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Patient satisfaction with Internet-based diabetes management in Native American communities : 

Patient satisfaction with Internet-based diabetes management in Native American communities Betty A. Levine Pam Angelus, Jackie McCormack, Donna Johnson, Ming-Jye Hu, Seong K. Mun

Diabetes in AI/AN : 

Diabetes in AI/AN 14.9% of AI/AN aged 20 or older and receiving care from IHS have diabetes AI/AN are 2.3% times as likely to have diabetes than non-Hispanic whites From 1990-1998 number of young AI/AN with diabetes increased 71% Most common in Southeastern US (27.8%)

MyCareTeamTM: 

MyCareTeamTM

MyCareTeamTM: 

MyCareTeamTM Internet based diabetes management application Electronic capture of clinical data Automated analysis of clinical data Simple user interface presents patients and providers with clinical information Efficient & secure communications between patients and providers Disease specific Personal Health Record (PHR)

MyCareTeamTM: 

MyCareTeamTM Features: Automated capture of BG values Automatic analysis and multi-formatted presentation of BG values Tracking of other information – meds, lab results, exercise, blood pressure Secure communications with provider

MyCareTeamTM: 

MyCareTeamTM

Native American Sites: 

Native American Sites Poarch Band of Creek Indians, AL Nez Perce, ID Tlingit and Haida Tribes, AK Mandan Hidatsa & Arikara Nation, ND Native Hawaiians, HI Phoenix Indian Medical Center, AZ

Outcome Measures: 

Outcome Measures Clinical outcomes HbA1c – laboratory blood test that measures long-term glycemic control American Diabetes Association recommends a value of under 7.0 Satisfaction Surveys

Results – Clinical Outcomes: 

Results – Clinical Outcomes

Satisfaction Survey: 

Satisfaction Survey Educational level 77% had some college or more Where they use the computer most 33% @ home; 42% @ work; 25% @ other Features they use most often Log Book – 70% @ baseline; 48% @ follow-up Line chart – 16% @ baseline; 44% @ follow-up TOD Pie chart – 14% @ baseline; 41% @ follow-up Internet use 57.1% find Health Information

Satisfaction Survey: 

Satisfaction Survey Satisfaction measures Experience using MyCareTeamTM Experience learning about diabetes through MyCareTeamTM Communicating with their provider over MyCareTeamTM

Results - Satisfaction: 

Results - Satisfaction Older participants more apt to state a positive experience using MyCareTeamTM (p<.05) Older participants were more positive about talking with a provider via MyCareTeamTM (n/s) Those reporting a positive experience using MyCareTeamTM, also report positively that they use it to learn about diabetes (p<.001) Those reporting positive experiences at baseline also reported positive experiences at follow-up for: using MyCareTeamTM (p<.02) Learning about diabetes (n/s but in the correct direction) communicating with their provider (p<.005)

Future Work: 

Future Work Continue collecting data at existing sites Enroll new sites Expand to include the Diabetes Center at National Naval Medical Center Integrate into existing Health Information Systems

Acknowledgement: 

Acknowledgement Thank you U.S. Army Medical Research and Materiel Command for their support under contract #W81XWH-04-2-0002 Partners at Nez Perce and Poarch Band of Creek Indians Tribes Alan Neustadtl, PhD and Jim Grigsby, PhD for their statistical support