Patient Engagement in Type 2 Diabetes: A Collaborative Community Health Initiative

Abstract

Purpose The purpose of this study was to describe the effects of an innovative rural community-based, diabetes self-management education and support (DSMES) program on patient behaviors and outcomes. Methods A 12-month pre-post study design with physiological data collection at program initiation, 16 weeks, and 6 and 12 months postenrollment was used for program assessment. The program consisted of an American Diabetes Association-accredited curriculum provided by the hospital and interfaced with a YMCA curriculum promoting lifestyle change. The 28-session program was delivered over a 1-year period. Results The sample size was 115. Participants were primarily white and female, with a mean age of 57 years. Mean body mass index (BMI) at program initiation was 37; mean A1C was 8.5 (69.4 mmol/mol). Significant reductions were obtained in weight, BMI (at 16 weeks), and A1C (at 6 months); these reductions were sustained at 12 months. Medication intake was significantly reduced, and diabetes-related emergency department visits were below national averages. Conclusions Results support the positive impact of a year-long, community-based, healthy behavior, DSMES program on health outcomes and overall costs of care delivery in the rural setting.

Behavioral health conditions and potentially preventable diabetes-related hospitalizations in the United States: Findings from a national sample of commercial claims data

“…Furthermore, community-based diabetes self-management programs have shown promise in improving diabetes-related knowledge and health outcomes [45, 46]. For example, in a pilot test and subsequent randomized control trial of a community-based program delivered by a team of nurses and peer educators, researchers observed significant improvement in diabetes knowledge among people with diabetes and mental health disorders after 60 weeks [47, 48].…”

Community-Based Participatory Research Interventions to Improve Diabetes Outcomes: A Systematic Review

“…28,30,33 Of the 14 studies measuring A1C, 9 demonstrated statistically significant reduction in A1C. 29,31,33,[37][38][39][40][41][42] Of the 9 studies measuring BP, 3 demonstrated statistically significant improvements in BP. 27,38,41 Three of the 6 studies measuring lipids demonstrated statistically significant improvements in lipids, 30,40,42 and 4 of the 5 studies measuring fasting glucose demonstrated statistically significant improvements in fasting glucose.…”

“…[28][29][30][31][32][33][34][35][36][38][39][40] Four studies were conducted outside the US in the following countries: Belgium, 37 Dominican Republic, 41 India, 27 and Iran. 42 When looking at each study by community setting, 11 studies were conducted in a local community site, 28,30,31,[33][34][35]38,[40][41][42] 1 study was conducted in a community pharmacy, 37 2 studies were conducted at a community clinic, 29,32 and 2 studies were conducted in the home or a community site based on participant availability. 36,39 Additionally, Table 1 summarizes the type of intervention that was conducted as well as the impact on outcomes.…”

“…Fourteen of the 16 studies measured A1C as a primary outcome. 28,29,[31][32][33][34][35][36][37][38][39][40][41]42 Nine studies measured blood pressure (BP) as an outcome. [33][34][35][38][39][40][41][42] Six studies measured lipids as an outcome.…”

Effects of a Family-Based Diabetes Intervention on Family Social Capital Outcomes for Mexican American Adults

“…13 Positive effects of family social capital for persons with T2DM include improved self-management capabilities and glycemic control, reduced weight and A1C, fewer medications, and fewer emergency department visits. 13,[25][26][27] Mechanisms that may mediate the relationship between family social capital and health include the influence of social networks, connections through social engagement, and emotional, instrumental, and informational support. 24,28 Understanding how to increase family social capital in T2DM selfmanagement may provide meaningful information to inform interventions for MA adults with T2DM.…”