Lasting Effects of a Community-Based Self-Management Intervention for Patients With Type 2 Diabetes in China: Outcomes at 2-Year Follow-up of a Randomized Trial

2020 ◽  
pp. 101053952097526
Author(s):  
Yingying Jiang ◽  
Fan Mao ◽  
Wenlan Dong ◽  
Xingxing Zhang ◽  
Jianqun Dong
Keyword(s):  
Type 2 Diabetes ◽  
Self Efficacy ◽  
Intervention Group ◽  
Blood Glucose Monitoring ◽  
Self Management ◽  
Community Based ◽  
Management Intervention ◽  
Patients With Diabetes

This research is to evaluate the lasting effects of a community-based self-management intervention for patients with type 2 diabetes at 2-year follow-up in China. Five hundred patients with diabetes were recruited and randomly divided into intervention group and control group. Eight times standardized self-management intervention group activities were conducted. The results of physical examination, biochemical laboratory examination, health behavior, and self-efficacy information were collected before intervention, 3 months after intervention, and 2 years after intervention. The total score for self-efficacy in the intervention group increased from 96.12 ± 17.48 to 112.90 ± 14.58 after intervention and decreased after 2 years (106.98 ± 18.03; F = 6.64, P = .0014). The number of days of self-blood glucose monitoring in the intervention group was increased from 1 day per week to 2 days per week after intervention, and 2 days per week at 2-year follow-up ( F = 8.02, P = .0003). The frequency of average number of aerobic exercises in the intervention group increased from 6 days per week to 7 days per week after intervention and was 7 days per week at 2-year follow-up ( F = 3.63, P = .0269). Community-based self-management group intervention for patients with diabetes has long-term effects.

scholarly journals The Impact of an Internet-Based Self-Management Intervention (HeLP-Diabetes) on the Psychological Well-Being of Adults with Type 2 Diabetes: A Mixed-Method Cohort Study

2016 ◽  
Vol 2016 ◽  
pp. 1-13 ◽  
Author(s):  
Megan Hofmann ◽  
Charlotte Dack ◽  
Chris Barker ◽  
Elizabeth Murray
Keyword(s):  
Type 2 Diabetes ◽  
Mixed Method ◽  
Self Efficacy ◽  
Qualitative Data ◽  
Well Being ◽  
Self Management ◽  
Psychological Well Being ◽  
Management Intervention ◽  
The Impact

This mixed-method study assessed the impact of an internet-based, self-management intervention (“HeLP-Diabetes”) on the psychological well-being of adults with type 2 diabetes. Nineteen participants were recruited from 3 general practices. Data were collected at baseline and at 6 weeks follow-up. Access to HeLP-Diabetes was associated with a significant decrease in participants’ diabetes-related distress (Z=2.04,p=0.04, andd=0.28). No significant differences were found in emotional distress or self-efficacy. The qualitative data found that participants reported improvements including increased self-efficacy and support, better management of low mood, greater diabetes awareness, and taking the condition more seriously. Participants also reported making improvements to their eating habits, exercise routine, and medical management. Some negative experiences associated with using the intervention were mentioned including feelings of guilt for not using the intervention as suggested or not making any behavioral changes, as well as technical and navigational frustrations with the intervention. Internet-based self-management interventions may have the potential to decrease diabetes-related distress in people with type 2 diabetes. The qualitative data also suggests internet interventions can positively impact both psychological and behavioural outcomes of adults with type 2 diabetes.

scholarly journals Person-Centred, Occupation Based Intervention Program Supported with Problem-Solving Therapy for Type 2 Diabetes: a randomized controlled trial

2020 ◽  
Author(s):  
Zeynep Bahadır Ağce ◽  
Gamze Ekici
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Problem Solving ◽  
Self Efficacy ◽  
Intervention Group ◽  
Well Being ◽  
Problem Solving Therapy

