Focus Groups Reveal Uneasiness With Diabetes Educators' Role

LOS ANGELES — Physicians, patients with diabetes, and diabetes educators expressed reservations about the current state of diabetes education in a series of focus groups sponsored by the American Association of Diabetes Educators and presented at the organization's annual meeting.

Preliminary findings suggest that there are significant gaps in awareness of diabetes education resources and an underlying uneasiness about the role of educators in overall diabetes care, reported Mark Peyrot, Ph.D., professor of sociology at Loyola College in Baltimore.

The six focus groups each consisted of about 15 members of a particular constituency—physicians who care for patients with diabetes, diabetes educators, or patients.

During teleconference calls, participants discussed a wide range of issues involving the general topic of diabetes education. Results will be used to devise an Internet survey to better capture positive and negative impressions of diabetes education and direct future resources in improving the field, explained Dr. Peyrot.

Early focus group findings suggest there is work to be done in improving access to, awareness of, usefulness of, and funding for diabetes education programs offered through hospitals, health care groups, and communities.

“A few bad experiences will turn you off,” said one physician during a focus group session.

Physicians suggested they would like to see diabetes education programs that personalize messages for their patients rather than rely on textbooklike, pedantic lessons. They want an easier referral process, better feedback from diabetes educators, and an assurance that treatment decisions will be left to them.

One physician also expressed the concern that diabetes educators may try to “steal patients.” Others also feared that patients' allegiances might be torn if they were taking advice from two different health care providers.

On a positive note, physicians said they appreciated diabetes education programs based on scientifically reliable, authoritative sources that offered practical strategies for dealing with everyday issues of diabetes control.

Several diabetes educators noted that they had customized their education programs based on physician requests: for example, by taking patients to the grocery store to help them learn how to make good nutritional choices.

Diabetes educators universally said they felt economic pressure to justify their positions. They bemoaned the lack of reasonable reimbursement for their services and a general dearth of awareness regarding the benefits they can provide to patients with diabetes.

They perceived that “need [for their services] was much higher than actual demand,” said Dr. Peyrot. Use of services seemed to vary greatly; some educators reported 3- to 6-month waiting lists for their services, whereas others had “wide open” appointment books.

Many diabetes educators believed that physicians did not sufficiently emphasize the importance of diabetes education to their patients: for example, by failing to ask whether patients had actually attended sessions they had prescribed.

Physicians “didn't give the impression it was critical,” said Dr. Peyrot, in summarizing the statements of diabetes educators.

Patients in separate focus groups displayed little understanding of diabetes education, in many cases failing to even recall whether they had attended educational sessions on diet, blood glucose monitoring, or medication management.

Exposure to diabetes education was broad, ranging from none to 40 hours. Patients had mixed impressions of its effectiveness, saying that in some cases, education sessions were too long, presented too much information at once, focused too much on negative messages, and could be overwhelming. On the other hand, they said they liked assistance with dealing with any type of technologic device, such as insulin pumps, and appreciated dietary advice and take-home materials they could study later.

Patients who had not sought out education sometimes volunteered that they did not need it, saying they learned whatever they needed to know from sources such as the Internet or family members with diabetes.

LOS ANGELES — Physicians, patients with diabetes, and diabetes educators expressed reservations about the current state of diabetes education in a series of focus groups sponsored by the American Association of Diabetes Educators and presented at the organization's annual meeting.

Preliminary findings suggest that there are significant gaps in awareness of diabetes education resources and an underlying uneasiness about the role of educators in overall diabetes care, reported Mark Peyrot, Ph.D., professor of sociology at Loyola College in Baltimore.

The six focus groups each consisted of about 15 members of a particular constituency—physicians who care for patients with diabetes, diabetes educators, or patients.

During teleconference calls, participants discussed a wide range of issues involving the general topic of diabetes education. Results will be used to devise an Internet survey to better capture positive and negative impressions of diabetes education and direct future resources in improving the field, explained Dr. Peyrot.

Early focus group findings suggest there is work to be done in improving access to, awareness of, usefulness of, and funding for diabetes education programs offered through hospitals, health care groups, and communities.

“A few bad experiences will turn you off,” said one physician during a focus group session.

Physicians suggested they would like to see diabetes education programs that personalize messages for their patients rather than rely on textbooklike, pedantic lessons. They want an easier referral process, better feedback from diabetes educators, and an assurance that treatment decisions will be left to them.

One physician also expressed the concern that diabetes educators may try to “steal patients.” Others also feared that patients' allegiances might be torn if they were taking advice from two different health care providers.

On a positive note, physicians said they appreciated diabetes education programs based on scientifically reliable, authoritative sources that offered practical strategies for dealing with everyday issues of diabetes control.

