As a registered nurse, Jane Bolin knows it's not uncommon in poor, rural areas for residents to walk into their doctor's office with a blood-sugar level more than five times the normal range.
An elevated blood-sugar level is a clear sign of diabetes, said Bolin, associate professor and director of the Southwest Rural Health Research Center within the Texas A&M Health Science Center School of Rural Public Health.
Yet, patients often don't realize their blood-sugar level has skyrocketed from normal -- between 90 and 120 -- to a dangerously high level, she said.
"Some people are coming in with 500 and don't even know that they have diabetes," Bolin said.
More than 20 million adults and children in the United States have diabetes, and about one-third of those people have not been diagnosed, the diabetes association Web site states. Though an exact cause is not known, experts believe genetics and environmental factors -- such as obesity and lack of exercise -- play a role.
Rural doctors can diagnose the disease, Bolin said, but they often don't have the resources to offer extensive diabetes education and nutritional counseling. That's where an educational computer kiosk designed by School of Rural Public Health researchers comes in, she said.
The interactive program employs a touch-screen that allows patients to pick and choose different aspects of the disease -- such as diabetes care or prevention -- they want to learn about, Bolin said. It also lets patients set goals.
The program targets patients with a fifth- and sixth-grade reading level, Bolin said as she scrolled through the screens on a kiosk in her office.
"It's hitting the segment of the population that could really use it," Bolin said, explaining that the kiosks help diabetics take ownership of their disease.
The kiosks will be set up in community health centers in Madison, Grimes and Burleson counties, as well as the Family Practice Residency and at the Brazos Valley Community Health Center, both in Bryan, according to School of Rural Public Health officials.
Curriculum for the program was developed by Bolin and professor Marcia Ory, working with a team of researchers. A grant from Dell is being used to purchase some of the computer kiosks.
School of Rural Public Health spokeswoman Rae Lynn Mitchell said funding for the project came from the Centers for Disease Control and Prevention as part of the school's designation as a national Prevention Research Center. Dell also provided a grant to purchase the touch-screen monitors.
The kiosks will be tested for six months, and during that time, participants will be asked to evaluate their use. Researchers also will retrieve data detailing how many clients -- their names removed -- used the program repeatedly, how many set goals and which were the most viewed educational components.
If the project is successful, it could be used as a national model, Mitchell said.
Bolin said the next step for the pilot program is translating the kiosk information into Spanish and expanding the data to include other chronic diseases. She said she hopes the machines become as ubiquitous as blood-pressure machines stationed in pharmacies.
At the Brazos Family Medicine Residency clinic, the kiosk hasn't yet been fully installed. But employees and some patients have scrolled through the information.
Clinic program Director David McClellan said the kiosk isn't designed to be a replacement for doctors' advice. Rather, it should be used as a supplement. He hopes the kiosk is used by patients in the clinic who are curious about diabetes or have friends with the disease, as well as those who are newly diagnosed.
Clinic Health Educator Melissa Fisher said the kiosks are designed to allow patients to go at their own pace, letting them scroll back and forth through the pages if they want to move ahead or reread a page.
Perhaps, she said, patients will scroll through the computer screens as they wait for the doctor and read something that triggers a question.
Busy doctors often are focused on the diagnosis, health management and medication and simply don't have the time to cover every topic during a visit with a patient. The kiosks allow patients to get more indepth with topics such as diet and exercise.
"With diabetes, there just can't be too much education," Fisher said. "It's just another great format for education on a very simple level for all patients."
• Holly Huffman's e-mail address is holly.huffman@theeagle.com.
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