927
,
2004
58.
Siminerio
L
,
Piatt
G
,
Zgibor
J
:
Implementing the chronic care model in a rural practice
.
Diabetes Educ
31
:
225
234
,
2005
59.
Anderson
RM
,
Goddard
CE
,
Garcia
R
,
Guzman
JR
,
Vazquez
F
:
Using focus groups to identify diabetes care and education issues for Latinos with diabetes
.
Diabetes Educ
24
:
618
625
,
1998
60.
Zgibor
JC
,
Simmons
D
:
Barriers to blood glucose monitoring in a multiethnic community
.
Diabetes Care
25
:
1772
1777
,
2002
61.
Johnson
K
,
Schubring
L
:
The evolution of a hospital-based decentralized case management model
.
Nursing Economics
17
:
29
48
,
1999
62.
Diabetes Control and Complications Trial Research Group
:
The impact of the trial coordinator in the Diabetes Control and Complications Trial (DCCT)
.
Diabetes Educ
19
:
509
512
,
1993
63.
Koproski
J
,
Pretto
Z
,
Poretsky
L
:
Effects of an intervention by a diabetes team in hospitalized patients with diabetes
.
Diabetes Care
20
:
1553
1555
,
1997
64.
Davis
ED
:
Role of the diabetes nurse educator in improving patient education
.
Diabetes Educ
16
:
36
43
,
1990
65.
Fedderson
E
,
Lockwood
DH
:
An inpatient diabetes educator's impact on length of hospital stay
.
Diabetes Educ
20
:
125
128
,
1994
66.
Weinberger
M
,
Kirkman
MS
,
Samsa
GP
,
Shortliffe
EA
,
Landsman
PB
,
Cowper
PA
,
Simel
DL
,
Feussner
JR
:
A nurse-coordinated intervention for primary care patients with non-insulin dependent diabetes mellitus: impact on glycemic control and health-related quality of life
.
J Gen Intern Med
10
:
59
66
,
1995
67.
Spellbring
AM
:
Nursing's role in health promotion
.
Nurs Clin North Am
26
:
805
814
,
1991
68.
Glasgow
RE
,
Toobert
DJ
,
Hampson
SE
,
Brown
JE
,
Lewinsohn
PM
,
Donnelly
J
:
Improving self-care among older patients with type II diabetes: the “sixty-something.” study
.
Patient Educ Couns
19
:
61
74
,
1992
69.
Diabetes Control and Complications Trial Research Group
:
Expanded role of the dietitian in the Diabetes Control and Complications Trial: implications for practice
.
J Am Diet Assoc
93
:
758
767
,
1993
70.
Delahanty
LM
,
Halford
BH
:
The role of diet behaviors in achieving improved glycemic control in intensively treated patients in the Diabetes Control and Complications Trial
.
Diabetes Care
16
:
1453
1458
,
1993
71.
Franz
MJ
,
Monk
A
,
Barry
B
,
McLain
K
,
Weaver
T
,
Cooper
N
,
Upham
P
,
Bergenstal
R
,
Mazze
R
:
Effectiveness of medical nutrition therapy provided by dietitians in the management of non-insulin-dependent diabetes mellitus: a randomized, controlled clinical trial
.
J Am Diet Assoc
95
:
1009
1017
,
1995
72.
Khakpour
D
,
Thompson
L
:
The nutrition specialist on the diabetes management team
.
Clin Diabetes
16
:
21
22
,
1998
73.
Baran
R
,
Crumlish
K
,
Patterson
H
,
Shaw
J
,
Erwin
G
,
Wylie
J
,
Duong
P
:
Improving outcomes of community-dwelling older patients with diabetes through pharmacist counseling
.
Am J Health Syst Pharm
56
:
1535
1539
,
1999
74.
Coast-Senior
EA
,
Kroner
BA
,
Kelley
CL
,
Trilli
LE
:
Management of patients with type 2 diabetes by pharmacists in primary care clinics
.
Ann Pharmacother
32
:
636
641
,
1998
75.
Huff
PS
,
Ives
TJ
,
Almond
SN
,
Griffin
NW
:
Pharmacist-managed diabetes education service
.
Am J Hosp Pharm
40
:
991
993
,
1983
76.
Canter
CL
:
The Asheville Project: Long term-clinical and economic outcomes of a community pharmacy diabetes care program
.
