PROPOSAL FOR A PROGRAM TO ENHANCE BEHAVIORAL INTERVENTION
SKILLS AMONG DIABETES EDUCATORS
There is increasing support in the literature for integrating the principles of behavioral
change within programs of diabetes care and education. Clinical findings clearly show that
programs combining behavioral change and education have the best outcomes over time in terms
of improving and sustaining diabetes self-care behaviors. Recently, there has been a desire by
many diabetes educators to acquire the additional behavioral intervention skills necessary to
more fully reach these goals. This proposal outlines the structure and content of such a program.
Unlike many continuing education programs, however, the proposed program utilizes a
combination of initial training and ongoing support so that the new skills learned can be slowly
integrated into active programs of care. To reach this goal, we adopt a training model that
combines knowledge-based, experiential, skill enhancement, and supervisory components into an
intensive, comprehensive skill-based program. We outline the preliminary program as follows:
1. An intensive, 2-day workshop for no more than 15-18 people. We would provide written
materials, readings, etc, and undertake a highly structured, clinically focused workshop
that would teach behavioral theory translated into practice techniques for diabetes
education interventions. We would also use a series of role-plays and clinical scenarios
during the workshop to help participants practice their newly developing skills. The
program uses the primary principles of motivational interviewing as applied to diabetes
care, addresses the clinician-patient relationship and structure, teaches active listening
skills, and focuses on patients’ application of diabetes knowledge and problem solving
skills into the context of their real-world lives. This process re-defines the diabetes
educator role as both a provider of information and an agent for sustained behavioral
change.
2. We propose that the group re-convene 3 times after the workshop at 2-week intervals for
a live or telephone consultation program with the workshop leader. The idea here is to
have each participant select and follow a small group of patients over time, and to bring
the clinical material to the group meetings. The meetings will serve as an ongoing
clinical case conference to help participants put into practice what they learned in the
workshop with real patients in a real clinical setting using a continuity of learning
approach. The group may continue to meet after the initial three consultation meetings
with or without the workshop leaders.
3. We propose to build an evaluation component into the design of the program, with
baseline, post-training and follow-up evaluations. This process will inform us about the
effectiveness of the program and will provide information about how different
components might be enhanced.