Increasing Diabetes Self-Management Education in Community Settings. A Systematic Review

Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
American Journal of Preventive Medicine (Impact Factor: 4.53). 06/2002; 22(4 Suppl):39-66. DOI: 10.1016/S0749-3797(02)00424-5
Source: PubMed


This report presents the results of a systematic review of the effectiveness and economic efficiency of self-management education interventions for people with diabetes and forms the basis for recommendations by the Task Force on Community Preventive Services. Data on glycemic control provide sufficient evidence that self-management education is effective in community gathering places for adults with type 2 diabetes and in the home for adolescents with type 1 diabetes. Evidence is insufficient to assess the effectiveness of self-management education interventions at the worksite or in summer camps for either type 1 or type 2 diabetes or in the home for type 2 diabetes. Evidence is also insufficient to assess the effectiveness of educating coworkers and school personnel about diabetes.

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Available from: Susan R Snyder, Jul 18, 2014
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    • "Therapeutic education is considered the cornerstone of the treatment of diabetes because patients must have skills and knowledge which enable them to manage daily symptoms and limitations related to the disease. But according to Norris et al. (2002a), 50-80% of diabetic patients have tiny knowledge about their disease and few skills to put them into practice. This lack of knowledge results in a poor control of the disease, with very high HbA1c values. "
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    ABSTRACT: It is expected that people with diabetes, throughout their lives, integrate and initiate a range of behavioral, therapeutic or preventive actions, suggesting the confirmed risk of occurring a globalized noncompliance, deteriorating their quality of life and an exponential economic impact.
    Preview · Article · Jan 2015 · Procedia - Social and Behavioral Sciences
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    • "Family practice is an ideal setting for most chronic disease prevention and screening (CDPS) actions and there are several evidence-based tools and strategies available to improve CDPS, but they are inconsistently applied [3-17]. Examples include the use of electronic medical records (EMR), reminder systems [11], evidence-based guidelines and tools for CDPS actions, patient targeted interventions such as self-management tools [8-10,12,13], and practice-based quality improvement strategies such as practice facilitators [4,6,7,14-16,18]. "
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    ABSTRACT: Our randomized controlled trial (The BETTER Trial) found that training a clinician to become a Prevention Practitioner (PP) in family practices improved chronic disease prevention and screening (CDPS). PPs were trained on CDPS and provided prevention prescriptions tailored to participating patients. For this embedded qualitative study, we explored perceptions of this new role to understand the PP intervention. We used grounded theory methodology and purposefully sampled participants involved in any capacity with the BETTER Trial. Two physicians and one coordinator in each of two cities (Toronto, Ontario and Edmonton, Alberta) conducted eight individual semi-structured interviews and seven focus groups. We used an interview guide and documented research activities through an audit trail, journals, field notes and memos. We analyzed the data using the constant comparative method throughout open coding followed by theoretical coding. A framework and process involving external and internal practice facilitation using the new role of PP was thought to impact CDPS. The PP facilitated CDPS through on-going relationships with patients and practice team members. Key components included: 1) approaching CDPS in a comprehensive manner, 2) an individualized and personalized approach at multiple levels, 3) integrated continuity that included linking the patients and practices to CPDS resources, and 4) adaptability to different practices and settings. The BETTER framework and key components are described as impacting CDPS through a process that involved a new role, the PP. The introduction of a novel role of a clinician within the primary care practice with skills in CDPS could appropriately address gaps in prevention and screening.
    Full-text · Article · Apr 2014 · BMC Family Practice
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    • "Managing diabetes requires a concerted effort on the part of the patient. A wide body of evidence now demonstrates that knowledge alone is insufficient to promote behavior change.13,14 Management of a chronic condition, such as diabetes, requires engaging the individual to take an active role in self-care. "
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    ABSTRACT: Diabetes is a chronic, progressive disease that affects millions worldwide. The paradigm of diabetes management has shifted to focus on empowering the person with diabetes to manage the disease successfully and to improve their quality of life. Diabetes self-management education is a collaborative process through which people with diabetes gain the knowledge and skills needed to modify their behavior and to self-manage successfully the disease and its related conditions. Diabetes educators are health care professionals who apply in-depth knowledge and skills in the biological and social sciences, communication, counseling, and pedagogy to enable patients to manage daily and future challenges. Diabetes educators are integral in providing individualized education and promoting behavior change, using a framework of seven self-care behaviors known as the AADE7 Self-Care Behaviors™, developed by the American Association of Diabetes Educators. The iterative process of promoting behavior change includes assessment, goal setting, planning, implementation, evaluation, and documentation. Diabetes educators work as part of the patient's health care team to engage with the patient in informed, shared decision making. The increasing prevalence of diabetes and the growing focus on its prevention require strategies for providing people with knowledge, skills, and strategies they need and can use. The diabetes educator is the logical facilitator of change. Access to diabetes education is critically important; incorporating diabetes educators into more and varied practice settings will serve to improve clinical and quality of life outcomes for persons with diabetes.
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