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Diabetes Self-Management Education Programs in Nonmetropolitan Counties - United States, 2016.

Abstract Diabetes self-management education (DSME) is a clinical practice intended to improve preventive practices and behaviors with a focus on decision-making, problem-solving, and self-care. The distribution and correlates of established DSME programs in nonmetropolitan counties across the United States have not been previously described, nor have the characteristics of the nonmetropolitan counties with DSME programs.
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Self Care

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Journal Title morbidity and mortality weekly report. surveillance summaries (washington, d.c. : 2002)
Publication Year Start




PMID- 28448482
OWN - NLM
STAT- MEDLINE
DA  - 20170427
DCOM- 20170502
LR  - 20170502
IS  - 1545-8636 (Electronic)
IS  - 0892-3787 (Linking)
VI  - 66
IP  - 10
DP  - 2017 Apr 28
TI  - Diabetes Self-Management Education Programs in Nonmetropolitan Counties - United 
      States, 2016.
PG  - 1-6
LID - 10.15585/mmwr.ss6610a1 [doi]
AB  - PROBLEM/CONDITION: Diabetes self-management education (DSME) is a clinical
      practice intended to improve preventive practices and behaviors with a focus on
      decision-making, problem-solving, and self-care. The distribution and correlates 
      of established DSME programs in nonmetropolitan counties across the United States
      have not been previously described, nor have the characteristics of the
      nonmetropolitan counties with DSME programs. REPORTING PERIOD: July 2016.
      DESCRIPTION OF SYSTEMS: DSME programs recognized by the American Diabetes
      Association or accredited by the American Association of Diabetes Educators
      (i.e., active programs) as of July 2016 were shared with CDC by both
      organizations. The U.S. Census Bureau's census geocoder was used to identify the 
      county of each DSME program site using documented addresses. County
      characteristic data originated from the U.S. Census Bureau, compiled by the U.S. 
      Department of Agriculture's Economic Research Service into the 2013 Atlas of
      Rural and Small-Town America data set. County levels of diagnosed diabetes
      prevalence and incidence, as well as the number of persons with diagnosed
      diabetes, were previously estimated by CDC. This report defined nonmetropolitan
      counties using the rural-urban continuum code from the 2013 Atlas of Rural and
      Small-Town America data set. This code included six nonmetropolitan categories of
      1,976 urban and rural counties (62% of counties) adjacent to and nonadjacent to
      metropolitan counties. RESULTS: In 2016, a total of 1,065 DSME programs were
      located in 38% of the 1,976 nonmetropolitan counties; 62% of nonmetropolitan
      counties did not have a DSME program. The total number of DSME programs for
      nonmetropolitan counties with at least one DSME program ranged from 1 to 8, with 
      an average of 1.4 programs. After adjusting for county-level characteristics, the
      odds of a nonmetropolitan county having at least one DSME program increased as
      the percentage insured increased (adjusted odds ratio [AOR] = 1.10, 95%
      confidence interval [CI] = 1.08-1.13), the percentage with a high school
      education or less decreased (AOR = 1.06, 95% CI = 1.04-1.07), the unemployment
      rate decreased (AOR = 1.19, 95% CI = 1.11-1.23), and the natural logarithm of the
      number of persons with diabetes increased (AOR = 3.63, 95% CI = 3.15-4.19).
      INTERPRETATION: In 2016, there were few DMSE programs in nonmetropolitan,
      socially disadvantaged counties in the United States. The number of persons with 
      diabetes, percentage insured, percentage with a high school education or less,
      and the percentage unemployed were significantly associated with whether a DSME
      program was located in a nonmetropolitan county. PUBLIC HEALTH ACTION: Monitoring
      the distribution of DSME programs at the county level provides insight needed to 
      strategically address rural disparities in diabetes care and outcomes. These
      findings provide information needed to assess lack of availability of DSME
      programs and to explore evidence-based strategies and innovative technologies to 
      deliver DSME programs in underserved rural communities.
FAU - Rutledge, Stephanie A
AU  - Rutledge SA
AD  - National Center for Chronic Disease Prevention and Health Promotion, CDC,
      Atlanta, Georgia.
FAU - Masalovich, Svetlana
AU  - Masalovich S
AD  - Northrop Grumman, Atlanta, Georgia.
FAU - Blacher, Rachel J
AU  - Blacher RJ
AD  - National Center for Chronic Disease Prevention and Health Promotion, CDC,
      Atlanta, Georgia.
FAU - Saunders, Magon M
AU  - Saunders MM
AD  - National Center for Chronic Disease Prevention and Health Promotion, CDC,
      Atlanta, Georgia.
LA  - eng
PT  - Journal Article
DEP - 20170428
PL  - United States
TA  - MMWR Surveill Summ
JT  - Morbidity and mortality weekly report. Surveillance summaries (Washington, D.C. :
      2002)
JID - 101142015
SB  - IM
MH  - Diabetes Mellitus/epidemiology/*therapy
MH  - Humans
MH  - Medically Underserved Area
MH  - Patient Education as Topic/*statistics & numerical data
MH  - Rural Health Services/*statistics & numerical data
MH  - *Self Care
MH  - United States/epidemiology
EDAT- 2017/04/28 06:00
MHDA- 2017/05/04 06:00
CRDT- 2017/04/28 06:00
AID - 10.15585/mmwr.ss6610a1 [doi]
PST - epublish
SO  - MMWR Surveill Summ. 2017 Apr 28;66(10):1-6. doi: 10.15585/mmwr.ss6610a1.

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