title: Improving access to quality diabetes education in a rural state: the Montana Quality Diabetes Education Initiative.
abstract: 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.
authors.affiliation: The Montana Department of Public Health and Human Services, Helena (Ms Butcher, Ms McDowall, Ms Oser, Ms Johnson, Mr Harwell, Dr Helgerson, Dr Gohdes)
authors.forename: Marcene K
authors.initials: MK
authors.lastname: Butcher
authors.affiliation: St Patrick Hospital and Health Sciences Center, Missoula, Montana (Ms Gilman)
authors.forename: Judy
authors.initials: J
authors.lastname: Gilman
authors.affiliation: St Vincent Healthcare, Billings, Montana (Ms Meszaros)
authors.forename: Jane Fitch
authors.initials: JF
authors.lastname: Meszaros
authors.affiliation: Great Falls Clinic, Great Falls, Montana (Ms Bjorsness)
authors.forename: Deb
authors.initials: D
authors.lastname: Bjorsness
authors.affiliation: Fort Peck Service Unit, Indian Health Service, Poplar, Montana (Ms Madison)
authors.forename: Mary
authors.initials: M
authors.lastname: Madison
authors.affiliation: The Montana Department of Public Health and Human Services, Helena (Ms Butcher, Ms McDowall, Ms Oser, Ms Johnson, Mr Harwell, Dr Helgerson, Dr Gohdes)
authors.forename: Janet M
authors.initials: JM
authors.lastname: McDowall
authors.affiliation: The Montana Department of Public Health and Human Services, Helena (Ms Butcher, Ms McDowall, Ms Oser, Ms Johnson, Mr Harwell, Dr Helgerson, Dr Gohdes)
authors.forename: Carrie S
authors.initials: CS
authors.lastname: Oser
authors.affiliation: The Montana Department of Public Health and Human Services, Helena (Ms Butcher, Ms McDowall, Ms Oser, Ms Johnson, Mr Harwell, Dr Helgerson, Dr Gohdes)
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Johnson
authors.affiliation: The Montana Department of Public Health and Human Services, Helena (Ms Butcher, Ms McDowall, Ms Oser, Ms Johnson, Mr Harwell, Dr Helgerson, Dr Gohdes)
authors.forename: Todd S
authors.initials: TS
authors.lastname: Harwell
authors.affiliation: The Montana Department of Public Health and Human Services, Helena (Ms Butcher, Ms McDowall, Ms Oser, Ms Johnson, Mr Harwell, Dr Helgerson, Dr Gohdes)
authors.forename: Steven D
authors.initials: SD
authors.lastname: Helgerson
authors.affiliation: The Montana Department of Public Health and Human Services, Helena (Ms Butcher, Ms McDowall, Ms Oser, Ms Johnson, Mr Harwell, Dr Helgerson, Dr Gohdes)
authors.forename: Dorothy
authors.initials: D
authors.lastname: Gohdes
mesh_terms: 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