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For residents of the Henry Street Settlement, would the implementation of a diabetes education seminar compared to prior knowledge improve knowledge of diabetes prevention and maintenance?

PICO Question

Background

Search Strategy

• An increase in patient knowledge of diabetes results in better compliance to treatment and decrease in complications (Chavan et al., 2015)

• At follow-up from diabetes education, participants were less likely to be depressed, more compliant with medications, and scored higher on an assessment of diabetes knowledge (Hughes, Yang, Ramanathan, & Benjamins, 2016).

• Su et al. (2016) found that individual educational levels are associated with a higher rate of awareness, treatment, adherence to medications, and glucose monitoring.

• Diabetic patients with a lower level of education and household income are less likely to receive treatment. Findings suggest that greater attention should be paid to these populations to achieve a higher rate of compliance (Su et al., 2016).

• Patients who had at least one visit with a Chronic Care Coordinator (CCC) experienced more diagnostic testing (Solorio et al., 2015).

• The CCC helps the patient become more aware about the next steps needed in the managements of their diabetes (Solorio et al., 2015).

Research Literature Review

Major EBP Recommendations● Seminars, counseling sessions, and workshops should be arranged periodically

for diabetic patients to increase awareness (Chavan et al., 2015).● Diabetes education improves clinical outcomes and quality of life

demonstrating how accurate knowledge increases diabetic regimen compliance (Funnell et al., 2011).

● Diabetic education helps residents achieve self-care behaviors (Buss et al., 2012).

● Buss et al. (2012) recommends assessing and prescribing physical activity based on needs and conditions.

● Providing individualized case management, care coordination, goal setting, and self-management through clinical site interventions are recommended (Solorio et al., 2015).

● Focus education on general diabetes knowledge, blood glucose monitoring, nutrition, physical activity, foot care, and medications (Solorio et al., 2015).

Evaluation● Pretest consisting of 10 questions● Post-test (same as pre-test) to assess efficacy● Success will be measured based on the difference in number of

questions answered correctly between the pretest and posttest● No difference between pre-test and post-test = low efficacy● Two questions or more answered correctly = moderate efficacy● All questions answered correctly by at least 50% of residents = high

efficacy● To conclude, the seminar was a success. The residents of the Henry

Street and the neighboring towns were receptive to the information of Diabetes. This was measured by the feedback given to us after the seminar.

Change Process● Clearance of educational seminar by Henry Street Settlement

administration● Preparation of seminar● Information of time and location will be distributed to residents● A pre-test and post-test will be given to evaluate residents’ knowledge

of diabetes.● If the educational seminar is successful, additional learning seminars

should be considered to reinforce learning and healthy habits to prevent and manage diabetes.

• 29.1 million people have diabetes in the US population. 27.8% are undiagnosed (Centers for Disease Control and Prevention, 2014)

• High mortality rate related to diabetes (Chavan et al., 2015)• Minorities and low-income groups have the highest

likelihood of developing life-threatening diseases (our community, 2016)

• Diabetes is associated with serious complications (Solorio et al., 2015)

• Diabetes is the seventh leading cause of death in the US (Centers for Disease Control and Prevention, 2014)

• Residents of Henry Street Settlement have limited knowledge of diabetes

• Low socioeconomic status and lack of access to quality healthcare and education (our community, 2016)

Pace University, College of Health Professions, Lienhard School of Nursing

Suraiya Chowdhury, Karen Dwelley, Tess Farenwald, Brianna Franco, Donna Hughes, Sheryl John, Anne Kim, and Claudine Pearson

Evidence Based Practice Improvement: Diabetes Education Seminar to Improve Knowledge

Proposed Practice Change• Interactive educational presentation on diabetes risk factors, management,

and prevention led by Henry Street Settlement on-site nurse• Considerations: language, reading, learning, and educational levels• Prior to seminar, a pre-test of 10 questions will be given to assess prior

knowledge of diabetes.• After the seminar, a post-test will be given to assess efficacy of diabetes

teaching seminar.• Information of on-site healthcare resources for diabetes control and

management services will be provided.

References

● PubMed, CINAHL, National Clinical Guideline Clearinghouse and Medline via EBSCO

● Delimitations: peer-reviewed, recent scholarly articles, low income patients, and English only

● Inclusions/exclusions were made based on education before and after the seminar, and the population being tested.

● Keywords: diabetes, prevention, education, pre-test, post-test, low income, and management

● Seven research articles, two systematic reviews, and two clinical guidelines

Buss, K., Chene, R., Cuadros, J., Fournier, J., Higgins, K., Inturrisi, M., . . . Wilson, J., (2012). Basic guidelines for diabetes care. Agency for Healthcare Research and Quality …..(AHRQ). California diabetes Program. Retrieved from: https://www.guideline.gov/summaries/summary/38460/basic-guidelines-for-diabetes-care (This is an EBP Guideline …..included in level one of Evidence Hierarchy)Centers for Disease Control and Prevention (2014). Estimates on diabetes and its burden in the United States. Atlanta, GA: Centers for Disease Control and Prevention; 2012. …..Retrieved from: http://ww.cdc.gov/diabetes/pubs/statsreport14/national-diabetes-report-web.pdf (This is a descriptive qualitative study included in level six of Evidence …..Hierarchy)Chavan, G. M., Waghachavare, V. B., Gore, A. D., Chavan, V. M., Dhobale, R. V., & Dhumale, G. B. (2015). Knowledge about diabetes and relationship between compliance to …..the management among the diabetic patients from rural area of Sangli District, Maharashtra, India. Journal of Family Medicine and Primary Care, 4(3), 439–443. …..http://doi.org/10.4103/2249-4863.161349 (This is a cohort …….study included in level four of Evidence Hierarchy)Funnell, M. M., Brown, T. L., Childs, B. P., Haas, L. B., Hosey, G. M., Jensen, B., … Weiss, M. A. (2011). National standards for diabetes self-management education. Diabetes …..Care, 34(Suppl 1), S89–96. http://doi.org/10.2337/dc11-S089 (This is a case control study included in level four of Evidence Hierarchy) Hughes, M., Yang, E., Ramanathan, D., & Benjamin, M. (2016). Community-based diabetes community health worker intervention in an underserved chicago population. …..Journal of Community Health.1-8. doi 10.1007/s10900-016-0212-8 (This is a randomized controlled trial included in level two of Evidence Hierarchy)Our community. (2016). Retrieved July 24, 2016, from http://www.henrystreet.org/about/our-community/ (This is a descriptive qualitative study included in level six of …..Evidence Hierarchy) Rong, S., Cai, L., Cui, W., He, J., You, D., & Golden, A. (2016). Multilevel analysis of socioeconomic determinants on diabetes prevalence, awareness, treatment and …..self-management in ethnic minorities of Yunnan Province, China. International Journal of Environmental Research and Public Health, 13, 751.doi:10.3390/ijerph13080751 …..(This is a meta-analysis included in level one of Evidence Hierarchy) Solorio, R., Bansal, A., Comstock, B., Ulatowski, K., & Barker, S. (2015). Impact of a chronic care coordinator intervention on diabetes quality of care in a community health …..center. Health Services Research, 50:3. (This is a systematic review included in level one of Evidence Hierarchy)

Retrieved from: http://www.mcnt.com/images/diabetes-program/feature-diabetes-.jpg

Retrieved from: Claudine Pearson