Comprehensive Informatics Framework for Comparative Effectiveness Research (CER) Dissemination

Interactive, computer-based education has the potential to greatly increase interest,
because the learner actively participates in the learning process (Fox, 2009). In addition,
the involvement of auditory, visual, and interactive learning strategies can increase recall
of information. Computer-assisted educational programs may incorporate features that promote
ease of use, be written in multiple languages, be scripted at a level that addresses the
needs of low literacy learners, and be viewed as often as needed by a patient (Fox, 2009).

Several studies reported results of using computer technology in educating elderly patients
about health conditions. Stromberg et al (2006) used a single-session, interactive
computer-based educational program about chronic heart failure in elderly patients. They
demonstrated that interactive computer-mediated education may be effectively used to
increase patients' knowledge, about heart failure. Another study, conducted by Lin et al
(2009), evaluated the usability of a touch-screen-enabled personal education program (PEP).
The results showed that the system was evaluated as usable and useful, and older adults were
satisfied with their experience. Similar findings were reported by Neafsey et al (2008) who
also evaluated a patient-centered computer-mediated program using touch screen computers.
Authors reported high satisfaction of the older adult users, increased knowledge and
self-efficacy for avoiding adverse self-medication behaviors.

Elderly patients are less likely than younger patients to seek incidental information on
their condition via internet. (Tian & Robinson, 2008) Elderly patients therefore are less
likely to navigate internet looking for information about evidence or treatment guidelines
for their conditions. More targeted efforts may be needed to reach such populations.
Disseminating information via combination of high technology media along with traditional
media that are easily usable is helpful (Longo, 2005). A recent review of barriers and
drivers of health IT use by elderly, very ill, and underserved, revealed that such
technology can play a role in offering effective interventions. The consumer perceptions on
benefits from use of system, convenience of use, and familiar technology were all important
factors for intervention success (Jimison et al., 2008).

Inclusion Criteria:

- have clinical diagnosis of Type 2 diabetes;

- take oral diabetes medications;

- be 65 years of age or older at the time of randomization;

- plan to remain in the Maryland/DC area until the completion of the study follow-up;

- understand English at the 5th grade level.

Exclusion Criteria:

- plan to leave Maryland/DC area before the completion of the study follow- up;

- presence of significant cognitive impairment based on a Mini-Mental State Examination
(MMSE) score ≤23

- do not speak English.