Developing Quiz Content for a Mobile Health App for Diabetes Self-Management Education and Support Restricted; Files Only

Rayford, Sheritha (Summer 2022)

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Background: In the United States, diabetes is considered an epidemic, and minority populations, i.e., African Americans, Hispanic/ Latino Americans, Asian Americans, and Indigenous people, are at higher risk for developing diabetes than their White counterparts. Since there is no cure for diabetes, effective self-management with a particular focus on healthy eating, being active, and medication is an essential aspect of living a healthy life with diabetes. Self-management requires navigating challenges, such as accessing healthy foods, supplies, and safe places to exercise. Although there have been many improvements with diabetes self-management tools, lifestyle modifications are still challenging to initiate and maintain, and diabetes self-management is particularly difficult for under-resourced populations.

Purpose: This project aimed to develop educational content for a mobile application to support self-management amongst those living with diabetes who attend the Diabetes Center of Grady Memorial Hospital, Atlanta’s inner-city safety-net hospital. The goal was to identify priority topics across different diabetes self-management education and support (DSMES) curricula and develop sample educational quiz questions for two of the seven key behaviors: healthy eating and being active.

Methods: The educational content was developed based on six diabetes self-management curricula. The six selected curricula allowed us to understand the priority topics across healthy eating and being active, defined as those which all curricula included. In addition, sample quiz questions were developed for the learning objectives common to the six DSMES curricula reviewed.

Results: The creation of the sample quiz questions targeted learning objectives common across the six curricula, along with supplementary ones, included due to their importance despite not appearing in all reviewed curricula. In addition, sample feedback was developed for all quiz answer options to encourage information retention and skills-building.

Conclusion: This special studies project identified topics that were most commonly addressed across six different DSMES curricula for two key behaviors. The sample quiz questions can serve as a foundation for developing a more comprehensive DSMES quiz on all seven critical behaviors for a mobile application to educate, motivate, and empower individuals to understand and self-manage diabetes and improve their quality of life.

Table of Contents

Chapter 1: Introduction and Background. 1

Introduction and Rationale. 1

Problem Statement 3

Purpose Statement and Project Objectives. 4

Significance Statement 4

Abbreviations. 5

Chapter 2: Review of Literature. 5

Overview of Diabetes. 5

Diabetes Treatment 7

Diabetes Self-Management Education and Support 7

Diabetes Self-Management Challenges. 9

Current Diabetes Self-Management Resources. 11

Digital Applications. 12

Benefits of mHealth Interventions. 14

Educational Quiz Design. 15

Grady DSMES Curriculum.. 17

Chapter 3: Methods. 18

Curriculum Selection 18

Sample Quiz Questions Development 20

Ethical Considerations. 21

Chapter 4: Results. 22

Grady Diabetes Self-Management Education (DSMES) Program Curriculum.. 23

Maine DSMES Program Manual 24

North Carolina (NC) DSMES Curriculum - Curriculum For Persons With Type 2 Diabetes and Their Families 25

Six-Session Diabetes Self-Management Curriculum.. 26

Association of Diabetes Care & Education (ADCES7) Curriculum.. 27

Power to Prevent Curriculum.. 28

Educational Content Development for Healthy Eating Learning Objectives. 29

Healthy Eating. 29

Educational Content Development for Being Active Learning Objectives. 43

Being Active. 43

Educational Content Development for Additional Learning Objectives. 51

Supplemented Learning Objectives (topics that were not included in all or more than four of the six DSMES curricula). 51

Chapter 5: Discussion. 53

Limitations. 56

Conclusion. 57

Recommendations. 57

References. 59

Appendices:. 0

Appendix A: Comparison Table for Eating Healthy Learning Objectives. 0

Appendix B: Comparison Table for Be Active Learning Objectives. 5

Appendix C: Table of Summary of External Sources from Results. 0

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