Abstract Background: Individuals with diabetes mellitus both have difficulty in solving problems in daily life and have similar difficulties with self-care regimens. We examined the effect of occupation-based intervention supported with problem-solving therapy of individuals with type 2 diabetes mellitus on participation and satisfaction of meaningful occupations, diabetes-related psychosocial self-efficacy, preferred coping strategies and individual well-being. Methods: This study was planned as a single-blind, randomized controlled study with 3-months’ follow-up involving sixty-seven adults with type 2 diabetes. The Canadian Occupational Performance Measure, the Diabetes Empowerment Scale, the Brief COPE and the Five-item World Health Organization Well-Being Index were used. The intervention was conducted in 6 modules, and each implemented about 60 minutes and for 1 session per week. The six modules included evaluations, diabetes education, and problem-solving therapy. The most important feature of the program is its focus on meaningful occupations for the person and provided an opportunity for the participants to apply problem-solving therapy through valued occupation. Differences between groups were analysed with the Mann Whitney U test, and the Friedman test was used to calculate group-time interaction differences (i.e. baseline, after six modules and after three months). Results: Individuals with type 2 diabetes mellitus in both groups identified the most significant meaningful activity problems in self-care as personal care. Significant improvement was reported in the intervention group when compared to the control group regarding the participation in meaningful occupation, the satisfaction of performance, psychological self-efficacy and well-being results (p<0.001) after the six modules and 3 months follow-up. The participants' use of the effective coping strategies, active coping and acceptance strategies, self-efficacy as revealed results showed improvement in favor of the intervention group (p<0.05). The intervention group showed significantly improving between measurements at baseline and after three months of modules except for ineffective coping style (p<0.001). Conclusions: The person-centred occupation-based problem-solving therapy encourages participation in meaningful occupations, positive effects on psychological self-efficacy, and improves effective coping styles and well-being of type 2 diabetes mellitus. Problem-solving therapies that incorporate individuals’ priorities via meaningful occupation could be used to supported to lead a meaningful life of individuals of type 2 diabetes mellitus. Trial Registration: ClinicalTrials.gov Identifier: NCT03783598. Retrospectively Registered. First Posted-December 21, 2018, Last Update Posted-February 18, 2020. Key words: Diabetes mellitus, Person-centred, Occupation-based, Problem-solving, Psychosocial self-efficacy, Coping, Well-being, Quality of life, Occupational therapy

scholarly journals Effect of a Short-Duration, Culturally Tailored, Community-Based Diabetes Self-management Intervention for Korean Immigrants

2012 ◽  
Vol 38 (3) ◽  
pp. 377-385 ◽  
Author(s):  
Sarah E. Choi ◽  
Elizabeth B. Rush
Keyword(s):  
Type 2 Diabetes ◽  
Short Duration ◽  
Well Being ◽  
Korean Immigrants ◽  
Self Management ◽  
Community Center ◽  
Community Based ◽  
Culturally Tailored

Purpose The purpose of this pilot study was to assess the effectiveness, feasibility, and acceptability of a short-duration, culturally tailored, community-based diabetes self- management program (CTCDSP) for Korean immigrants with type 2 diabetes delivered at a non-clinic-affiliated community center. Methods Forty-one Korean adults with type 2 diabetes participated in a 2-session CTCDSP delivered by a bilingual nurse practitioner at a Korean community center. Outcome measures included biological, behavioral, and general health well-being; diabetes knowledge; and self-efficacy assessed at baseline, post-education, and 3-month follow-up. Repeated-measures analyses of variance were used to explore mean differences in outcomes across the 3 assessment points. Results From baseline to 3-month follow-up assessment, participants exhibited significant improvement on several physiological and behavioral measures. Mean levels of hemoglobin A1c and waist circumference decreased, whereas high-density lipoprotein levels increased. Additionally, participants reported an increase in weekly feet checks, and there was a trend increase in participants’ reported frequency of exercise activities. The feasibility of the CTCDSP was established, and participant satisfaction with the program was high. Conclusions A short-duration CTCDSP may be an effective, feasible, and favorably received approach to improving diabetes outcomes in Korean and potentially other underserved ethnic minority immigrants who have limited access to mainstream clinic-based diabetes self-management programs.

scholarly journals The Teach-Back Effect on Self-Efficacy in Patients with Type 2 Diabetes

2020 ◽  
Vol 16 (1) ◽  
pp. 46-50
Author(s):  
Marhamat Farahaninia ◽  
Tahere Sarboozi Hoseinabadi ◽  
Rasool Raznahan ◽  
Shima Haghani
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Self Efficacy ◽  
Intervention Group ◽  
Self Management ◽  
Control Group ◽  
Training Procedure ◽  
Treatment Regimens ◽  
The Impact

