Diabetes is one of the most common, costly, and debilitating diseases present in the US health care system. Its prevalence is higher in some populations than others - e.g., 13% in non-Hispanic blacks; 10.2% in Hispanic/Latino populations. Nationally, there are an estimated 16 million people with """"""""pre-diabetes"""""""" - people with impaired fasting glucose and impaired glucose tolerance, and at-risk for diabetes, in Illinois, the prevalence of diabetes in rural areas is 9.2%. The value of diabetes education is clearly documented. However, according to Healthy People 2010, only 45% of persons with diabetes receive formal education and research shows that diabetes patients who never receive education are at 4-fold increased risk for major complications. The present research further examines the impact of diabetes education and the effect of patient-centered strategies on health outcomes of diabetes patients. Older adults 60 years of age and older are targeted, with recruitment in urban and rural areas from minority and majority populations. Four interventions are examined: 1. Flow sheet only; 2. Flow sheet and patient education; 3. Flow sheet, patient education, chronic disease self-management program (CDSMP) for patients only; 4. Flow sheet, patient education, CDSMP for patients-family member caregivers as dyads. Analysis will allow for comparisons between practice-based interventions (1,2) versus those with patient-centered emphasis (3,4). CDSMP with caregivers has not previously been studied. Analysis will focus on rural-urban and race/ethnicity comparisons. Results will inform practitioners regarding effectiveness of monitoring and education to improve health outcomes of diabetes patients.
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