Knowledge improvement with web-based diabetes education program: brainfood.

BACKGROUND Health literacy has a direct effect on health outcomes, but the complexity of diabetes education and time constraints on the health care team have made delivery of this education difficult. METHODS The Florida Initiative in Telemedicine and Education developed an education website (Brainfood) for multiple literacy levels. The site consists of 19 education units, 15 of which provided gradable test scores; a narrated cartoon provides essential information to low reading level learners. Text is presented at both 4th and 10th grade level. Literacy level of the user is not evaluated; rather, users choose their preferred format. The administrative backbone stores user demographics and test scores. Nurses can receive credit hours for completion of Brainfood, 13 tests required. Results were analyzed by a non-paired t test. RESULTS Five hundred thirteen users have logged in to the site and clicked "I agree" on an informed consent. Of non-nurses, 145 of 389 took pre-tests (range 89-145 depending on module), and 135 took post-tests (range 84-135). For each of the 15 modules, post-test scores improved significantly (P < 0.001 by non-paired t test). Of nurses, 68 of the 124 took pre-tests (range 26-68), and up to 56 (range 24-56) took post-tests. Post-test scores improved significantly (P < 0.05 by non-paired t test) on 13 modules. Post-test scores improved, but were not statistically significant for "Nutrition 101," a module about very basic nutrition. Web-based education about Type 1 diabetes mellitus improved the knowledge level of all users. Nurses had a lower margin of improvement for most modules as they started with a higher base knowledge level. Non-nurses improved significantly on all modules from pre-test to post-test. Post-test scores for the nurses and non-nurses were indistinguishable. CONCLUSION Brainfood, a web-based diabetes education program, is educationally sound and effective at delivering Type 1 diabetes mellitus education to both professionals and non-professionals. Web access from non-clinic settings can improve access to high-quality education for learners in remote or underserved locations.