J Am Pharm Assoc (Wash)
43
:
173
184
,
2003
77.
Van Veldhuizen-Scott
MK
,
Widmer
LB
,
Stacey
SA
,
Popovich
NG
:
Developing and implementing a pharmaceutical care model in an ambulatory care setting for patients with diabetes
.
Diabetes Educ
21
:
117
123
,
1995
78.
Garrentt
DG
,
Blumi
BM
:
Patient self-management program for diabetes: first-year clinical, humanistic, and economic outcomes
.
J Am Pharm Assoc
45
:
130
137
,
2005
79.
Shane-McWhorter
L
,
Fermo
JD
,
Bultemeir
NC
,
Oderda
GM
:
National survey of pharmacist certified diabetes educators
.
Pharmacotherapy
22
:
1579
1593
,
2002
80.
Franz
MJ
,
Callahan
T
,
Castle
G
:
Changing roles: educators and clinicians
.
Clin Diabetes
12
:
53
54
,
1994
81.
Rubin
RR
,
Peyrot
M
,
Saudek
CD
:
Effect of diabetes education on self-care, metabolic control, and emotional well-being
.
Diabetes Care
12
:
673
679
,
1989
82.
Campbell
EM
,
Redman
S
,
Moffitt
PS
,
Sanson-Fisher
RW
:
The relative effectiveness of educational and behavioral instruction programs for patients with NIDDM: a randomized trial
.
Diabetes Educ
22
:
379
386
,
1996
83.
Rubin
RR
,
Peyrot
M
,
Saudek
CD
:
The effect of a diabetes education program incorporating coping skills, training on emotional well-being, and diabetes self-efficacy
.
Diabetes Educ
19
:
210
214
,
1993
84.
Emerson
S
:
Implementing diabetes self-management education in primary care
.
Diabetes Spectrum
19
:
79
83
,
2006
85.
Satterfield
D
,
Burd
C
,
Valdez
L
,
Hosey
G
,
Eagle Shield
J
:
The “In-Between People”: participation of community health representatives and lay health workers in diabetes prevention and care in American Indian and Alaska Native communities
.
Health Promotion Practice
3
:
66
175
,
2002
86.
American Association of Diabetes Educators
:
American Association of Diabetes Educators Position Statement: diabetes community health workers
.
Diabetes Educ
29
:
818
823
,
2003
87.
American Public Health Association (APHA) Policy Statement No. 2001–15
.
Recognition and support for community health workers' contributions to meeting our nation's health care needs. Policy Statements Adopted by the Governing Council of the American Public Health Association, October 24, 2001
.
Am J Public Health
92
:
451
483
,
2002
88.
Norris
SL
,
Chowdhury
FE
,
VanLet
K
,
Horsley
T
,
Brownstein
JN
,
Zhang
X
,
Jack
L
 Jr
,
Satterfield
DW
:
Effectiveness of community health workers in the care of persons with diabetes
.
Diabet Med
23
:
544
556
,
2006
89.
Lewin
SA
,
Dick
J
,
Pond
P
,
Zwarenstein
M
,
Aja
G
,
van Wyk
B
,
Bosch-Copblanch
Z
,
Patrick
M
:
Lay health workers in primary and community health care
.
Cochrane Database Syst Rev
1
:
2005
90.
Norris
SL
,
Nichols
PJ
,
Caspersen
CJ
, et al
:
Increasing diabetes self-management education in community settings. a systematic review
.
Am J Prev Med
22
:
39
43
,
2002
91.
Lorig
KR
,
Ritter
P
,
Stewart
AL
, et al
:
Chronic disease self-management programs
.
Medical Care
39
:
1217
1221
,
2001
92.
Heisler
M
:
Building peer support programs to manage chronic disease: seven models for success
.
Oakland, CA
,
California Health Care Foundation
,
2006
93.
Anderson
RM
,
Donnelly
MB
,
Gressard
CP
:
The attitudes of nurses, dietitians, and physicians toward diabetes
.
Diabetes Educ
17
:
261
268
,
1991
94.
Lorenz
RA
,
Bubb
J
,
Davis
D
,
Jacobson
A
,
Jannasch
K
,
Kramer
J
,
Lipps
J
,
Schlundt
D
:
Changing behavior: practical lessons from the Diabetes Control and Complications Trial
.
Diabetes Care
19
:
648
652
,
1996
95.
