Provider impact in diabetes education. What we know, what we would like to know, paradigms for asking.
OBJECTIVE
A literature search from 1985 to the present was performed using Web-based search engines to identify evidence-based studies of diabetes education.


METHODS
Twelve studies were identified in which a provider characteristic was defined as a discriminate variable associated with impact or efficacy of the education intervention. Provider was defined as all those participating in diabetes care and education (e.g., patient, education and care teams, funding and policy agencies). The Certified Diabetes Educator credential also was described.


RESULTS
Specialty or discipline of the provider/care team, technology when used to assist providers, and physician practice patterns have been assessed. There is a paucity of research that assesses provider impact or the specific impact of provider characteristics on diabetes outcomes in a controlled and scientifically rigorous fashion.


CONCLUSIONS
Suggestions for evaluating provider impact based on literature concerning psychotherapy and healthcare education outcomes are: identify provider characteristics/attitudes/skills and link them to outcomes, define therapeutic alliance in diabetes care/education and assess its contribution to outcomes; and use performance measures as provider characteristics.
Young-Hyman
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University of Maryland Medical School, Department of Pediatric Endocrinology, Baltimore 21201, USA.
D003920:Diabetes Mellitus / Q000628:therapy*; D019317:Evidence-Based Medicine; D006801:Humans; D017145:Models, Educational; D017063:Outcome Assessment, Health Care; D010348:Patient Care Team; D010353:Patient Education as Topic / Q000592:standards*; D012106:Research / Q000458:organization & administration*; D012109:Research Support as Topic