Implementation of a diabetes education kiosk in a low-income clinical setting: a community implementation process.

Abstract

The rapid rise in rates of diabetes among the U.S. population1 underscores the crucial need for assistance in everyday self-management of chronic illness.2,3 Yet, a major gap exists in the dissemination and implementation of research findings on 1 ) the extent to which communities are aware of best practice guidelines for diabetes prevention and management and 2 ) strategies for assisting communities in adopting identified best practices.4 A community needs assessment of key stakeholders in central Texas revealed a need for diabetes patient education in low-literacy rural communities because of residents' limited access to trained educators for diabetes self-management.5 In an effort to address the double challenges of limited access to health care providers (HCPs) and insufficient educational materials for disadvantaged, at-risk populations, the Diabetes Prevention and Management Program (DPMP) at the Center for Community Health Development6 developed a low-literacy, touch-screen computer module, the Diabetes Education Kiosk (DEK). The DEK is a form of interactive behavior-change technology (IBCT) designed to encourage healthy behavior changes by motivating patients to be more independent and improve their self-management with little or no assistance from their HCPs.7 IBCT can also improve communication between patients and health care teams by facilitating clinicians' review of patients' status and guiding delivery of educational messages.8 IBCTs include the use of hardware and software to promote and sustain behavior changes. Examples include e-mail messages, patient-centered websites, personal digital assistants, DVDs, smartphone and iPad applications, voice-response or automated phone calls, and touch-screen kiosks. Touch-screen kiosks or monitors have been used effectively for health education and other medical purposes.9–12 This article describes the pilot implementation of a computer-based touch-screen diabetes educational training tool in a central Texas family medicine residency training clinical setting that serves predominantly low-income and low-literacy patient populations. …