457 TELEMEDICINE AND e-HEALTH Volume 12, Number 4, 2006 © Mary Ann Liebert, Inc. Original Research Evaluation of a Diabetes Education Call Center Intervention SUZANNE AUSTIN BOREN, Ph.D., M.H.A., 1 GIANLUCA DE LEO, Ph.D., 2 F. FUNGAI CHANETSA, Ph.D., M.P.H., 1 JOE DONALDSON, Ph.D., 3 SANTOSH KRISHNA, Ph.D., Ed.S., 2 and E. ANDREW BALAS, M.D., Ph.D. 4 ABSTRACT Patients require education and information as they engage in self-help, self-care, and disease management activities. The purpose of this study was to determine how effective voice tech- nologies are in diabetes patient education. A pretest–posttest study was conducted to evalu- ate the effectiveness of prerecorded educational messages delivered via the telephone to par- ticipants with diabetes. The intervention consisted of 24 four-minute messages on the topics of knowledge and prevention, glucose level, diet and activity, and management and coping. Eighteen persons with diabetes participated in the pretest–posttest trial. A total of 324 edu- cational messages were listened to over a 12-week intervention period. The pretest–posttest trial demonstrated that a brief telephone-based diabetes education intervention can have a significant impact on increasing frequency of checking blood for glucose (p  0.017), im- proving general diabetes knowledge (p  0.048), and improving insulin-specific knowledge (p  0.020). Automated educational interventions should be based on scientifically sound ev- idence and can be effectively delivered by telephone. Automated telephone-based diabetes education may be used alone or as a supplement to existing diabetes education. Automated education is a viable solution when healthcare organizations and regions that as a result of a lack of human and financial resources cannot afford a diabetes educator. 1 School of Medicine, University of Missouri, Columbia, Missouri. 2 School of Public Health, Saint Louis University, St. Louis, Missouri. 3 College of Education, University of Missouri, Columbia, Missouri. 4 College of Health Sciences, Old Dominion University, Norfolk, Virginia. INTRODUCTION S TUDIES HAVE DOCUMENTED the deteriorating health and incompetent actions of patients with chronic diseases when they are not ade- quately informed and involved in the manage- ment of their care. In the United States, 18.2 million people, approximately 6.3% of the pop- ulation, have diabetes. 1 Diabetes is the fifth leading cause of death and accounted for $132 billion in direct and indirect medical expendi- tures in 2002. 2 Patients with no diabetes edu- cation are four times more likely to develop complications. 3 A study focusing on diabetic