The purpose of this study was to determine whether a telecommunications diabetes self-management (DSM) intervention would improve health-related outcomes among frontier participants with diabetes. A one-group pre-test/post-test quasi-experimental design with two groups of participants was used. Differences between pre and post-test periods on measures of physical and emotional health, knowledge of diabetes, and self-care behaviors were measured. Overall, participants did better along measures of blood pressure, HbA(1c), self-efficacy, knowledge of diabetes, understanding of DSM, monitoring behaviors, and reported less personal and social disruption from diabetes. Six-month follow-up results showed continued positive outcomes.

This study evaluated weight loss and cardiometabolic risk reduction achieved through an adapted Diabetes Prevention Program lifestyle intervention among adults at high risk for cardiovascular disease (CVD) and diabetes. A 16-session lifestyle intervention was delivered through a partnership between a diabetes self-management education (DSME) program and the Young Men's Christian Association (YMCA). Overweight adults with ≥ 1 additional risk factors for CVD or diabetes were enrolled (n = 265). Lifestyle coaches from the DSME program coordinated intervention delivery and taught the curriculum. YMCA staff delivered the physical activity component of the intervention. Two-hundred and nineteen participants (83%) completed the program. Seventy-five percent of participants achieved the physical activity goal (≥ 150 minutes/week), 34% achieved the 7% weight loss goal, and 60% achieved weight loss ≥ 5%. There were significant improvements in cardiometabolic risk factors among participants completing the intervention. Our findings suggest that an adapted lifestyle intervention can be successfully implemented through collaboration between a DSME program and a YMCA. Implementation of effective prevention programs in multiple settings throughout the United States will be needed to ensure that the large subpopulation of adults at high risk for CVD and diabetes have access to this prevention service.

Mentoring and technical support is an effective method to increase personnel skills for DSME and to increase access to quality education programs in rural areas.