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Improving Prediabetes Screenings at Rural Missouri County Health Departments

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Abstract

With prediabetes criteria expanding in recent years, nurses offering prediabetes screenings require updates to stay abreast of current clinical guidelines. This study looked to improve rural Missouri health department nurses’ understanding of prediabetes, improve the identification of prediabetes at participating health departments, and educate the nurses on existing prediabetes guidelines. A convenience sample of twenty-two nurses from seven rural Missouri health departments participated. Nurses completed a demographic questionnaire and a prediabetes knowledge pre-test prior to the intervention. Seven to eight weeks post-intervention, the health department nurses completed the prediabetes post-tests. A single live education session was conducted at each health department. Data from the pre- and post-tests was reviewed within three result categories. The overall, laboratory nursing knowledge, and general nursing knowledge divisions each showed statistically significant improvement with a p < 0.05. This study’s post-test improvement in prediabetes knowledge replicates the usefulness of a simple, low cost educational update. Nurses improved the identification of prediabetes laboratory values on post-test data and showed an increase in overall prediabetes knowledge. A single and simple continuing education program is a useful tool for rural health nurses.

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References

  1. American Diabetes Association. (2014). Standards of medical care in diabetes. Diabetes Care, 37(1), S14–S80. doi:10.2337/dc14-S014.

    Article  Google Scholar 

  2. Ammerman, A., Keyserling, T., Atwood, J., Hosking, J., Zayed, H., & Krasny, C. (2003). A randomized controlled trial of a public health nurse directed treatment program for rural patients with high blood cholesterol. Preventative Medicine, 36(3), 340–351.

    Article  Google Scholar 

  3. Aroda, V., & Ratner, R. (2008). Approach to patient with prediabetes. Journal of Clinical Endocrinology, 93(9), 3259–3265.

    Article  CAS  Google Scholar 

  4. Bushy, A. (2006). Nursing in rural and frontier areas: Issues, challenges, and opportunities. Harvard Health Policy Review, 36(3), 17–27.

    Google Scholar 

  5. Carter, C. (2008). Examination of prediabetes and diabetes perceptions and knowledge using focus groups. Doctoral dissertation: Appendic C. Clemson University, South Carolina: http://etd.lib.clemson.edu/documents/1239897019/Carter_clemson_0050M_10099.pdf/.

  6. Center for Local Public Health Services. (2014). Local public health agency infrastructure survey report 2011. Retrieved from Missouri Department of Health and Senior Services: http://health.mo.gov/living/lpha/report11/2011survey.pdf.

  7. Centers for Disease Control and Prevention. (2014). National diabetes statistics report, 2014. Retrieved from Centers for Disease Control and Prevention: http://www.cdc.gov/diabetes/pubs/estimates14.htm#6.

  8. Centers for Disease Control and Prevention. (2015). Missouri prediabetes. Retrieved from Centers for Disease Control and Prevention: http://gis.cdc.gov/grasp/diabetes/DiabetesAtlas.html.

  9. Centers for Disease Control and Prevention National Diabetes Surveillance System. (2014). Missouri—Total number (in thousands) of adults (aged 18 years or older) reporting prediabetes, 2008–2009. Retrieved from Centers for Disease Control and Prevention: http://apps.nccd.cdc.gov/DDTSTRS/Index.aspx?stateId=29&state=Missouri&cat=riskfactorsfordiabetes&Data=data&view=TOP&trend=Prediabetes&id=27.

  10. Dabney, B., & Gosschalk, A. (2010). Diabetes in rural America: A literature review. Rural Healthy People, 26, 57–72.

    Google Scholar 

  11. Diabetes Coalition of California. (2011). Algorithm for pre-diabetes idenfitication and intervention in adults. Retrieved from Diabetes Coalition of California: www.caldaibetes.org/files.cfm?filesID=873.

  12. Diabetes Screening Guidelines Work Group. (2006). State of Missouri Consensus Screening Guidelines for Pre-diabetes and Diabetes in a Medical Setting. Retrieved from Missouri Department of Health and Senior Services: http://health.mo.gov/living/healthcondiseases/chronic/diabetes/pdf/FinalScreeningGuidelines.pdf.

  13. Eaton-Spiva, L., & Day, A. (2011). Effectiveness of a computerized educational module on nurses’ knowledge and confidence level related to diabetes. Journal for Nurses in Staff Development, 27(6), 285–289. doi:10.1097/NND.0b013e3182371164.

    Article  PubMed  Google Scholar 

  14. Ford, E. S., Zhao, G., & Li, C. (2010). Pre-diabetes and the risk for cardiovascular disease: A systematic review of the evidence. Journal of the American College of Cardiology, 55(13), 1310–1317.

    Article  PubMed  Google Scholar 

  15. Forsetlund, L., Bjorndal, A., Rashidian, A., Jamtvedt, G., O’Brien, M., Wolf, F., et al. (2009). Continuing education meetings and workshops: Effects on professional practice and health care outcomes. Cochrane System Review. doi:10.1002/14651858.CD003030.PUB2.

    Google Scholar 

  16. Frieden, T. (2004). Asleep at the switch: Local public health and chronic disease. American Journal of Public Health, 94(12), 2059–2061.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Gilmer, T., & O’Connor, P. (2010). The growing importance of diabetes screening. Diabetes Care. doi:10.2337/dc10-0855.

