Telemedicine Linking Diabetes Self-Management Education (DSME) to Underserved Pregnant Women in AR
Sunday, October 19, 2014
Posted by: Adeline Yerkes, BSN, MPH and Joan Ware, BSN, MSPH
The Arkansas GDM Collaborative identified a number of educational and service gaps and barriers for pregnant women with Gestational Diabetes. These gaps and barriers included:
lack of planning and coordination of appropriate referrals for medical care and/or self management diabetes education for women diagnosed with Gestational Diabetes
inability to conduct individualized educational plans due to lack of access to healthcare providers for educational services
lack of transportation to and from home to Local Health Unit or hospital delivery sites where women receive prenatal and delivery care
information overload for patients, especially women with low health literacy or limited English proficiency
lack of coordination of continuum of care between OB-GYN, primary care providers and delivery sites for both delivery and post-partum care.
From these identified gaps and barriers, the Arkansas Gestational Diabetes Collaborative composed of health department and community members partnered on a plan of action:
develop a Gestational Diabetes Self-Management Education curriculum in both English and Spanish to address the education gaps and barriers
deliver the education to regions of the state with no access to diabetes education and limited healthcare providers by telemedicine to address the access barrier
The Arkansas Department of Health Chronic Disease Program collaborated with the Maternal Child Health Program to contract with ANGELS, telemedicine project of the University of Arkansas Medical Center, to pilot test the Diabetes Management Education Curriculum Telemedicine in 2 areas of the state where healthcare provider access is limited. Pregnant women were recruited from eight (8) counties; 18 women were English speaking and 20 women were spanish speaking; for a total of 38 women completing the two session course.
Impact: Enhanced collaboration between the programs within the Arkansas State Department of Health increased access for patient education and identification of "at-risk populations" for prevention activities to reduce type 2 diabetes and hypertension. Programs included: Chronic Disease Prevention and Control Program, Maternal Child Health Program, Women and Infant and Children's Feeding Program plus an external partner, the ANGELS-telemedicine from the University of Arkansas Medical Center for improved patient care coordination. This project has generated other actions such as breastfeeding forums for high risk women and the development of a GDM focused subcommittee of the Arkansas Diabetes Advisory Committee. The project further establishes this health department with evidence on strategies to address pre-diabetes and high risk populations for type 2 diabetes prevention and awareness, activities for grant award 1305.