Ockene
JK
,
Ockene
IS
,
Quirk
ME
,
Hebert
JR
,
Saperia
GM
,
Luippold
RS
,
Merriam
PA
,
Ellis
S
:
Physician training for patient-centered nutrition counseling in a lipid intervention trial
.
Prev Med
24
:
563
570
,
1995
96.
Cypress
M
,
Wylie-Rosett
J
,
Engel
SS
,
Stager
TB
:
The scope of practice of diabetes educators in a metropolitan area
.
Diabetes Educ
18
:
111
114
,
1992
97.
Leggett-Frazier
N
,
Swanson
MS
,
Vincent
PA
,
Pokorny
ME
,
Engelke
MK
:
Telephone communication between diabetes clients and nurse educators
.
Diabetes Educ
23
:
287
293
,
1997
98.
American Association of Diabetes Educators
:
The scope of practice for diabetes educators and the standards of practice for diabetes educators
.
Diabetes Educ
26
:
25
31
,
2000
99.
Valentine
V
,
Kulkarni
K
,
Hinnen
D
:
Evolving roles: from diabetes educators to advanced diabetes managers
.
Diabetes Spectrum
16
:
27
31
,
2004
100.
Glasgow
RE
,
Funnell
MM
,
Bonomi
AE
,
Davis
CL
,
Beckham
V
,
Wagner
EH
:
Self-management aspects of the Improving Chronic Illness Care Breakthrough series: design and implementation with diabetes and heart failure teams
.
Ann Behav Med
24
:
80
87
,
2002
101.
Ofman
JJ
,
Badamgarav
E
,
Henning
JM
,
Knight
K
,
Gano
AD
 Jr
,
Levan
RK
,
Gur-Arie
S
,
Richards
MS
,
Hasselblad
V
,
Weingarten
SR
:
Does disease management improve clinical and economic outcomes in patients with chronic diseases? A systematic review
.
Am J Med
117
:
182
192
,
2004
102.
Wensing
M
,
Wollersheim
H
,
Grol
R
:
Organizational interventions to implement improvements in patient care: a structured review of reviews
.
Implementation Sci
1
:
2
,
2006
103.
Mazze
R
,
Albin
J
,
Friedman
J
,
Hahn
S
,
Murphy
JA
,
Reese
P
,
Rosen
S
,
Scaggs
C
,
Shamoon
H
,
Vaccaro-Olko
MJ
:
Diabetes education teams
.
Professional Education in Diabetes: Proceedings of the DRTC Conference
.
National Diabetes Information Clearinghouse and National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health
,
December
1980
104.
Skovlund
SE
,
Peyrot
M
on behalf of the DAWN International Advisory Panel
:
The Diabetes Attitudes, Wishes, and Needs (DAWN) program: a new approach to improving outcomes of diabetes care
.
Diabetes Spectrum
18
:
136
142
,
2005
105.
Norris
SL
,
Nichols
PJ
,
Caspersen
CJ
,
Glasgow
RE
,
Emgelgau
MM
,
Jack
J
,
Snyder
SR
,
Carande-Kulis
VG
,
Isham
G
,
Garfield
S
,
Briss
P
,
McCulloch
D
the Task Force on Community Preventive Services
.
Increasing diabetes self-management education in community settings: a systematic review
.
Am J Prev Med
22
:
33
66
,
2002
106.
Norris
SL
,
Zhang
X
,
Avenell
A
,
Gregg
E
,
Bowman
B
,
Serdula
M
,
Brown
TJ
,
Schmid
CH
,
Lau
J
:
Long term effectiveness of lifestyle and behavioral weight loss interventions in adults with type 2 diabetes: a meta-analysis
.
Am J Med
117
:
762
74
,
2004
107.
Ellis
SE
,
Speroff
T
,
Dittus
RS
,
Brown
A
,
Pichert
JW
,
Elasy
TA
:
Diabetes patient education: a meta-analysis and meta-regression
.
Patient Educ Counsel
52
:
97
105
,
2004
108.
Brown
SA
:
Studies of educational interventions in diabetes care: a meta-analysis revisited
.
Patient Educ Counsel
16
:
189
215
,
1990
109.
Armour
TA
,
Norris
SL
,
Jack
L
 Jr
,
Zhang
X
,
Fisher
L
:
The effectiveness of family interventions in people with diabetes mellitus: a systematic review
.
