Development and Initiation of a Diabetes Self-Management Program for an Underserved Population

Harris, Frances; Chamings, Patricia A.; Piper, Susie; Levick, Frederick R.

doi:10.1177/014572170002600505

Cited by 8 publications

(15 citation statements)

References 2 publications

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“…241 Community-based teaching sessions led by volunteer educators provided diabetes group education on lifestyle behaviours, diabetes complications and medication, and individual sessions addressed blood glucose monitoring and insulin administration. 239 Of the 22 patients who provided data before and after the intervention, 16 (73%) had lower HbA 1c levels and 5 (23%) had increased levels. Barriers to participation included poor public transport links, while expensive dietary changes and the cost of medication inhibited sustained behaviour change.…”

Section: Deprived Communitiesmentioning

confidence: 97%

“…Five papers reporting three studies focused on T1DM, [251][252][253][254][255] eight focused on T2DM, [246][247][248][249][250]260,261,264 the remaining 15 included mixed populations. [237][238][239][240][241][242][243][244][245][256][257][258][259]262,263 Thirteen of the studies were conducted in the USA, [237][238][239][244][245][246][247][248][256][257][258][259]262 one in the UK, 240 three from Germany (in five papers), 251,[253][254][255]260 three from Austria, 250,…”

Section: Description Of the Studiesmentioning

confidence: 99%

“…[237][238][239][240][241][242][243][244][245][256][257][258][259]262,263 Thirteen of the studies were conducted in the USA, [237][238][239][244][245][246][247][248][256][257][258][259]262 one in the UK, 240 three from Germany (in five papers), 251,[253][254][255]260 three from Austria, 250,252,261 four from Australia, [241][242][243]249 and one each from Canada 263 and Italy. 264 About half (n = 12) were conducted in primary care or community settings, [239][240][241]246,247,…”

Section: Description Of the Studiesmentioning

confidence: 99%

“…[238][239][240][241][242][243][244][245][246][247][248][249][250][251][252][253][254][255] Education programmes encompassed interventions delivered by MCOs, 238,240,244,245 in primary 241 …”

Section: Primarily Professional Training With or Without Organisationmentioning

confidence: 99%

“…Four before-and-after studies observed the impact of complex interventions in deprived ethnic minority communities in US cities, 239,[246][247][248] and one in a Chinese community in Australia. 241 Community-based teaching sessions led by volunteer educators provided diabetes group education on lifestyle behaviours, diabetes complications and medication, and individual sessions addressed blood glucose monitoring and insulin administration.…”

Section: Deprived Communitiesmentioning

confidence: 99%

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A rapid synthesis of the evidence on interventions supporting self-management for people with long-term conditions: PRISMS – Practical systematic RevIew of Self-Management Support for long-term conditions

