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• Background on Provider Education Systems
• Evidence on Provider Education Systems
• Example Provider Education Systems
• Action Steps to Create and Implement Provider Education Systems
• Tools and Resources for Provider Education Systems
• Evaluation of Provider Education Systems

Provider education systems can enhance health care providers’ knowledge and skills related to counseling patients or clients about diabetes prevention and management through information and education. These systems train qualified health care providers to counsel or provide advice to individuals in order to encourage them to change their diabetes-related behaviors (e.g., glucose monitoring, taking medications, eating balanced nutritional meals, getting physical activity, quitting tobacco use). This training offers health care providers access to information and resources about:

• the benefits of good nutrition and physical activity for preventing and managing diabetes;
• the health risks of not monitoring glucose levels and taking medications; and
• ways to change individuals’ diabetes-related behavioral patterns by increasing support (e.g., physician recommendations for nutrition and physical activity) and reducing barriers (e.g., access to low-cost diabetes test kits or medications) for self-management.

Provider reminder systems can be developed as part of provider training. Provider reminder systems give cues or prompts to providers to increase the likelihood that they will discuss diabetes-related information with their patients or clients. Provider reminder systems utilize various strategies to prompt providers to discuss diabetes with their patients or clients, including changes to the patient’s chart (e.g., stickers, colored folders), changes in the physical environment (e.g., posters in exam rooms), or personal prompts (e.g., laminated pocket sized information sheets).

Provider education systems are usually offered to health care providers in traditional public or private health care settings, including a provider’s office, hospital, pharmacy, health department, or assisted living facility. However, health care providers with or without specialized medical training can participate in provider education systems training for non-traditional settings, including communities (e.g., mobile clinics), schools (e.g., school nurses), worksites (e.g., health screening), faith-based settings (e.g., health ministry), or individuals’ homes.

Health care providers are a primary and respected source of health information. Many individuals and families seek out the advice of health care providers to maintain their health and quality of life on a regular basis. Therefore, health care providers are ideally suited to have an ongoing influence on individuals’ decisions to prevent or manage their diabetes.

As part of their interaction with individuals, health care providers typically include the following:

• An assessment of an individual’s health, diabetes-related conditions, nutrition, physical activity, tobacco use, and readiness to make behavior changes. This assessment enables the provider to provide personally relevant information to the individual about their risk factors and health needs. For example, it may be used to increase knowledge or awareness of the importance of glucose monitoring, change attitudes about eating patterns or physical activity, teach skills for taking diabetes medications regularly, or provide social support to assist the individual in quitting tobacco use.
• An opportunity for the individual to ask questions or clarify what they have been told. This exchange with the provider can help to ensure that the individual understands the information and recommendations that they have been provided.
• Referrals and resources within the community to assist the individual in following diabetes recommendations for prevention and management of the disease. For example, the provider can give the individual a shopping list of recommended foods and beverages, phone numbers for walking clubs in the community, or a list of pharmacies with reduced costs for diabetes test kits and medications.
• (Subsequent interactions) A reassessment of the individual’s health and diabetes-related behaviors as well as a discussion of challenges, benefits, and advice for maintaining behaviors over time.

Provider education systems training works best if it is hands-on and practical. This may include discussions among health care providers about how to counsel or provide advice to specific individuals (e.g., those with special health care needs, those who show no change over time), how to respond to individual barriers to diabetes prevention and management (e.g., family traditions involving food or beverages, access to parks or recreation centers, cost of diabetes medications), how to reach high risk populations, how to work in different settings, and how to integrate effective practice strategies into different practice styles. Previous studies also suggest the need to consider longitudinal education strategies, building relationships with specialists (e.g., nutritionists, exercise physiologists, podiatrists), tailoring provider education about diabetes to specific conditions (e.g., hypertension, high cholesterol, pregnancy), training on community and policy influences on diabetes in addition to the more traditional focus on individual services, and improved methods for patient or client tracking, repeat testing, and referral to other community resources.

It is difficult to understand the effectiveness of these interventions because the interaction between the provider and individual is unique for each individual, short in duration (less than 5 minutes), may involve recommendations for multiple behaviors at once (e.g., eat healthy, be active, and quit smoking), or may lack institutional support for sharing this type of information during a visit (e.g., policies, procedures, training, or incentives).

Provider education systems can also reinforce other intervention strategies in order to help individuals prevent or manage their diabetes (e.g., individual information exchange, supportive relationships).