Diabet Med
10
:
1295
1305
,
2005
110.
Redman
BK
:
The Practice of Patient Education
. 10th ed.
St. Louis, MO
,
Mosby
,
2007
111.
Wikipedia
.
Curriculum definition
. . Accessed 7 January 2007
112.
Mulcahy
K
,
Maryniuk
M
,
Peeples
M
,
Peyrot
M
,
Tomky
D
,
Weaver
T
,
Yarborough
P
:
Diabetes self-management education core outcome measures
.
Diabetes Educ
29
:
768
803
,
2003
113.
American Association of Diabetes Educators
:
The scope of practice, standards of practice, and standards of professional performance for diabetes educators
.
Diabetes Educ
31
:
487
513
,
2005
114.
American Diabetes Association
:
Standards of medical care in diabetes—2009
.
Diabetes Care
32
(
Suppl. 1
):
S13
S61
,
2009
115.
American Diabetes Association
:
Nutrition recommendations and interventions for diabetes: a position statement of the American Diabetes Association (Position Statement)
.
Diabetes Care
30
(
Suppl. 1
):
S48
S65
,
2007
116.
Reader
D
,
Splett
P
,
Gunderson
EP
:
Impact of gestational diabetes mellitus nutrition practice guidelines implemented by registered dietitians on pregnancy outcomes
.
J Am Dietetic Association
9
:
1426
1433
,
2006
117.
Kulkarni
K
,
Boucher
JL
,
Daly
A
,
Shwide-Slavin
C
,
Silvers
BT
,
O-Sullivan-Maillet
J
,
Pritchett
E
American Dietetic Association, Diabetes Care and Education Practice Group, American Dietetic Association
:
Standards of practice and standards of professional performance for registered dietitians (generalist, specialty, and advanced) in diabetes care
.
J Am Dietetic Association
105
:
819
824
,
2005
118.
Blanchard
MA
,
Rose
LE
,
Taylor
J
,
McEntee
MA
,
Latchaw
L
:
Using a focus group to design a diabetes program for an African American population
.
Diabetes Educ
25
:
917
923
,
1999
119.
Sarkadi
A
,
Rosenqvist
U
:
Study circles at the pharmacy – a new model for diabetes education in groups
.
Patient Ed and Counselling
37
:
89
96
,
1999
120.
Norris
SL
:
Health related quality of life among adults with diabetes
.
Curr Diab Reports
5
:
124
30
,
2005
121.
Tang
TS
,
Gillard
ML
,
Funnell
MM
, et al
:
Developing a new generation of ongoing diabetes self-management support interventions (DSMS): a preliminary report
.
Diabetes Educ
31
:
91
97
,
2005
122.
Funnell
MM
,
Nwankwo
R
,
Gillard
ML
,
Anderson
RM
,
Tang
TS
:
Implementing an empowerment-based diabetes self-management education program
.
Diabetes Educ
31
:
53
61
,
2005
123.
Glazier
RH
,
Bajcar
J
,
Kennie
NR
,
Willson
K
:
A systematic review of interventions to improve diabetes care in socially disadvantaged populations
.
Diabetes Care
26
:
1675
88
,
2006
124.
Samuel-Hodge
CD
,
Keyserling
TC
,
France
R
,
Ingram
AF
,
Johnston
LF
,
Pullen Davis
L
,
Davis
G
,
Cole
AS
:
A church based diabetes self-management education program for African Americans with type 2 diabetes
.
Prev Chronic Dis
3
:
A93
,
2006
125.
Trento
M
,
Passera
P
,
Borgo
E
,
Tomalino
M
,
Bajardi
M
,
Cavallo
F
,
Porta
M
:
A 5-year randomized controlled study of learning, problem solving ability, and quality of life modifications in people with type 2 diabetes managed by group care
.
Diabetes Care
27
:
670
675
,
2004
126.
Izquierdo
RE
,
Knudson
PE
,
Meyer
S
,
Kearns
J
,
Ploutz-Snyder
R
,
Weinstock
R
:
A comparison of diabetes education administered through telemedicine versus in person
.
Diabetes Care
26
:
1002
1007
,
2003
127.
Garrett
N
,
Hageman
CM
,
Sibley
SD
,
Davern
M
,
Berger
M
,
Brunzell
C
,
Malecha
K
,
Richards
SW
:
The effectiveness of an interactive small group diabetes intervention in improving knowledge, feeling of control and behavior
.
