Is physician engagement with Web-based CME associated with patients' baseline hemoglobin A1c levels? The Rural Diabetes Online Care study
Authors
Crenshaw, KatieCurry, William
Salanitro, Amanda H.
Safford, Monika M.
Houston, Thomas K.
Allison, Jeroan J.
Estrada, Carlos A.
UMass Chan Affiliations
Department of Quantitative Health SciencesDocument Type
Journal ArticlePublication Date
2010-08-26Keywords
Diabetes Mellitus*Education, Medical, Continuing
Hemoglobin A, Glycosylated
Humans
*Internet
Physician's Practice Patterns
Rural Health
Southeastern United States
Statistics, Nonparametric
Bioinformatics
Biostatistics
Epidemiology
Health Services Research
Metadata
Show full item recordAbstract
PURPOSE: To investigate the association between physician participants' levels of engagement in a Web-based educational intervention and their patients' baseline diabetes measures. METHOD: The authors conducted a randomized trial of online CME activities designed to improve diabetes care provided by family, general, and internal medicine physicians in rural areas of 11 southeastern states between September 2006 and July 2008. Using incidence rate ratios derived from negative binomial models, the relationship between physicians' engagement with the study Web site and baseline proportion of their patients having controlled diabetes (hemoglobin A1c < or = 7%) was explored. RESULTS: One hundred thirty-three participants (intervention = 64; control = 69) provided information for 1,637 patients with diabetes. In the intervention group, physicians in practices in the worst quartiles of A1c control were least engaged with the study Web site in nearly all dimensions. Total number of pages viewed decreased as quartile of A1c control worsened (137, 73, 68, 57; P = .007); similarly, for a given 10% increase in proportion of patients with controlled A1c, participants viewed 1.13 times more pages (95% CI: 1.02-1.26, P = .02). In the control group, engagement was neither correlated with A1c control nor different across quartiles of A1c control. CONCLUSIONS: Engagement in Web-based interventions is measurable and has important implications for research and education. Because physicians of patients with the greatest need for improvement in A1c control may not use online educational resources as intensely as others, other strategies may be necessary to engage these physicians in professional development activities.Source
Acad Med. 2010 Sep;85(9):1511-7. Link to article on publisher's siteDOI
10.1097/ACM.0b013e3181eac036Permanent Link to this Item
http://hdl.handle.net/20.500.14038/47818PubMed ID
20736679Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1097/ACM.0b013e3181eac036