Taylor

Pinnock

Epiphaniou

et al. 2014

Health Services and Delivery Research

337

451

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BackgroundDespite robust evidence concerning self-management for some long-term conditions (LTCs), others lack research explicitly on self-management and, consequently, some patient groups may be overlooked.AimTo undertake a rapid, systematic overview of the evidence on self-management support for LTCs to inform health-care commissioners and providers about what works, for whom, and in what contexts.MethodsSelf-management is ‘the tasks . . . individuals must undertake to live with one or more chronic conditions . . . [including] . . . having the confidence to deal with medical management, role management and emotional management of their conditions’. We convened an expert workshop and identified characteristics of LTCs potentially of relevance to self-management and 14 diverse exemplar LTCs (stroke, asthma, type 2 diabetes mellitus, depression, chronic obstructive pulmonary disease, chronic kidney disease, dementia, epilepsy, hypertension, inflammatory arthropathies, irritable bowel syndrome, low back pain, progressive neurological disorders and type 1 diabetes mellitus). For each LTC we conducted systematic overviews of systematic reviews of randomised controlled trials (RCTs) of self-management support interventions (‘quantitative meta-reviews’); and systematic overviews of systematic reviews of qualitative studies of patients’ experiences relating to self-management (‘qualitative meta-reviews’). We also conducted an original systematic review of implementation studies of self-management support in the LTCs. We synthesised all our data considering the different characteristics of LTCs. In parallel, we developed a taxonomy of the potential components of self-management support.ResultsWe included 30 qualitative systematic reviews (including 515 unique studies), 102 quantitative systematic reviews (including 969 RCTs), and 61 studies in the implementation systematic review. Effective self-management support interventions are multifaceted, should be tailored to the individual, their culture and beliefs, a specific LTC and position on the disease trajectory, and underpinned by a collaborative/communicative relationship between the patient and health-care professional (HCP) within the context of a health-care organisation that actively promotes self-management. Self-management support is a complex intervention and although many components were described and trialled in the studies no single component stood out as more important than any other. Core components include (1) provision of education about the LTC, recognising the importance of understanding patients’ pre-existing knowledge and beliefs about their LTC; (2) psychological strategies to support adjustment to life with a LTC; (3) strategies specifically to support adherence to treatments; (4) practical support tailored to the specific LTC, including support around activities of daily living for disabling conditions, action plans in conditions subject to marked exacerbations, intensive disease-specific training to enable self-management of specific clinical tasks; and (5) social support as appropriate. Implementation requires a whole-systems approach which intervenes at the level of the patient, the HCP and the organisation. The health-care organisation is responsible for providing the means (both training and time/material resources) to enable HCPs to implement, and patients to benefit from, self-management support, regularly evaluating self-management processes and clinical outcomes. More widely there is a societal need to address public understanding of LTCs. The lack of public story for many conditions impacted on patient help-seeking behaviour and public perceptions of need.ConclusionsSupporting self-management is inseparable from the high-quality care for LTCs. Commissioners and health-care providers should promote a culture of actively supporting self-management as a normal, expected, monitored and rewarded aspect of care. Further research is needed to understand how health service managers and staff can achieve this culture change in their health-care organisations.Study registrationThis study is registered as PROSPERO CRD42012002898.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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Section: Deprived Communitiesmentioning

confidence: 97%

Section: Description Of the Studiesmentioning

confidence: 99%

Section: Description Of the Studiesmentioning

confidence: 99%

Section: Primarily Professional Training With or Without Organisationmentioning

confidence: 99%

Section: Deprived Communitiesmentioning

confidence: 99%

See 3 more Smart Citations

A rapid synthesis of the evidence on interventions supporting self-management for people with long-term conditions: PRISMS – Practical systematic RevIew of Self-Management Support for long-term conditions

Taylor

Pinnock

Epiphaniou

et al. 2014

Health Services and Delivery Research

337

451

View full text Add to dashboard Cite

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Current Awareness

2001

Diabetes Metab. Res. Rev.

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of diabetes/metabolism. Each bibliography is divided into 17 sections: 1 Books, Reviews & Symposia; 2 General; 3 Genetics; 4 Epidemiology; 5 Immunology; 6 Prediction; 7 Prevention; 8 Intervention: a) General; b) Pharmacology; 9 Pathology: a) General; b) Cardiovascular; c) Neurological; d) Renal; 10 Endocrinology & Metabolism; 11 Nutrition; 12 Animal Studies; 13 Techniques. Within each section, articles are listed in alphabetical order with respect to author (11 Weeks journals ‐ Search completed at 15th Nov. 2000)

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Disseminating Health Information and Diabetes Care for Latinos Via Electronic Information Kiosks

Matthews

Darbisi

Sandmann

et al. 2008

J Immigrant Minority Health

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This study investigated the use of electronic, web-enabled touch-screen information kiosks as a tool to provide culturally and linguistically appropriate diabetes information to Latino audiences. Two kiosk models (high privacy sit-down, group enabled stand-up) in two locations (pharmacy, community center) in Northeast Georgia provided bilingual, read-aloud diabetes education and local resource information on health care. Data from public use and interviews with focus group participants showed that users found the kiosks and their functions helpful and usable, though usage was moderated by presence or absence of a peer health educator (promotora); participants also preferred the sit-down, multi-function kiosk model.

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Development and Initiation of a Diabetes Self-Management Program for an Underserved Population

Cited by 8 publications

References 2 publications

A rapid synthesis of the evidence on interventions supporting self-management for people with long-term conditions: PRISMS – Practical systematic RevIew of Self-Management Support for long-term conditions

A rapid synthesis of the evidence on interventions supporting self-management for people with long-term conditions: PRISMS – Practical systematic RevIew of Self-Management Support for long-term conditions

Current Awareness

Disseminating Health Information and Diabetes Care for Latinos Via Electronic Information Kiosks

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