Supporting Lifestyle Change With a Computerized Psychosocial Assessment Tool

There are now more than 12,400 certified diabetes educators practicing in the United States.1 Their primary role is to provide diabetes education, diabetes self-management training, and lifestyle change support. The prevalence of type 2 diabetes, which comprises 90–95% of diabetes cases, is increasing at an alarming rate, reflecting recent cultural changes in our eating and exercise habits and a sharp increase in the prevalence of obesity and its associated insulin resistance.2 The need is becoming more urgent for innovative and effective behavior change strategies in diabetes management. Further, as Glasgow and Eakin3, p.144 have noted, “to impact diabetes management, behavioral assessments, interventions, and models should be practical and efficient, be readily understood by non-psychologists, and address issues that diabetes patients and providers (rather than psychologists) perceive as important.” Historically, we have not done a good job in conducting behavioral research that translates behavior change theories and concepts into brief educational interventions that can work in busy clinical settings. Instead, we have focused almost exclusively on academic behavioral research studies that do not get down into the clinical “trenches.” Rollnick et al.,4, p. vii for example, noted that, “despite the abundance of research on treatment adherence [in chronic illness], there is a paucity of teachable methods that have emerged from this body of work.” Harnessing the power of computerization to gather patient questionnaire data, create user-friendly summary reports, and free educators to spend more time counseling patients also makes sense as a behavioral intervention support strategy given the time constraints and logistical challenges diabetes educators typically face. The Accu-Chek Interview,5 a patient assessment tool, was developed to meet the need to translate a promising behavior change theory into practical strategies for diabetes educators and to utilize computerization in the patient assessment process. The tool …

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