title: Diabetes Educators: Perceived Experiences, Supports and Barriers to Use of Common Diabetes-Related Technologies.
abstract: Various technologies are commonly used to support type 1 diabetes management (continuous subcutaneous insulin infusion therapy, continuous glucose monitoring systems, smartphone and tablet applications, and video conferencing) and may foster self-care, communication, and engagement with health care services. Diabetes educators are key professional supporters of this patient group, and ideally positioned to promote and support technology use. The aim of this study was to examine diabetes educators' perceived experiences, supports, and barriers to use of common diabetes-related technologies for people with type 1 diabetes.
  
  
  
  This qualitative ethnographic study recruited across metropolitan, regional and rural areas of Australia using purposive sampling of Australian Diabetes Educators Association members. Data were collected by semistructured telephone interviews and analyzed using thematic analysis.
  
  
  
  Participants (n = 31) overwhelmingly indicated that overall the use of technology in the care of patients with type 1 diabetes was burdensome for them. They identified 3 themes involving common diabetes-related technologies: access to technology, available support, and technological advances. Overall, these themes demonstrated that while care was usually well intentioned it was more often fragmented and inconsistent. Most often care was provided by a small number of diabetes educators who had technology expertise.
  
  
  
  To realize the potential benefits of these relatively new but common diabetes technologies, many diabetes educators need to attain and retain the skills required to deliver this essential component of care. Furthermore, policy and strategy review is required, with reconfiguration of services to better support care delivery.
authors.affiliation: University of Technology Sydney, Ultimo, NSW, Australia stevenjames_76@yahoo.co.uk.
authors.forename: Steven
authors.initials: S
authors.lastname: James
authors.affiliation: University of Technology Sydney/South East Sydney Local Health District, Prince of Wales Hospital, Randwick, NSW, Australia.
authors.forename: Lin
authors.initials: L
authors.lastname: Perry
authors.affiliation: University of Sydney, Sydney, NSW, Australia.
authors.forename: Robyn
authors.initials: R
authors.lastname: Gallagher
authors.affiliation: Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
authors.forename: Julia
authors.initials: J
authors.lastname: Lowe
mesh_terms: D000328:Adult; D001315:Australia; D015190:Blood Glucose Self-Monitoring; D003922:Diabetes Mellitus, Type 1 / Q000451:nursing*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006801:Humans; D007332:Insulin Infusion Systems; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D063731:Mobile Applications; D009726:Nurses; D010353:Patient Education as Topic / Q000379:methods; D017216:Telemedicine
keywords: applications; barriers; continuous glucose monitoring system; continuous subcutaneous insulin infusion; diabetes educators; supports; telehealth