BACKGROUND: Diabetes is a chronic, metabolic disease, which is commonly associated with increased blood glucose levels caused by impaired secretion or function of insulin. Therefore, daily blood glucose control, adherence to a dietary and pharmaceutical regimen, regular physical activity, and foot care are fundamental components of disease management. In order to optimize effective self-management, patients need to be trained. Teach-back is a method which aims to improve patients' understanding and perception of treatment regimens based on the interaction between patient and caregiver. AIM: This study was conducted to investigate the impact of the teach-back method on the effectiveness of self-management in patients with type 2 diabetes (T2D). METHODS: A total of 74 patients with T2D were included in the study by convenience sampling at the Endocrine and Metabolism Clinic. The subjects were assigned to control or intervention group. Data collection was performed by using a demographic data form and a self-efficacy questionnaire that were provided to the patients before and 1 month after training. The patients in the intervention group received a 5-session training program using the teach-back method. The control group received only routine programs. One month after completion of the training sessions, the questionnaires were completed by the subjects in the 2 groups, and the data obtained were analyzed. RESULTS: In contrast to the control group, mean and standard deviation of self-efficacy were significantly higher in the intervention group one month after training by the teach-back method than before training. The two groups did not significantly differ regarding mean score of self-efficacy before training, but there was a significant difference one month after training: the mean score of self-efficacy in the intervention group was significantly higher than in the control group (p < 0.001). CONCLUSIONS: Teach-back is a training procedure aimed at improving patients' understanding of treatment regimens. This study showed that teach-back significantly improved patients' self-efficacy even over as short a period as one month. It may be interesting to study the long-term effects of this simple but effective training method.

scholarly journals Nurse Coaching and Mobile Health Compared With Usual Care to Improve Diabetes Self-Efficacy for Persons With Type 2 Diabetes: Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Heather M Young ◽  
Sheridan Miyamoto ◽  
Madan Dharmar ◽  
Yajarayma Tang-Feldman
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Usual Care ◽  
Self Efficacy ◽  
Controlled Trial ◽  
Intervention Group ◽  
Self Management ◽  
Randomized Controlled ◽  
Mhealth Technology

BACKGROUND Type 2 diabetes is a growing public health problem amenable to prevention and health promotion. As healthy behaviors have an impact on disease outcomes, approaches to support and sustain diabetes self-management are vital. OBJECTIVE This study aimed to evaluate the effectiveness of a nurse coaching program using motivational interviewing paired with mobile health (mHealth) technology on diabetes self-efficacy and self-management for persons with type 2 diabetes. METHODS This randomized controlled trial compared usual care with an intervention that entailed nurse health coaching and mHealth technology to track patient-generated health data and integrate these data into an electronic health record. The inclusion criteria were as follows: (1) enrolled at 1 of 3 primary care clinics, (2) aged 18 years or above, (3) living with type 2 diabetes, and (4) English-speaking. We collected outcome measures at baseline, 3 months, and 9 months. The primary outcome was diabetes self-efficacy; secondary outcomes were depressive symptoms, perceived stress, physical functioning, and emotional distress and anxiety. Linear regression mixed modeling estimated the population trends and individual differences in change. RESULTS We enrolled 319 participants; 287 participants completed the study (155 control and 132 intervention). The participants in the intervention group had significant improvements in diabetes self-efficacy (Diabetes Empowerment Scale, 0.34; 95% CI –0.15,0.53; <i>P</i>&lt;.01) and a decrease in depressive symptoms compared with usual care at 3 months (Patient Health Questionnaire-9; 0.89; 95% CI 0.01-1.77; <i>P</i>=.05), with no differences in the other outcomes. The differences in self-efficacy and depression scores between the 2 arms at 9 months were not sustained. The participants in the intervention group demonstrated a significant increase in physical activity (from 23,770 steps per week to 39,167 steps per week at 3 months and 32,601 per week at 9 months). CONCLUSIONS We demonstrated the short-term effectiveness of this intervention; however, by 9 months, although physical activity remained above the baseline, the improvements in self-efficacy were not sustained. Further research should evaluate the minimum dose of coaching required to continue progress after active intervention and the potential of technology to provide effective ongoing automated reinforcement for behavior change. CLINICALTRIAL ClinicalTrials.gov NCT02672176; https://clinicaltrials.gov/ct2/show/NCT02672176

scholarly journals Nurse Coaching and Mobile Health Compared With Usual Care to Improve Diabetes Self-Efficacy for Persons With Type 2 Diabetes: Randomized Controlled Trial

10.2196/16665 ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. e16665 ◽  
Author(s):  
Heather M Young ◽  
Sheridan Miyamoto ◽  
Madan Dharmar ◽  
Yajarayma Tang-Feldman
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Usual Care ◽  
Self Efficacy ◽  
Controlled Trial ◽  
Intervention Group ◽  
Self Management ◽  
Randomized Controlled ◽  
Mhealth Technology

