title: Capacity of diabetes education programs to provide both diabetes self-management education and to implement diabetes prevention services.
abstract: OBJECTIVE
  The purpose of this study was to assess the capacity of diabetes self-management education (DSME) programs in urban and rural counties to provide services to patients with diagnosed diabetes, lifestyle services to persons at high risk for developing diabetes, and to assess the potential barriers to providing diabetes prevention services.
  
  
  METHODS
  In 2009, the Montana Department of Public Health and Human Services conducted an Internet-based survey of all DSME programs in Montana.
  
  
  RESULTS
  Thirty of the 39 (77%) DSME programs completed the survey. Seventy-seven percent of the urban programs and 50% of the rural programs reported a capacity to provide DSME to additional patients with diagnosed diabetes. More than 70% of the urban and the rural programs currently provide lifestyle services to patients with abnormal glucose tolerance but without diabetes. Eighty-four percent of the urban programs and 60% of the rural programs reported a capacity to provide lifestyle services to additional persons at high risk for diabetes. Eighty-five percent of the urban programs and 58% of the rural programs have already implemented or intend to implement a lifestyle intervention service consistent with the Diabetes Prevention Program. Overall, the most frequently reported barriers to implementing a diabetes prevention services were lack of reimbursement (80%) and the lack of staff to provide the service (60%).
  
  
  CONCLUSIONS
  Urban and rural DSME programs in Montana have the capacity to implement both DSME for patients with diagnosed diabetes and diabetes prevention lifestyle services to additional people at high risk for diabetes. Reimbursement for diabetes prevention services is critical to ensure program development and implementation.
authors.affiliation: Montana Department of Public Health and Human Services, Chronic Disease Prevention and Health Promotion Bureau, Helena, Montana, USA.
authors.forename: Marcene K
authors.initials: MK
authors.lastname: Butcher
authors.forename: Karl K
authors.initials: KK
authors.lastname: Vanderwood
authors.forename: Taryn O
authors.initials: TO
authors.lastname: Hall
authors.forename: Dorothy
authors.initials: D
authors.lastname: Gohdes
authors.forename: Steven D
authors.initials: SD
authors.lastname: Helgerson
authors.forename: Todd S
authors.initials: TS
authors.lastname: Harwell
mesh_terms: D003625:Data Collection; D003920:Diabetes Mellitus / Q000517:prevention & control*; D018588:Fee-for-Service Plans; D006293:Health Promotion; D006801:Humans; D008019:Life Style; D009009:Montana; D010353:Patient Education as Topic; D012424:Rural Population; D012648:Self Care; D014505:Urban Population