Diabetes Self-Management Interventions for Adults with Type 2 Diabetes Living in Rural Areas: A Systematic Literature Review

Lepard, Morgan Griesemer; Joseph, Alessandra L.; Agne, April A.; Cherrington, Andrea

doi:10.1007/s11892-015-0608-3

Cited by 54 publications

(61 citation statements)

References 32 publications

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“…For example, they must include tasks around medical or diet adherence (medical self-management), tasks in changing or maintaining new behavioral/life roles within social relationships (role management), or tasks in coping with the emotional burden of living with a long-term condition (emotional management) [42]. To our knowledge, existing reviews mostly focus on medical management [43]. For instance, a recent review that explored online self-management interventions around lifestyle modification examined outcomes that were behavioral (role) and physiological (medical), excluding psychological and emotional management [44].…”

Section: Introductionmentioning

confidence: 99%

Do Web-Based Interventions Improve Well-Being in Type 2 Diabetes? A Systematic Review and Meta-Analysis

Hadjiconstantinou¹,

Byrne²,

Bodicoat³

et al. 2016

J Med Internet Res

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BackgroundPoor diabetes self-care can have a negative impact on psychological well-being and quality of life. Given the scarcity of traditional psychological support and the barriers to uptake of and attendance at face-to-face education programs, Web-based interventions are becoming a popular approach to provide an additional platform for psychological support in long-term conditions. However, there is limited evidence to assess the effect of Web-based psychological support in people with type 2 diabetes.ObjectiveThis systematic review is the first review to critically appraise and quantify the evidence on the effect of Web-based interventions that aim to improve well-being in people with type 2 diabetes.MethodsSearches were carried out in the following electronic databases: MEDLINE, EMBASE, CINAHL, PsycINFO, and Cochrane Library. Reference lists were hand-searched. A meta-analysis was conducted for depression and distress outcomes.ResultsA total of 16 randomized controlled studies met the inclusion criteria for the systematic review and 9 were included in the meta-analyses. Theories were applied to the majority of the interventions. The most common behavior change techniques were “General information” and “Tracking/monitoring.” Interventions with a duration of 2-6 months providing professional-led support with asynchronous and synchronous communication appeared to be associated with significant well-being outcomes. The pooled mean (95% confidence interval) difference between the intervention and control arms at follow-up on depression score was -0.31 (-0.73 to 0.11). The pooled mean difference on distress scores at follow-up was -0.11 (-0.38 to 0.16). No significant improvements in depression (P=.15) or distress (P=.43) were found following meta-analyses.ConclusionsWhile the meta-analyses demonstrated nonsignificant results for depression and distress scores, this review has shown that there is a potential for Web-based interventions to improve well-being outcomes in type 2 diabetes. Further research is required to confirm the findings of this review.

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Section: Introductionmentioning

confidence: 99%

Do Web-Based Interventions Improve Well-Being in Type 2 Diabetes? A Systematic Review and Meta-Analysis

Hadjiconstantinou¹,

Byrne²,

Bodicoat³

et al. 2016

J Med Internet Res

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“…Some studies using CHWs and peer coaches to deliver DSME interventions have found improvements in patient activation levels but did not identify clinically significant improvements in HgA1C levels (Lawson et al, 2013;Lorig, Ritter, Villa, & Armas, 2009;Safford et al, 2015). Although DSME can promote positive health outcomes, education alone may not be sufficient for sustained behavior change (Lepard et al, 2015;Norris, Lau, Smith, Schmid, & Engelgau, 2002).…”

Section: Discussionmentioning

confidence: 99%

“…Community-based interventions have been known to improve diabetes outcomes, with most evidence for minority, underresourced, and urban populations; however, increasing evidence is available regarding rural communities (Lepard, Joseph, Agne, & Cherrington, 2015;Palmas et al, 2015). A recent study of rural-dwelling, African-American women found no significant improvements in glycemic control or blood pressure in the community health worker (CHW) intervention group compared to the control group, but significant weight loss (−1.35 ± 6.22 kg) was reported (Lutes, Cummings, Littlewood, Dinatale, & Hambridge, 2017).…”