Background Type 2 diabetes is a growing public health problem amenable to prevention and health promotion. As healthy behaviors have an impact on disease outcomes, approaches to support and sustain diabetes self-management are vital. Objective This study aimed to evaluate the effectiveness of a nurse coaching program using motivational interviewing paired with mobile health (mHealth) technology on diabetes self-efficacy and self-management for persons with type 2 diabetes. Methods This randomized controlled trial compared usual care with an intervention that entailed nurse health coaching and mHealth technology to track patient-generated health data and integrate these data into an electronic health record. The inclusion criteria were as follows: (1) enrolled at 1 of 3 primary care clinics, (2) aged 18 years or above, (3) living with type 2 diabetes, and (4) English-speaking. We collected outcome measures at baseline, 3 months, and 9 months. The primary outcome was diabetes self-efficacy; secondary outcomes were depressive symptoms, perceived stress, physical functioning, and emotional distress and anxiety. Linear regression mixed modeling estimated the population trends and individual differences in change. Results We enrolled 319 participants; 287 participants completed the study (155 control and 132 intervention). The participants in the intervention group had significant improvements in diabetes self-efficacy (Diabetes Empowerment Scale, 0.34; 95% CI –0.15,0.53; P<.01) and a decrease in depressive symptoms compared with usual care at 3 months (Patient Health Questionnaire-9; 0.89; 95% CI 0.01-1.77; P=.05), with no differences in the other outcomes. The differences in self-efficacy and depression scores between the 2 arms at 9 months were not sustained. The participants in the intervention group demonstrated a significant increase in physical activity (from 23,770 steps per week to 39,167 steps per week at 3 months and 32,601 per week at 9 months). Conclusions We demonstrated the short-term effectiveness of this intervention; however, by 9 months, although physical activity remained above the baseline, the improvements in self-efficacy were not sustained. Further research should evaluate the minimum dose of coaching required to continue progress after active intervention and the potential of technology to provide effective ongoing automated reinforcement for behavior change. Trial Registration ClinicalTrials.gov NCT02672176; https://clinicaltrials.gov/ct2/show/NCT02672176

Abstract TP190: The Effectiveness of a Person-centered Empowerment-based Self-management Intervention in Reducing Risk of Stroke Among Male Patients With Poorly Controlled Type 2 Diabetes: A Mixed-method Study

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Li Cheng ◽  
Janet W Sit ◽  
Sek-ying Chair
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Mixed Method ◽  
Intervention Group ◽  
Self Management ◽  
Post Intervention ◽  
Management Intervention ◽  
Male Patients ◽  
Male Subjects

Introduction: The overall incidence of stroke was higher in men than women. Type 2 diabetes is found to be a risk factor for stroke. Previous prospective studies showed each 1% increase in HbA1c would be associated with 12% increase in the risk of developing a stroke. Identifying effective strategies to optimize the glycemic control of male patients with poorly controlled type 2 diabetes would be valuable for reducing the risk of stroke. This mixed-method study aims to examine how male patients with poorly controlled type 2 diabetes responded to a person-centered empowerment-based self-management intervention. Methods: Phase I study was based on a sub-group analysis of 179 male subjects with poorly controlled type 2 diabetes [with Glycated hemoglobin (HbA1c) ≥7.5%] who received a six-week empowerment-based self-management intervention (n= 93) or attentional control (n= 86), respectively. The primary outcome was HbA1c level from baseline to three-month post-intervention. Phase II study was an in-depth individual interview with the purpose to reveal how facilitating factors or barriers become apparent in the implementation of self-management practice. Integration of quantitative and qualitative data was performed to disclose a comprehensive picture of intervention effect and mechanism. Results: The pre-post HbA1c change for male subjects in the intervention group was 1.01%, which indicated a clinical significant reduction in the risk of developing stroke. At three-month post-intervention, male participants in the intervention group showed significant improvement in glycemic control (8.99% vs. 9.68%, between-group difference: 0.69±2.64, p= 0.045). Content analysis revealed that setting personally meaningful goals, making a personalized action plan, and reflecting and solution-finding were facilitating factors perceived by male subjects with poorly controlled type 2 diabetes. Two categories for barriers to optimal glycemic control were identified, including collective culture and diabetes fatalism. Conclusions: Person-centered empowerment-based intervention could facilitate male subjects with poorly controlled type 2 diabetes to actively engage in self-management activities for stroke prevention.

scholarly journals Efficacy of a Brief Self-management Intervention in Type 2 Diabetes Mellitus: A Randomized Controlled Trial from India

