By Max Bingham, PhD A team-based gaming approach delivering self-managed diabetes education via a mobile app and e-mail can lead to reductions in HbA1c that are comparable to starting a new diabetes medication, according to Kerfoot et al. ( p. 1218 ). They suggest this may represent a scalable solution to improve outcomes among patients with poorly controlled diabetes across wide geographic areas. The spaced education paradigm involves presenting various health scenarios to participants who are then asked to immediately answer multiple-choice questions on the subjects. Following their answers, the participants receive the correct answers combined with an explanation of the topic and a score based on their performance. The material is then presented again to the participants in the following weeks and months to reinforce learning and generate meaningful behavior change. The approach is not unique to diabetes education and has previously been employed in diverse environments such as commercial sales where learning and behavior change are key objectives. Traditional diabetes self-management education has had some success in achieving meaningful short-term reductions in HbA1c. However, the effects reportedly wear off quickly. By modifying the approach to include spaced education, the authors hypothesized that they might be able to generate more sustained HbA1c reductions. In a randomized trial design, the researchers assigned ∼200 patients who are veterans with poorly controlled diabetes to the diabetes self-management education game and ∼200 others to an active control game. They found that the intervention group had significantly greater reductions in HbA1c over 12 months in comparison to control subjects. Going further with a post-hoc analysis, they showed that additional reductions might be possible when baseline HbA1c is particularly high and out of control. Commenting further, author B. Price …

中文翻译：

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在本期糖尿病护理中

据Kerfoot等人说，基于团队的游戏方法通过移动应用程序和电子邮件提供自我管理的糖尿病教育，可以降低HbA1c，这与开始新的糖尿病治疗相当。（第1218页）。他们认为，这可能是可扩展的解决方案，以改善广泛地理区域中控制不良的糖尿病患者的预后。间隔教育范式涉及向参与者呈现各种健康状况，然后要求参与者立即回答有关该主题的多项选择题。在回答之后，参与者会收到正确的答案，并结合对主题的解释和基于他们的表现的分数。然后，在接下来的几周和几个月中，将材料再次呈现给参与者，以加强学习并产生有意义的行为改变。该方法并非糖尿病教育所独有，并且先前已在多种环境中采用，例如以学习和行为改变为主要目标的商业销售。传统的糖尿病自我管理教育在实现有意义的短期HbA1c减少方面取得了一些成功。但是，据报道效果很快消失了。通过修改方法以包括间隔教育，作者假设他们可能能够产生更持久的HbA1c减少。在随机试验设计中，研究人员将大约200名糖尿病控制不佳的退伍军人患者分配到糖尿病自我管理教育游戏中，将大约200名患者分配给主动控制游戏。他们发现，与对照组相比，干预组在12个月内HbA1c的降低显着更大。进一步进行事后分析，他们表明，当基线HbA1c特别高且失控时，可能还会有进一步的减少。进一步评论，作者B. Price…