    Google Scholar 

  18. Handelsman, Y., Mechanick, J., Blonde, L., Grunberger, G. B., Bray, G., et al. (2011). American association of clinical endocrinologists medical guidelines for clinical practice for developing a diabetes mellitus comprehensive care plan. Endocrine Practice, 17, 1–53.

  19. Iowa Diabetes Prevention and Control Program. (2014). Iowa diabetes prevention and control program. Retrieved from Iowa Department of Public Health: www.idph.state.ia.us/IDPHChannelsService/file.ashx.

  20. Missouri Department of Health and Senior Services. (2014). Local public health agencies. Retrieved from Missouri Department of Health and Senior Services: http://health.mo.gov/living/lpha/.

  21. Moattari, M., Moosavinasab, E., Dabbaghmanesh, M., & ZarifSanaiey, N. (2014). Validating a web-based diabetes education program in continuing nursing education: Knowledge and competency change and user perceptions on usability and quality. Journal of Diabetes and Metabolic Disorders. doi:10.1186/2251-6581-13-70.

    PubMed Central  PubMed  Google Scholar 

  22. National Association of County and City Health Officials. (2008). 2008 National profile of local health departmetns. Retrieved from National Association of County and City Health Officials: http://www.naccho.org/topics/infrastructure/profile/resources/2008report/upload/NACCHO_2008_ProfileReport_post-to-website-2.pdf.

  23. Nebraska Diabetes Prevention and Control Program. (2014). Nebraska Diabetes Consensus Guidelines. Retrieved from Nebraska Department of Health and Human Services: http://dhhs.ne.gov/publichealth/Documents/10-09-13%20NEW%20One-Sheet%20Summary.pdf.

  24. Patel, K., Larson, C., Hargreaves, M., Schlundt, D., Wang, H., Jones, C., & Beard, K. (2010). Community screening outcomes for diabetes, hypertension, and cholesterol. Journal of Ambulatory Care Manage, 33(2), 155–162.

    Article  Google Scholar 

  25. Peragallo-Dittko, V. (2010). Diabetes screenings in community settings, revisited. The Diabetes Educator, 36(6), 853. doi:10.1177/0145721710387244.

    Article  PubMed  Google Scholar 

  26. Ramos, M., Fullerton, L., Sapien, R., Greenberg, C., & Bauer-Creegan, J. (2014). Rural–urban disparities in school nursing: Implications for continuing education and rural school health. The Journal of Rural Health, 30(3), 265–274. doi:10.1111/jrh.12058.

    Article  PubMed  Google Scholar 

  27. Siminerio, L., Funnell, M., Peyrot, M., & Rubin, R. (2007). US nurses’ perceptions of their role in diabetes care. The Diabetes Educator, 33(1), 152–162. doi:10.1177/0145721706298194.

    Article  PubMed  Google Scholar 

  28. Siminerio, L., Piatt, G., & Zgibor, J. (2005). Implementing the chronic care model for improvements in diabetes care and education in a rural primary care practice. The Diabetes Educator, 31(2), 225–234. doi:10.1177/0145721705275325.

    Article  PubMed  Google Scholar 

  29. Turner, A., & Altamore, R. (2008). From the ground up: Information needs of nurses in a rural public health department in Oregon. Journal of the Medical Library Association, 96(4), 335–342.

    Article  PubMed Central  PubMed  Google Scholar 

  30. Uding, J., Jackson, E., & Hart, L. (2002). Efficacy of a teaching intervention on nurses’ knowledge regarding diabetes. Journal for Nurses in Staff Development, 18(6), 297–303.

    Article  PubMed  Google Scholar 

  31. United States Census Bureau. (2014). State and county quickfacts. Retrieved from United States Census Bureau: http://quickfacts.census.gov/qfd/states/29/29186.html.

  32. West, B., Parikh, P. A., & Horoqitz, C. (2010). Observations and recommendations for community based diabetes screenings. The Diabetes Educator, 36(3), 887–893. doi:10.1177/0145721710386973.

    Article  PubMed Central  PubMed  Google Scholar 

  33. Zhang, X., Luo, H., & Albright, A. (2010). Obesity prevention and diabetes screening at local health departments. American Journal of Public Health, 100(8), 1434–1441. doi:10.2105/AJPH.2009.168831.

    Article  PubMed Central  PubMed  Google Scholar 

  34. Zulkowski, K., & Coon, P. (2005). Patient perceptions and provider documentation of diabetes care in rural areas. Ostomy Wound Management, 51(3), 50–58.

    Google Scholar 

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Acknowledgments

Authors would like to thank Paula Buchanan, PhD, MPH, Saint Louis University, Saint Louis, Missouri Statistical Support.

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Authors and Affiliations

  1. School of Nursing, Saint Louis University, Saint Louis, MO, USA

    Christina Ann Rariden & Mary Ann Lavin

  2. Office of Epidemiology, Missouri Department of Health and Senior Services, Jefferson City, MO, USA

    Shumei Yun

  3. 3525 Caroline St, St. Louis, MO, 63104, USA

    Christina Ann Rariden

Authors
  1. Christina Ann Rariden
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  2. Mary Ann Lavin
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  3. Shumei Yun
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Correspondence to Christina Ann Rariden.

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Rariden, C.A., Lavin, M.A. & Yun, S. Improving Prediabetes Screenings at Rural Missouri County Health Departments. J Community Health 40, 1107–1114 (2015). https://doi.org/10.1007/s10900-015-0036-y

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  • DOI: https://doi.org/10.1007/s10900-015-0036-y

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