title: Telemedicine for Reach, Education, Access, and Treatment (TREAT): linking telemedicine with diabetes self-management education to improve care in rural communities.
abstract: The purpose of this study was to examine diabetes-related behavioral and psychosocial outcomes as well as patient satisfaction with the Telemedicine for Reach, Education, Access, and Treatment (TREAT) model.
  
  
  
  TREAT employs telemedicine services provided by an endocrinologist at an urban area in partnership with a diabetes educator in a rural area, working together with patients and primary care providers (PCPs). Thirty-five patients with type 2 diabetes were referred by PCPs and received glycemic management and education in the TREAT model. A diabetes educator operated the videoconferencing equipment, remained with the patient to receive and review plan communicated by the endocrinologist during the visit, coordinated services, administered surveys, and provided self-management education and support. Empowerment, self-care, diabetes distress, adherence to monitoring, and patient satisfaction were assessed by survey at baseline and follow-up.
  
  
  
  There was significant improvement in empowerment, self-care (adherence to diet and monitoring), and reduction in diabetes distress. Patients reported high levels of satisfaction.
  
  
  
  In rural areas, the TREAT model delivers improvements in behavioral and psychosocial outcomes and high patient satisfaction. The TREAT model may be a viable option for rural communities that suffer from a shortage of team-based diabetes specialist and self-management support services.
authors.affiliation: Department of Medicine, Division of Endocrinology and Metabolism, University of Pittsburgh, Pittsburgh, Pennsylvania (Dr Siminerio, Dr Toledo)
authors.forename: Linda
authors.initials: L
authors.lastname: Siminerio
authors.affiliation: Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania (Dr Ruppert)
authors.forename: Kristine
authors.initials: K
authors.lastname: Ruppert
authors.affiliation: Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania (Ms Huber)
authors.forename: Kimberly
authors.initials: K
authors.lastname: Huber
authors.affiliation: Department of Medicine, Division of Endocrinology and Metabolism, University of Pittsburgh, Pittsburgh, Pennsylvania (Dr Siminerio, Dr Toledo)
authors.forename: Fredrico G S
authors.initials: FG
authors.lastname: Toledo
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000523:psychology / Q000628:therapy*; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008507:Medically Underserved Area; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011209:Power, Psychological; D011785:Quality Assurance, Health Care; D019035:Rural Health Services / Q000458:organization & administration*; D012424:Rural Population; D012648:Self Care / Q000523:psychology; D017216:Telemedicine / Q000706:statistics & numerical data