Telehealth in Rural Montana: Promoting Realistic Independent Self-Management of Diabetes

Holloway, Barbara; Coon, Patricia J.; Kersten, Diane; Ciemins, Elizabeth L.

doi:10.2337/diaspect.24.1.50

Cited by 5 publications

(17 citation statements)

References 2 publications

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“…Telehealth technology demonstrated high patient satisfaction and reduced patient costs as evidenced in studies by Levin et al ( 12 ), Davis et al ( 19 ), and Holloway et al ( 7 ). Patients ( n = 118) enrolled in an intervention study that provided DSME by telehealth in rural Montana adapted quickly to the new technology and openly shared personal or sensitive issues via the video conferencing system ( 7 ).…”

Section: Resultsmentioning

confidence: 88%

“…Six telehealth models reviewed used an endocrinologist at an urban site working in partnership with a diabetes educator, nurse, or registered dietitian (RD) in a rural location to provide focused DSME ( 7 , 16 – 20 ). Siminerio et al ( 17 ) performed behavioral and psychosocial surveys and monitored A1C measures at baseline and after telehealth programs over a 6-month timeframe in the Telemedicine for Reach, Education, Access, and Treatment (TREAT) model.…”

Section: Resultsmentioning

confidence: 99%

“…Patients ( n = 118) enrolled in an intervention study that provided DSME by telehealth in rural Montana adapted quickly to the new technology and openly shared personal or sensitive issues via the video conferencing system ( 7 ). High participant retention rates and cost savings on patients’ travel expenses and time away from work were major additional benefits using telehealth models ( 7 , 12 , 16 , 21 ).…”

Section: Resultsmentioning

confidence: 99%

“…Interactive video telehealth technology may improve glycemic control through improved access to quality care ( 7 , 12 , 13 , 18 , 22 , 24 ). Patient empowerment and self-care management through DSME also may be improved ( 17 , 23 ).…”

Section: Discussionmentioning

confidence: 99%

“…Rural populations are at increased risk for diabetes complications because of several barriers to care, including lower income levels, lower levels of educational attainment, limited health insurance, physician shortages, and distance to health clinics. Also, primary care providers (PCPs) delivering services in rural areas face challenges with regard to a lack of health care resources and limited access to diabetes education centers ( 7 ).…”

mentioning

confidence: 99%

See 4 more Smart Citations

Interactive Video Telehealth Models to Improve Access to Diabetes Specialty Care and Education in the Rural Setting: A Systematic Review

McLendon

2017

Diabetes Spectrum

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Section: Resultsmentioning

confidence: 88%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Interactive Video Telehealth Models to Improve Access to Diabetes Specialty Care and Education in the Rural Setting: A Systematic Review

McLendon

2017

Diabetes Spectrum

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Telehealth Use for Enhancing the Health of Rural Older Adults: A Systematic Mixed Studies Review

et al. 2021

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Background and Objectives Telehealth holds potential for inclusive and cost-saving healthcare; however, a better understanding of the use and acceptance of telehealth for health promotion among rural older adults is needed. This systematic review aimed to synthesize evidence for telehealth use among rural-living older adults and to explore cost-effectiveness for health systems and patients. Research Design and Methods This systematic review was conducted in accordance with PRISMA guidelines. Study designs reporting health promotion telehealth interventions with rural-living adults aged 55+ were eligible for review. Following screening and inclusion, articles were quality rated and ranked by level of evidence. Data extraction was guided by the Technology Acceptance Model and organized into outcomes related to ease of use, usefulness, intention to use, and usage behavior along with cost-effectiveness. Results Of 2,247 articles screened, 42 were included. Positive findings for the usefulness of telehealth for promoting rural older adults’ health were reported in 37 studies. Evidence for ease of use and usage behavior was mixed. Five studies examined intention to continue to use telehealth, and in four of these patients preferred telehealth. Telehealth was cost-effective for healthcare delivery (as a process) compared to face-to-face. However, findings were mixed for cost-effectiveness with both reports of savings (e.g., reduced travel) and increased costs (e.g., insurance). Discussion and Implications Telehealth was useful for promoting health among rural-living older adults. Technological supports are needed to improve telehealth ease of use and adherence. Cost-effectiveness of telehealth needs more study, particularly targeting older adults.

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Intent-to-treat analysis of a simultaneous multisite telehealth diabetes prevention program

Ciemins

Coon

Coombs

et al. 2018

BMJ Open Diab Res Care

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ObjectiveDetermine the effectiveness of a 16-week modified diabetes prevention program (DPP) administered simultaneously to multiple rural communities from a single urban site, as compared with a similar face-to-face intervention. A 12-week intervention was evaluated to consider minimization of staff costs in communities where resources are limited.Research design and methodsA prospective cohort study compared DPP interventions implemented in rural (via telehealth technology) and urban (face-to-face) communities using an intent-to-treat analysis. Primary outcome measures included 5% and 7% body weight loss. Logistic regression analyses were used to determine predictors of intervention success and included a variable for treatment effect.ResultsBetween 2010 and 2015, up to 667 participants were enrolled in the study representing one urban and 15 rural communities across Montana. The 16-week urban and rural interventions were comparable; 33.5% and 34.6% of participants lost 7% body weight, respectively; 50% and 47% lost 5% (p=0.22). Participants who were male (OR=2.41; 95% CI 1.32 to 4.40), had lower baseline body mass index (OR=1.03; 95% CI 1.01 to 1.07), attended more sessions (OR=1.33; 95% CI 1.11 to 1.58), and more frequently reported (OR=3.84; 95% CI 1.05 to 14.13) and met daily fat gram (OR=4.26; 95% CI 1.7 to 10.6) and weekly activity goals (OR=2.46; 95% CI 1.06 to 5.71) were more likely to meet their 7% weight loss goal. Predictors of meeting weight loss goals were similar for participants enrolled in the 12-week intervention.ConclusionsUsing telehealth technology to administer a modified DPP to multiple rural communities simultaneously demonstrated weight loss results comparable to those in a face-to-face intervention. Given the limitation of resources, linking rural areas to urban centers using telemedicine may increase access to much needed services to prevent or delay progression to diabetes.

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Telehealth in Rural Montana: Promoting Realistic Independent Self-Management of Diabetes

Cited by 5 publications

References 2 publications

Interactive Video Telehealth Models to Improve Access to Diabetes Specialty Care and Education in the Rural Setting: A Systematic Review

Interactive Video Telehealth Models to Improve Access to Diabetes Specialty Care and Education in the Rural Setting: A Systematic Review

Telehealth Use for Enhancing the Health of Rural Older Adults: A Systematic Mixed Studies Review

Intent-to-treat analysis of a simultaneous multisite telehealth diabetes prevention program

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