Computer-Assisted Diabetes Risk Assessment and Education (CADRAE) for Medically Vulnerable Populations in the Middle...

The prevalence of diabetes in the Middle East is increasing rapidly due to urbanization, reduced levels of physical activity, and a nutritional transition toward increased consumption of fats and refined carbohydrates. Preventive strategies are of paramount importance to stemming the tide. Portable touch-screen computer technology may hold an answer for alleviating the burdens of cost, time, and training that limit the implementation of diabetes risk screening and intervention, especially among refugees and other vulnerable populations. The Computer-Assisted Diabetes Risk Assessment and Education (CADRAE) Arabic-language intervention program is proposed as a model method for practicing proactive type 2 diabetes prevention in resource-limited settings of the Middle East that combines the efficiency of risk-score screening methods, the advantages of portable computer interface, and the spirit of brief motivational interviewing. This paper aims to describe the theory and novel design of CADRAE-introduced at the Noor Al Hussein Foundation's Institute of Family Health in January 2014-as well as discuss opportunities and challenges for its implementation and evaluation in primary or emergency care settings. Features of CADRAE are elucidated in detail, including development, translation, conceptual framework, theoretical basis, method of risk assessment, brief intervention style, definition of outcomes, requirements for implementation, and potential means of evaluation and quality improvement. CADRAE offers the first example of portable computer technology integrating diabetes risk screening with behavior change counseling tailored for an Arabic-speaking population of mostly refugees and could offer a valuable model for researchers and policy makers of the Middle East as well as other resource-limited settings.