Targeted Programs Are Needed to Improve DSMES Completion Rate at LHDs

This entry is part 6 of 12 in the series September 2023

Targeted programs are needed to engage patients and improve diabetes self-management education and support (DSMES) completion at local health departments (LHDs).

In our article, “Diabetes Self-management Education and Support Completion Before and During the COVID-19 Pandemic: Results from Local Health Departments in North Carolina,” my colleagues, Drs Cummings and Xu, and collaborators, Ms Watson at Pitt County Health Department, North Carolina, and Ms Payton at Chronic Disease and Injury Section, North Carolina Division of Public Health, conducted a retrospective analysis of DSMES data to evaluate DSMES completion at two LHDs. We included a total of 660 patients (type 1 or type 2 diabetes).

North Carolina (NC) is one of 15 southern states identified as being in the “diabetes belt.” The prevalence of diabetes among adults in NC is much higher than the national average. In 2006, NC was the first state in the country to develop an ADA-recognized umbrella program—DiabetesSmart, which manages recognition requirements and administrative responsibilities for partner sites across the state, including local health departments (LHDs). The delivery model (eg, number and length of DSMES sessions used to deliver the required curriculum) varies across different DSMES providers. As a safety net provider, LHDs serve many disadvantaged populations, especially in rural communities. DSMES provided at LHDs is a valuable service to many disadvantaged patients. A better knowledge of the status of DSMES at LHDs can inform re-designing of DSMES delivery models.

What did we find:

  • Overall, the DSMES completion rate was 15.3% from 2017-2021.
  • The 2 four-hour sessions had a higher completion rate than the 4 two-hour sessions (19.2% vs. 12.3%).
  • The DSMES completion rate also decreased from 2017-2021.

Read our article in JPHMP

Lack of funding and staff have been key barriers for LHDs to provide DSMES and engage patients to complete DSMES. Also, it is urgently needed to identify the barriers to DSMES in rural communities and explore innovative delivery modes and number of sessions for the DSMES.

Read Our Article in the Journal of Public Health Management and Practice:

Huabin Luo, PhD, is an associate professor, Department of Public Health, Brody School of Medicine, East Carolina University, and a member of the JPHMP Editorial Board.

Doyle M. Cummings, PharmD, FCP, FCCP, is the Berbecker Distinguished Professor of Rural Medicine, Professor of Public Health, Adjunct Professor of Family Medicine, and Senior Faculty at the Health Disparities Center, Brody School of Medicine, East Carolina University, and a member of the North Carolina Institute of Medicine.

Lei Xu, PhD, works as the Associate Professor and the Director of the Public Health Genomics Lab at the Department of Health Education and Promotion at East Carolina University. Dr. Xu’s primary research interest focuses on health promotion and public health initiatives including diabetes education, autism genetic testing and screening, health disparities, and community-based participatory research.

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