PMID: 16524346Mar 10, 2006Paper

Robustness of a computer-assisted diabetes self-management intervention across patient characteristics, healthcare settings, and intervention staff

The American Journal of Managed Care
Russell E GlasgowPaul A Nutting

Abstract

A major problem in the dissemination of most interventions found to be efficacious is that they are of limited or unknown generalizability. To document the "robustness," or external validity, of a computer-assisted diabetes self-management program across different patient characteristics, healthcare settings (mixed payer vs health maintenance organization), intervention staff, and outcomes. A randomized controlled trial evaluating a computer-assisted behavior change program for adult patients with type 2 diabetes mellitus (n = 217) vs a computerized health risk assessment. Outcomes were identified using the RE-AIM framework and included program adoption among physicians, reach across patient groups, implementation, and behavioral (fat intake and physical activity) and biological (glycosylated hemoglobin and lipid levels) effectiveness measures. The program achieved 41% patient participation, variable adoption across healthcare settings (76% of health maintenance organization physicians vs 18% of non-health maintenance organization physicians participated), good implementation, and improvement in behavioral outcomes. There were few significant interactions between treatment condition and patient characteristics, type of healthca...Continue Reading

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