Section: Backg Rou N Dmentioning

confidence: 99%

“…A recent study of rural-dwelling, African-American women found no significant improvements in glycemic control or blood pressure in the community health worker (CHW) intervention group compared to the control group, but significant weight loss (−1.35 ± 6.22 kg) was reported (Lutes, Cummings, Littlewood, Dinatale, & Hambridge, 2017). Greater reductions in HgA1C have resulted from exposure to more contact hours from CHW's or peer advisors, otherwise known as the "dosage effect" (Lepard et al, 2015;Palmas et al, 2014;Samuel-Hodge et al, 2009;Tang et al, 2014).…”

Section: Backg Rou N Dmentioning

confidence: 99%

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Impact of a community‐based approach to patient engagement in rural, low‐income adults with type 2 diabetes

Glenn

Nichols

Enriquez

et al. 2019

Public Health Nursing

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Objective This secondary analysis examined the relationships between Patient Activation Measure (PAM) scores, use of health services, and HgA1C. Design A feasibility study was conducted for a community‐based intervention for high‐risk adults with uncontrolled diabetes. Data were collected at baseline and monthly, including PAM and modified Diabetes Self‐Management Assessment Report Tool. Intervention Participants (n = 58) were randomized to a 3‐month nurse (RN) telephone management or community health worker (CHW) in‐home intervention, focusing on medication adherence, timely follow‐up, diabetes self‐management coaching, and linkage to resources. Results Sample was mostly female (73%), African‐American (90%), low income (75%), high school education or less (80%), and mean age of 59 years. A positive association between PAM score and self‐reported diabetes care recommendations was found (r = .356, p = .014) and significant correlation between baseline PAM score and HgA1C levels (r = −.306, p = .029). A paired samples t test showed statistically significant increases in PAM scores in the CHW intervention group (mean increase +8.5, CI [+2.49 to +14.65]); baseline (M = 60.31, SD = 13.3) to end of study ([M = 68.89, SD = 16.39], t(22) = 2.924, p = .008 [two‐tailed]). Conclusion A community‐based approach to diabetes management demonstrated a positive effect on patient activation. Although disparities in health care access among rural, low‐income populations exist, community‐based interventions show potential for improving patient engagement in diabetes management and recommended health services.

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“…Among the barriers, the challenges are in adherence to healthy eating, in the practice of physical activity, in glucose monitoring, and in drug therapy (17) . Therefore, this aspect allows for strengthening the participation of health professionals in the development of educational programs, which is an important factor, because studies point to the existence of a direct influence of the total contact time between the user and the educator in terms of optimal program results (4,16,18) . In addition, studies have pointed out, among their key findings, the benefits obtained by educational interventions in the treatment and control of diabetes mellitus.…”

Section: Discussionmentioning

confidence: 99%

Relationship between the users' contact time in educational programs on diabetes mellitus and self-care skills and knowledge

Maia

Reis

Torres

2016

Rev. esc. enferm. USP

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Objective: Check the relationship between the users' contact time in educational programs and self-care and knowledge variables in diabetes mellitus. Method: A longitudinal study with a quantitative approach with the participation, in the initial phase, of 263 users linked to Basic Health Units in Belo Horizonte, Brazil during the years 2012 and 2013. The data were collected with respect to the total contact time of the users' participation in the educational program as regards knowledge and self-care in acquired diabetes mellitus. The data were analyzed using the Student t-test for comparison of means, considering a 0.05 significance level. Results: The final sample included 151 users. The analysis showed that the improvement in self-care scores was statistically higher during an educational intervention of eight hours or more (p-value <0.05). In relation to the scores for knowledge, there was a statistically significant improvement at the end of the educational program. It was not possible to identify a value for the contact time from which there was an increase in mean scores for the ability of knowledge. Conclusion: To improve the effectiveness of the promotion of skills related to knowledge and self-care in diabetes mellitus, it is necessary to consider the contact time as a relevant factor of the educational program.

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Diabetes Self-Management Interventions for Adults with Type 2 Diabetes Living in Rural Areas: A Systematic Literature Review

Cited by 54 publications

References 32 publications

Do Web-Based Interventions Improve Well-Being in Type 2 Diabetes? A Systematic Review and Meta-Analysis

Do Web-Based Interventions Improve Well-Being in Type 2 Diabetes? A Systematic Review and Meta-Analysis

Impact of a community‐based approach to patient engagement in rural, low‐income adults with type 2 diabetes

Relationship between the users' contact time in educational programs on diabetes mellitus and self-care skills and knowledge

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