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DOI: 10.1177/014572179902500621 © 1999 American Association of Diabetes Educators; Published by SAGE Publications Provider Impact in Diabetes EducationWhat We Know, What We Would Like to Know, Paradigms for AskingUniversity of Maryland Medical School, Department of Pediatric Endocrinology, 22 South Greene Street, NSE13, Baltimore, MD 21201. PURPOSE Literature search from 1985 to the present was performed using Web-based search engines to identify evidence-based studies of diabetes education. METHODS Twelve studies were identified in which a provider characteristic was defined as a discriminate variable associated with impact or efficacy of the education intervention. Provider was defined as all those participating in diabetes care and education (eg, patient, education and care teams, funding and policy agencies). The Certified Diabetes Educator credential also was described. RESULTS Specialty or discipline of the provider/care team, technology when used to assist providers, and physician practice patterns have been assessed. There is a paucity of research that assesses provider impact or the specific impact of provider characteristics on diabetes outcomes in a controlled and scientifically rigorous fashion. CONCLUSIONS Suggestions for evaluating provider impact based on literature concerning psychotherapy and healthcare education outcomes are: identify provider characteristics/attitudes/skills and link them to outcomes, define therapeutic alliance in diabetes care/ education and assess its contribution to outcomes; and use performance measures as provider characteristics.
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