TY - JOUR
T1 - Short and Long-Term Outcomes from a Multisession Diabetes Education Program Targeting Low-Income Minority Patients
T2 - A Six-Month Follow Up
AU - Ryan, John G.
AU - Jennings, Terri
AU - Vittoria, Isabel
AU - Fedders, Mark
PY - 2013/1/1
Y1 - 2013/1/1
N2 - Background: A diabetes self-management education (DSME) program was offered to patients at a primary care clinic serving low-income people. Objectives: The purpose of the analyses presented here was to understand the feasibility of the program and effectiveness of the intervention. Methods: The program was facilitated by a nurse and licensed dietician. Data were collected at baseline, after each class, and after 6 months. Patients were interviewed to identify diabetes self-care behaviors before the first class, after the fourth class, and at 6 months. Knowledge related to content areas was measured before and after each class. Glycosylated hemoglobin (HbA1c), blood pressure, weight, and body mass index (BMI) were collected at baseline and after 6 months. Medical records were reviewed for LDL levels, co-morbidity, and diabetes management. Frequencies, ×2 and t tests, and repeated measures t tests were used to analyze data. Results: Patients were mostly non-Hispanic black or Hispanic (93.1%); mean BMI was 34.89 kg/m2. About one-half (41.95%) completed the program. Significant improvements were observed for knowledge related to each of the 4 content areas: diet (P < 0.001), diabetes management (P = 0.003), monitoring blood glucose (P < 0.001), and preventing complications (P = 0.001). Among long-term outcomes, mean HbA 1c was significantly reduced (0.82%), from 8.60% to 7.78% (P = 0.007), with 26.67% of patients reducing HbA 1c from ≥7.0% at baseline to <7% at follow up (P < 0.001). Patients demonstrated a significant improvement in readiness to improve dietary behaviors (P = 0.016). Conclusions: Outcomes suggested that minority patients with a high risk for poor diabetes outcomes might be retained in a multisession DSME program and benefit from increasing knowledge of diabetes content. Further evaluation is necessary to determine the cost-effectiveness of this intervention.
AB - Background: A diabetes self-management education (DSME) program was offered to patients at a primary care clinic serving low-income people. Objectives: The purpose of the analyses presented here was to understand the feasibility of the program and effectiveness of the intervention. Methods: The program was facilitated by a nurse and licensed dietician. Data were collected at baseline, after each class, and after 6 months. Patients were interviewed to identify diabetes self-care behaviors before the first class, after the fourth class, and at 6 months. Knowledge related to content areas was measured before and after each class. Glycosylated hemoglobin (HbA1c), blood pressure, weight, and body mass index (BMI) were collected at baseline and after 6 months. Medical records were reviewed for LDL levels, co-morbidity, and diabetes management. Frequencies, ×2 and t tests, and repeated measures t tests were used to analyze data. Results: Patients were mostly non-Hispanic black or Hispanic (93.1%); mean BMI was 34.89 kg/m2. About one-half (41.95%) completed the program. Significant improvements were observed for knowledge related to each of the 4 content areas: diet (P < 0.001), diabetes management (P = 0.003), monitoring blood glucose (P < 0.001), and preventing complications (P = 0.001). Among long-term outcomes, mean HbA 1c was significantly reduced (0.82%), from 8.60% to 7.78% (P = 0.007), with 26.67% of patients reducing HbA 1c from ≥7.0% at baseline to <7% at follow up (P < 0.001). Patients demonstrated a significant improvement in readiness to improve dietary behaviors (P = 0.016). Conclusions: Outcomes suggested that minority patients with a high risk for poor diabetes outcomes might be retained in a multisession DSME program and benefit from increasing knowledge of diabetes content. Further evaluation is necessary to determine the cost-effectiveness of this intervention.
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U2 - 10.1016/j.clinthera.2012.12.007
DO - 10.1016/j.clinthera.2012.12.007
M3 - Article
C2 - 23328276
AN - SCOPUS:84872384708
VL - 35
SP - A43-A53
JO - Clinical Therapeutics
JF - Clinical Therapeutics
SN - 0149-2918
IS - 1
ER -