2020 ◽  
Vol 42 (6) ◽  
pp. 540-548
Author(s):  
Anisha Mary Abraham ◽  
Paulomi M Sudhir ◽  
Mariamma Philip ◽  
Ganapathi Bantwal
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Illness Perceptions ◽  
Self Care ◽  
Perceived Barriers ◽  
Self Management ◽  
Management Intervention

Background: Diabetes mellitus places a considerable burden on the individual and the family with respect to lifestyle changes. There is a paucity of systematic studies in India examining the efficacy of self-management programs for diabetes. The study examined the impact of a brief self-management intervention (SMI) on primary outcome of HbA1c and secondary outcomes of quality of life (QOL), self-care, perceived barriers to self-care (BSC), perceptions regarding illness and mood in patients with type 2 diabetes mellitus. Methods and materials: Eighty patients with type 2 diabetes mellitus were randomly allocated to either a 4-session SMI or treatment as usual (TAU) and were assessed on HbA1c levels, QOL, self-care, BSC, illness perceptions, anxiety, and depression at baseline, postintervention , and at three-month postintervention follow-up. Results: Repeated measures analysis of variance indicated significant improvement in the SMI group from baseline to follow-up on HbA1c (P = 0.001), impact of diabetes on QOL (P = 0.006), self-care with respect to diet and exercise (Ps = 0.001), perceived barriers in adherence to diet, exercise, (P = 0.001), medication (P < 0.01), glucose testing (P = 0.04), general BSC (P = 0.001), total barriers (P = 0.001), illness perceptions-timeline or chronicity of illness (P = 0.002), personal control over illness, (P = 0.001), belief in effectiveness of treatment (P = 0.002), understanding of one’s illness (P = 0.001), and emotional representations regarding illness (P =0.001), depression, (P = 0.001), and anxiety (P = 0.001). In the SMI group, large effect sizes were obtained at the postintervention assessment and the three-month follow-up on most outcome measures. Conclusions: Brief psychological intervention is efficacious in patients with type 2 diabetes.

scholarly journals ¡Sí, Yo Puedo Vivir Sano con Diabetes! A Self-Management Randomized Controlled Pilot Trial for Low-Income Adults with Type 2 Diabetes in Mexico City

2020 ◽  
Vol 4 (5) ◽  
Author(s):  
Robin Whittemore ◽  
Mireya Vilar-Compte ◽  
Selene De La Cerda ◽  
Roberta Delvy ◽  
Sangchoon Jeon ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Mexico City ◽  
Low Income ◽  
Self Efficacy ◽  
Pilot Trial ◽  
Intervention Group ◽  
Self Management ◽  
Control Group ◽  
Over Time

Abstract Background Type 2 diabetes (T2D) is a worldwide epidemic and a leading cause of death in Mexico, with a prevalence of 15.9%, and &gt;70% of diagnosed adults have poor glycemic control [glycated hemoglobin (HbA1c) &gt;7.5%]. We developed a diabetes self-management education program contextualized to the study population, including dietary preferences, health literacy, and health system. Objectives We aimed to evaluate the efficacy of a self-management + text message program (¡Sí, Yo Puedo Vivir Sano con Diabetes!) on primary (HbA1c), and secondary behavioral (self-management), clinical, and psychosocial outcomes in adults with T2D in Mexico City. Methods Participants were recruited at public primary healthcare centers (Seguro Popular), and randomly allocated to treatment (n = 26) or wait-list control groups (n = 21) with data collected at 3 and 6 mo. The program included 7 weekly sessions and 6 mo of daily text/picture messages. Descriptive statistics and a generalized linear mixed model with intent-to-treat analysis were calculated. Results Participants were 55.5 ± 8.8 y of age (mean ± SD), 68% female, 88.6% overweight/obese, and 57% lived in food-insecure households. Mean ± SD T2D duration was 11.9 ± 7.8 y and HbA1c was 9.2% ± 1.5%. There was 89% attendance at sessions and 6.4% attrition across both groups at 6 mo. Group-by-time effects were seen in self-monitoring of blood glucose (P &lt; 0.01) and diabetes self-efficacy (P &lt; 0.04); and a trend for lower HbA1c was seen in the intervention group at 6 mo (P = 0.11). Significant improvements in dietary behavior (P &lt; 0.01) were demonstrated in the intervention group over time, but this did not reach statistical significance compared with the control group. Conclusions The program was associated with clinically significant improvements in T2D self-management, self-efficacy, and HbA1c over time. Thus, T2D self-management skills, including diet, were improved in a vulnerable metropolitan population. This trial was registered at clinicaltrials.gov as NCT03159299.

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