Intervention to Enhance Numeracy in Diabetes (IntEND)
Intervention to Enhance Numeracy in Diabetes (IntEND)
The objective of this project is to test two interventions designed to improve
 diabetes-related numeracy. Numeracy is the ability to understand and use numbers. People with
 diabetes use numbers in a variety of ways in managing their condition (e.g., understanding
 blood sugar values, counting carbohydrates, taking medications at the right dose and time).
 As part of this project, the investigators developed and pilot tested two interventions to
 improve diabetes-related numeracy: (1) a series of in-person education classes and (2) a
 one-time, online diabetes education class. The investigators will look to see whether
 participants in the education classes show improvements in their diabetes-related numeracy
 skills, self-care behavior and attitudes, and clinical outcomes (i.e., body mass index, blood
 pressure, blood sugar [A1c]).
Sixty-five American Indians with diabetes were enrolled. Each participant was randomly
 assigned to 1 of 3 study arms: (1) the in-person education group, (2) the online education
 group, and (3) a control group. The in-person intervention group attended four class sessions
 addressing numeracy skills used in the management of diabetes (e.g., counting carbohydrates).
 The online education group completed a single online module providing training on
 diabetes-related numeracy skills. The control group received written diabetes educational
 materials. The investigators collected data at baseline, then again immediately after
 intervention participation (in-person or online classes), and one final time about three
 months after the conclusion of the intervention. The investigators will conduct analyses to
 determine if intervention participants experienced positive changes in diabetes numeracy (the
 primary outcome) as well as several secondary outcome measures following intervention.
 Secondary outcomes include: diabetes knowledge, self-efficacy, outcome expectancies,
 readiness to change, self-care behavior, and clinical outcomes (i.e., body mass index, blood
 pressure, blood sugar [A1c]) . The investigators also will assess whether change in numeracy
 predicts change in these secondary outcomes.
Inclusion Criteria:

 -  American Indian/Alaska Native;

 -  18 to 89 years old;

 -  diabetes diagnosis documented in medical records;

 -  active patient of the Yakama Indian Health Service.

 Exclusion Criteria:

 -  Does not speak English;

 -  pregnancy;

 -  dialysis;

 -  current cancer treatment;

 -  blindness;

 -  active alcohol/substance abuse;

 -  planning to move out of the area in the next six months.