Improving access to quality diabetes education in a rural state: the Montana Quality Diabetes Education Initiative.
Diabetes self-management education (DSME) is an integral component of diabetes care; however, skilled educators and recognized programs are not uniformly available in rural communities.



To increase access to quality DSME, the Montana Diabetes Control Program and the Montana chapter of the American Association of Diabetes Educators developed a mentoring program with 3 levels: basic, intermediate, and advanced. All participants were assisted by a volunteer certified diabetes educator (CDE) mentor. In addition, the program provided technical support for recognition through the American Diabetes Association and the Indian Health Service.



From 2000 to 2005, 90 individuals participated; 76% were nurses and 21% dietitians. Twenty-seven of the 90 enrollees (30%) completed their structured option, and 13 achieved CDE certification. Most provided services in frontier counties (66%). Statewide, the number of CDEs in Montana increased 46% from 52 in 2000 to 76 in 2005. Twenty-five of the 30 facilities that received technical assistance achieved recognition. Statewide, the number of recognized education programs increased from 2 in 2000 to 22 in 2005. Twelve (55%) of these programs were located in frontier counties.



Mentoring and technical support is an effective method to increase personnel skills for DSME and to increase access to quality education programs in rural areas.
Butcher
Marcene K
MK
The Montana Department of Public Health and Human Services, Helena (Ms Butcher, Ms McDowall, Ms Oser, Ms Johnson, Mr Harwell, Dr Helgerson, Dr Gohdes)
Gilman
Judy
J
St Patrick Hospital and Health Sciences Center, Missoula, Montana (Ms Gilman)
Meszaros
Jane Fitch
JF
St Vincent Healthcare, Billings, Montana (Ms Meszaros)
Bjorsness
Deb
D
Great Falls Clinic, Great Falls, Montana (Ms Bjorsness)
Madison
Mary
M
Fort Peck Service Unit, Indian Health Service, Poplar, Montana (Ms Madison)
McDowall
Janet M
JM
The Montana Department of Public Health and Human Services, Helena (Ms Butcher, Ms McDowall, Ms Oser, Ms Johnson, Mr Harwell, Dr Helgerson, Dr Gohdes)
Oser
Carrie S
CS
The Montana Department of Public Health and Human Services, Helena (Ms Butcher, Ms McDowall, Ms Oser, Ms Johnson, Mr Harwell, Dr Helgerson, Dr Gohdes)
Johnson
Elizabeth A
EA
The Montana Department of Public Health and Human Services, Helena (Ms Butcher, Ms McDowall, Ms Oser, Ms Johnson, Mr Harwell, Dr Helgerson, Dr Gohdes)
Harwell
Todd S
TS
The Montana Department of Public Health and Human Services, Helena (Ms Butcher, Ms McDowall, Ms Oser, Ms Johnson, Mr Harwell, Dr Helgerson, Dr Gohdes)
Helgerson
Steven D
SD
The Montana Department of Public Health and Human Services, Helena (Ms Butcher, Ms McDowall, Ms Oser, Ms Johnson, Mr Harwell, Dr Helgerson, Dr Gohdes)
Gohdes
Dorothy
D
The Montana Department of Public Health and Human Services, Helena (Ms Butcher, Ms McDowall, Ms Oser, Ms Johnson, Mr Harwell, Dr Helgerson, Dr Gohdes)
D003920:Diabetes Mellitus / Q000517:prevention & control / Q000534:rehabilitation*; D006801:Humans; D008611:Mentors; D009009:Montana; D010353:Patient Education as Topic / Q000592:standards*; D012424:Rural Population; D012648:Self Care; D014505:Urban Population