Health Promot Pract
6
:
320
328
,
2005
128.
Hayes
JT
,
Boucher
JL
,
Pronk
NP
,
Gehlin
E
,
Spencet
M
,
Waslaski
J
:
The role of the certified diabetes educator in telephone counseling
.
Diabetes Educ
27
:
377
386
,
2001
129.
Carlson
A
,
Rosenqvist
U
:
Diabetes care organization, process and patient out-comes: effects of a diabetes control program
.
Diabetes Educ
17
:
42
48
,
1991
130.
Handley
M
,
MacGregor
K
,
Schillinger
D
,
Scharifi
C
,
Wong
S
,
Bodenheimer
T
:
Using action plans to help primary care patients adopt healthy behaviors: A descriptive study
.
J Am Board Fam Med
19
:
224
231
,
2006
131.
Gilden
JL
,
Hendryx
M
,
Casia
C
,
Singh
SP
:
The effectiveness of diabetes education programs for older patients and their spouses
.
J Am Geriatr Soc
37
:
1023
1030
,
1989
132.
Brown
SA
:
Effects of educational interventions in diabetes care: a meta-analysis of findings
.
Nurs Res
37
:
223
230
,
1988
133.
Davis
WK
,
Hull
AL
,
Boutaugh
ML
:
Factors affecting the educational diagnosis of diabetic patients
.
Diabetes Care
4
:
275
278
,
1981
134.
Anderson
RM
,
Fitzgerald
JT
,
Oh
M
:
The relationship between diabetes-related attitudes and patients' self-reported adherence
.
Diabetes Educ
19
:
287
292
,
1993
135.
Funnell
MM
,
Anderson
RM
:
AADE Position Statement: individualization of diabetes self-management education
.
Diabetes Educ
33
:
45
49
,
2007
136.
Davis
TC
,
Crouch
MA
,
Wills
G
,
Miller
S
,
Abdehou
DM
:
The gap between patient reading comprehension and the readability of patient education materials
.
J Fam Pract
31
:
533
538
,
1990
137.
Hosey
GM
,
Freeman
WL
,
Stracqualursi
F
,
Gohdes
D
:
Designing and evaluating diabetes education material for American Indians
.
Diabetes Educ
16
:
407
414
,
1990
138.
Thomson
FJ
,
Masson
EA
:
Can elderly patients co-operate with routine foot care?
Diabetes Spectrum
8
:
218
219
,
1995
139.
Assal
JP
,
Jacquemet
S
,
Morel
Y
:
The added value of therapy in diabetes: the education of patients for self-management of their disease
.
Metabolism
46
:
61
64
,
1997
140.
Ad Hoc Committee on Health Literacy for the Council on Scientific Affairs, American Medical Association
:
Health literacy: report of the Council on Scientific Affairs
.
JAMA
281
:
552
557
,
1999
141.
Schillinger
D
,
Grumbach
K
,
Piette
J
,
Wang
F
,
Osmond
D
,
Daher
C
,
Palacios
J
,
Diaz Sullivan
G
,
Bindman
AB
:
Association of health literacy with diabetes outcomes
.
JAMA
288
:
475
482
,
2002
142.
Nurss
JR
,
Parker
R
,
Williams
M
,
Baker
D
:
STOFHLA Teaching Edition
.
Snow Camp, NC
,
Peppercorn Books
,
2003
143.
Chew
LD
,
Bradley
KA
,
Boyko
EJ
:
Brief questions to identify patients with inadequate health literacy
.
Family Medicine
36
:
588
594
,
2006
144.
Shillinger
D
,
Piette
J
,
Grumbach
K
,
Wang
F
,
Wilson
C
,
Daher
C
, et al
.:
Closing the loop: physician communication with diabetic patients who have low health literacy
.
Arch Intern Med
163
:
83
90
,
2003
145.
Piette
JD
,
Heisler
M
,
Wagner
TH
:
Problems paying out of pocket medication costs among older adults with diabetes
.
Diabetes Care
27
:
384
391
,
2004
146.
Peyrot
M
,
Rubin
RR
,
Lauritzen
T
,
Snoek
FJ
,
Matthews
DR
,
Skovlund
SE
:
Psychosocial problems and barriers to improved diabetes management: results of the cross-national Diabetes Attitudes, Wishes, and Needs study
.