Several diabetes educators noted that they had customized their education programs based on physician requests: for example, by taking patients to the grocery store to help them learn how to make good nutritional choices.

Diabetes educators universally said they felt economic pressure to justify their positions. They bemoaned the lack of reasonable reimbursement for their services and a general dearth of awareness regarding the benefits they can provide to patients with diabetes.

They perceived that “need [for their services] was much higher than actual demand,” said Dr. Peyrot. Use of services seemed to vary greatly; some educators reported 3- to 6-month waiting lists for their services, whereas others had “wide open” appointment books.

Many diabetes educators believed that physicians did not sufficiently emphasize the importance of diabetes education to their patients: for example, by failing to ask whether patients had actually attended sessions they had prescribed.

Physicians “didn't give the impression it was critical,” said Dr. Peyrot, in summarizing the statements of diabetes educators.

Patients in separate focus groups displayed little understanding of diabetes education, in many cases failing to even recall whether they had attended educational sessions on diet, blood glucose monitoring, or medication management.

Exposure to diabetes education was broad, ranging from none to 40 hours. Patients had mixed impressions of its effectiveness, saying that in some cases, education sessions were too long, presented too much information at once, focused too much on negative messages, and could be overwhelming. On the other hand, they said they liked assistance with dealing with any type of technologic device, such as insulin pumps, and appreciated dietary advice and take-home materials they could study later.

Patients who had not sought out education sometimes volunteered that they did not need it, saying they learned whatever they needed to know from sources such as the Internet or family members with diabetes.

LOS ANGELES — Physicians, patients with diabetes, and diabetes educators expressed reservations about the current state of diabetes education in a series of focus groups sponsored by the American Association of Diabetes Educators and presented at the organization's annual meeting.

Preliminary findings suggest that there are significant gaps in awareness of diabetes education resources and an underlying uneasiness about the role of educators in overall diabetes care, reported Mark Peyrot, Ph.D., professor of sociology at Loyola College in Baltimore.

The six focus groups each consisted of about 15 members of a particular constituency—physicians who care for patients with diabetes, diabetes educators, or patients.

During teleconference calls, participants discussed a wide range of issues involving the general topic of diabetes education. Results will be used to devise an Internet survey to better capture positive and negative impressions of diabetes education and direct future resources in improving the field, explained Dr. Peyrot.

Early focus group findings suggest there is work to be done in improving access to, awareness of, usefulness of, and funding for diabetes education programs offered through hospitals, health care groups, and communities.

“A few bad experiences will turn you off,” said one physician during a focus group session.

Physicians suggested they would like to see diabetes education programs that personalize messages for their patients rather than rely on textbooklike, pedantic lessons. They want an easier referral process, better feedback from diabetes educators, and an assurance that treatment decisions will be left to them.

One physician also expressed the concern that diabetes educators may try to “steal patients.” Others also feared that patients' allegiances might be torn if they were taking advice from two different health care providers.

On a positive note, physicians said they appreciated diabetes education programs based on scientifically reliable, authoritative sources that offered practical strategies for dealing with everyday issues of diabetes control.

Several diabetes educators noted that they had customized their education programs based on physician requests: for example, by taking patients to the grocery store to help them learn how to make good nutritional choices.

Diabetes educators universally said they felt economic pressure to justify their positions. They bemoaned the lack of reasonable reimbursement for their services and a general dearth of awareness regarding the benefits they can provide to patients with diabetes.

They perceived that “need [for their services] was much higher than actual demand,” said Dr. Peyrot. Use of services seemed to vary greatly; some educators reported 3- to 6-month waiting lists for their services, whereas others had “wide open” appointment books.

Many diabetes educators believed that physicians did not sufficiently emphasize the importance of diabetes education to their patients: for example, by failing to ask whether patients had actually attended sessions they had prescribed.

Physicians “didn't give the impression it was critical,” said Dr. Peyrot, in summarizing the statements of diabetes educators.

Patients in separate focus groups displayed little understanding of diabetes education, in many cases failing to even recall whether they had attended educational sessions on diet, blood glucose monitoring, or medication management.

Exposure to diabetes education was broad, ranging from none to 40 hours. Patients had mixed impressions of its effectiveness, saying that in some cases, education sessions were too long, presented too much information at once, focused too much on negative messages, and could be overwhelming. On the other hand, they said they liked assistance with dealing with any type of technologic device, such as insulin pumps, and appreciated dietary advice and take-home materials they could study later.

Patients who had not sought out education sometimes volunteered that they did not need it, saying they learned whatever they needed to know from sources such as the Internet or family members with diabetes.