Dr. Santosh Krishna and
Dr. Gianluca Deleo:
Diabetes Education by Phone to Hispanic
Populations using an
Abstract
Diabetes is a chronic disease that causes a great deal
of morbidity and mortality and poor quality of life for millions of people. It
also costs billions of dollars in treatment and other related expenses.
Hispanics are twice as likely as non-Hispanic Whites to have diabetes and are
also at higher risk for diabetes-related complications and poorer outcomes. In
2002, on average, Hispanic/Latino Americans were 1.5 times more likely to have
diabetes than non-Hispanic whites of similar age. (CDC, 2004) Maintaining good
glycemic control is the key to preventing complications but requires education
on how to control and manage it. Since current available resources are limited
to providing such an education during physician visits only, system barriers
such as language and access to care present significant problems for the
Hispanic and Latinos in
We have developed an automated call center that is
capable of providing people with diabetes educational messages in Spanish to a
phone number provided by the patient at
patients’ preferred time of the day (see Figure 1). This system is an interactive system
that allows a person to navigate through, select relevant information and
respond to questions using a telephone. Twenty-four
messages can be delivered in a sequential order or alternatively, patients can
call the system twenty-four hours a day and follow the diabetes educational
sections based on their interest and need. System also permits patients
to forward the educational messages to their friends and family members in HTML
format.
Educational messages are organized into four main topics, diabetes and prevention, glucose level, diet and activity and management and coping. Each main topic is broken down into their relative subtopics. (See Figure 3). Educational messages allow patients to learn more and get their progressive knowledge assessed by random questions on these topics. Each educational message takes approximately four minutes to be heard. A question is asked halfway during the educational messages to keep the patient’s attention in the message.
At the end of each message patients are asked to
provide feedback about the general quality of the messages heard. All
educational messages in English were recorded and certified by a certified
diabetes educator. The messages in Spanish
were translated and recorded by Spanish speaking person.
Each patient will receive
a laminated pocketsize card with the call center phone number, their personal
identification number and the list of topics. In the center of the card is the
message to remind patients to call their doctor in case of health emergency
(see Figure 2). Every time a patient logs into the computer telephony based
call center the same opening general information message is delivered prior to
playing any other educational messages. The
educational material has been structured so that in addition to being delivered
by telephone, it can also be offered via text and audio on the Web as well.
The automated call center is completely secure.
Security and privacy policies are addressed in the system by using user
identification number and password authentication, firewall policies and by
providing varying levels of access to users. For example, patients are allowed
to have access to the educational messages from anywhere but the administrative
access is available to authorized personnel only through user and password
authentication. The system uses local risk management and intrusion detection alerts through the
firewall software to support deterrence. In order to monitor the authorized and
unauthorized access and to determine the duration and frequency of the calls
and to keep track of the messages patients listened to, system stores user actions and the time of login and logout.
Contact Information:
Santosh Krishna, PhD, EdS
Gianluca Deleo, PhD,
Telephone: (314) 977-8280 (Office) (573) 268-2673 (
krishnas@slu.edu
or (for attachments) santoshkri2003@yahoo.com