Diabet Med
22
:
1379
1385
,
2005
147.
Peyrot
M
,
Rubin
RR
,
Siminerio
L
on behalf of the International DAWN Advisory Panel
:
Physician and nurse use of psychosocial strategies in diabetes care: results of the cross-national Diabetes Attitudes, Wishes, and Needs study
.
Diabetes Care
29
:
1256
1262
,
2006
148.
Rubin
RR
,
Peyrot
M
,
Siminerio
L
on behalf of the International DAWN Advisory Panel
:
Health care and patient-reported outcomes: results of the cross-national Diabetes Attitudes, Wishes, and Needs study
.
Diabetes Care
29
:
1249
1255
,
2006
149.
McKellar
JD
,
Humphreys
K
,
Piette
JD
:
Depression increases diabetes symptoms by complicating patients' self-care adherence
.
Diabetes Educ
30
:
485
492
,
2004
150.
Krein
SL
,
Heisler
M
,
Piette
JD
,
Makki
F
,
Kerr
EA
:
The effect of chronic pain on diabetes patients' self-management
.
Diabetes Care
28
:
65
70
,
2005
151.
Piette
JD
,
Kerr
E
:
The role of comorbid chronic conditions on diabetes care
.
Diabetes Care
29
:
239
253
,
2006
152.
Estey
AL
,
Tan
MH
,
Mann
K
:
Follow-up intervention: its effect on compliance behavior to a diabetes regimen
.
Diabetes Educ
16
:
291
295
,
1990
153.
Glasgow
RE
,
Davis
CL
,
Funnell
MM
, et al
:
Implementing practical interventions to support chronic illness self-management
.
Joint Commission Journal on Quality and Safety
29
:
563
574
,
2003
154.
Daly
A
,
Leontos
C
:
Legislation for health care coverage for diabetes self-management training, equipment and supplies: past, present and future
.
Diabetes Spectrum
12
:
222
230
,
1999
155.
Grebe
SKG
,
Smith
RBW
Clinical audit and standardized follow-up improve quality of documentation in diabetes care
.
N Z Med J
108
:
339
342
,
1995
156.
Schriger
DL
,
Baraff
LJ
,
Rogers
WH
,
Cretin
S
:
Implementation of clinical guidelines using a computer charting system: effect on the initial care of health care workers exposed to body fluids
.
JAMA
278
:
1585
1590
,
1997
157.
Aubert
RE
,
Herman
WH
,
Waters
J
,
Moore
W
,
Sutton
D
,
Peterson
BL
,
Bailey
CM
,
Koplan
JP
Nurse case management to improve glycemic control in diabetic patients in a health maintenance organization: a randomized, controlled trial
.
Ann Intern Med
129
605
612
,
1998
158.
Knight
K
,
Badamgarav
E
,
Henning
JM
,
Hasselblad
V
,
Gano
AD
 Jr
,
Ofman
JJ
,
Weingarten
SR
:
A systematic review of diabetes disease management programs
.
Am J Managed Care
11
:
242
50
,
2005
159.
Two Feathers
J
,
Kieffer
EC
,
Palmisano
G
, et al
:
Racial and ethnic approaches to community health (REACH) Detroit partnership: improving diabetes-related outcomes among African American and Latino adults
.
Am J Public Health
95
:
1552
1560
,
2005
160.
Mulcahy
K
,
Maryniuk
M
,
Peeple
M
,
Peyrot
M
,
Tomky
D
,
Weaver
T
,
Yarborough
P
:
AADE Position Statement: standards for outcomes measurement of diabetes self-management education
.
Diabetes Educ
29
:
804
816
,
2003
161.
Institute of Healthcare Improvement
:
How to improve: improvement methods
. . Accessed 24 April 2006
162.
Bardsley
J
,
Bronzini
B
,
Harriman
K
,
Lumber
T
:
CQI: A Step by Step Guide for Quality Improvement in Diabetes Education
.
Chicago, IL
,
American Association of Diabetes Educators
,
2005
163.
Joint Commission Resources
:
Cost-Effective Performance Improvement in Ambulatory Care
.
Oakbrook Terrace, IL
,
Joint Commission on Accreditation of Healthcare Organizations
,
2003
164.
Institute of Healthcare Improvement
:
Measures: diabetes
. . Accessed 24 April 2006
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