Improving the care of students with diabetes in rural schools utilizing an online diabetes education program for school personnel

Introduction: Diabetes is a critical health issue that impacts over 422 million people worldwide to include over 500,000 children. Diabetes prevalence is higher in rural areas compared to urban areas and people living with diabetes in rural areas face significant challenges to care. Children with diabetes need appropriate care in the school setting to reduce the risk of short- and long-term complications. The inconsistencies of laws surrounding diabetes care in schools and lack of access to resources has resulted in insufficient training and poor provision of care to students particularly in rural areas. The purpose of this study was to analyze the impact of the online diabetes education program Diabetes Care at School:  Bridging the Gap on the diabetes knowledge and self-efficacy of school personnel in rural areas to administer care to students with diabetes. 

Methods: 132 participants working in rural school districts throughout South Central Texas completed the program. A pretest-posttest design was used to measure knowledge and self-efficacy before and after completion of the 12 module online diabetes education program for school personnel. Knowledge and confidence to administer care change scores were compared, and user satisfaction with the online program was also analyzed.

Results: Results of this study showed a significant increase in the knowledge and confidence scores of the participants from pre to posttest. Although the non-medical school personnel had baseline knowledge and confidence scores that were lower than the school nurses, they had significant change scores resulting in similar posttest scores. Furthermore, those with no prior diabetes training had significant change in knowledge and confidence resulting in posttest scores that were almost equivocal to those with prior diabetes training.

Conclusions: As the prevalence of school-aged children with diabetes continues to increase, an important finding of this study is that online programs with up-to-date information on diabetes care may enhance the ability of school personnel to include both lay/non-medical individuals and school nurses to effectively manage the care of students with diabetes. With up-to-date diabetic information delivered in a user friendly and accessible format, more school personnel in rural and remote areas can be trained.  Ultimately, ensuring that staff receive adequate training on diabetes and possess the confidence to administer care should improve outcomes for students with diabetes in rural, remote, and underserved areas.