Effect of DECIDE (Decision-making Education for Choices In Diabetes Everyday) Program Delivery Modalities on Clinical and Behavioral Outcomes in Urban African Americans With Type 2 Diabetes: A Randomized Trial

Fitzpatrick, Stephanie L.; Golden, Sherita Hill; Stewart, Kerry J.; Sutherland, June; DeGross, Sharie; Brown, Tina; Wang, Nae Yuh; Allen, Jerilyn K.; Cooper, Lisa A.; Hill-Briggs, Felicia

doi:10.2337/dc16-0941

Cited by 40 publications

(45 citation statements)

References 30 publications

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“… 50 There is also initial evidence that patient diabetes self-management programmes focused on barriers to care and social determinants can improve diabetes self-management skills, health behaviours and HbA1c in low-income patients and communities. 51 52 For reference, our results regarding the 2-year incidence of diabetes in high socioeconomic status as compared with low socioeconomic status areas (HR=0.80 and 0.69 in men and women, respectively) have an association with reduced diabetes incidence similar to a 1.2 kg and 2.1 kg reduction in body weight in the DPP trial. 53 Focusing diabetes prevention efforts in lower NSES areas may help in ameliorating health inequalities.…”

Section: Discussionmentioning

confidence: 63%

Association of neighbourhood socioeconomic status and diabetes burden using electronic health records in Madrid (Spain): the HeartHealthyHoods study

et al. 2018

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ObjectiveTo study the association between neighbourhood socioeconomic status and diabetes prevalence, incidence, and control in the entire population of northeastern Madrid, Spain.SettingElectronic health records of the primary-care system in four districts of Madrid (Spain).Participants269 942 people aged 40 or older, followed from 2013 to 2014.ExposureNeighbourhoodsocioeconomic status (NSES), measured using a composite index of seven indicators from four domains of education, wealth, occupation and living conditions.Primary outcome measuresDiagnosis of diabetes based on ICPC-2 codes and glycated haemoglobin (HbA1c %).ResultsIn regression analyses adjusted by age and sex and compared with individuals living in low NSES neighbourhoods, men living in medium and high NSES neighbourhoods had 10% (95% CI: 6% to 15%) and 29% (95% CI: 25% to 32%) lower prevalence of diabetes, while women had 27% (95% CI: 23% to 30%) and 50% (95% CI: 47% to 52%) lower prevalence of diabetes. Moreover, the hazard of diabetes in men living in medium and high NSES neighbourhoods was 13% (95% CI: 1% to 23%) and 20% (95% CI: 9% to 29%) lower, while the hazard of diabetes in women living in medium and high NSES neighbourhoods was 17% (95% CI: 3% to 29%) and 31% (95% CI: 20% to 41%) lower. Individuals living in medium and high SES neighbourhoods had 8% (95% CI: 2% to 15%) and 15% (95% CI: 9% to 21%) lower prevalence of lack of diabetes control, and a decrease in average HbA1c % of 0.05 (95% CI: 0.01 to 0.10) and 0.11 (95% CI: 0.06 to 0.15).ConclusionsDiabetes prevalence, incidence and lack of control increased with decreasing NSES in a southern European city. Future studies should provide mechanistic insights and targets for intervention to address this health inequity.

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Section: Discussionmentioning

confidence: 63%

Association of neighbourhood socioeconomic status and diabetes burden using electronic health records in Madrid (Spain): the HeartHealthyHoods study

et al. 2018

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“…Patient performance of self-management behaviors, including its effect on clinical outcomes, health status, and quality of life, as well as the psychosocial factors impacting the person's ability to self-manage should be monitored as part of routine clinical care. A randomized controlled trial testing a decision-making education and skill-building program (8) showed that addressing these targets improved health outcomes in a population in need of health care resources. Furthermore, following a DSMES curriculum improves quality of care (9).…”

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confidence: 99%

5. Facilitating Behavior Change and Well-being to Improve Health Outcomes:Standards of Medical Care in Diabetes—2020

2019

Diabetes Care

284

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The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee (https://doi.org/10 .2337/dc20-SPPC), are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction (https://doi.org/10.2337/dc20-SINT). Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes .org/SOC. Effective behavior management and psychological well-being are foundational to achieving treatment goals for people with diabetes (1,2). Essential to achieving these goals are diabetes self-management education and support (DSMES), medical nutrition therapy (MNT), routine physical activity, smoking cessation counseling when needed, and psychosocial care. Following an initial comprehensive medical evaluation (see Section 4, "Comprehensive Medical Evaluation and Assessment of Comorbidities," https://doi.org/10.2337/dc20-S004), patients and providers are encouraged to engage in person-centered collaborative care (3-6), which is guided by shared decision-making in treatment regimen selection, facilitation of obtaining needed medical and psychosocial resources, and shared monitoring of agreed-upon regimen and lifestyle (7). Re-evaluation during routine care should include not only assessment of medical health but also behavioral and mental health outcomes, especially during times of deterioration in health and well-being. DIABETES SELF-MANAGEMENT EDUCATION AND SUPPORT Recommendations 5.1 In accordance with the national standards for diabetes self-management education and support, all people with diabetes should participate in diabetes self-management education and receive the support needed to facilitate the knowledge, decision-making, and skills mastery necessary for diabetes selfcare. A 5.2 There are four critical times to evaluate the need for diabetes selfmanagement education to promote skills acquisition in support of regimen Suggested citation: American Diabetes Association. 5. Facilitating behavior change and wellbeing to improve health outcomes:

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“…Having a concrete goal for self-management activities is more beneficial than general, non-specified plan. Not having any plans or not even having a will to make a plan could be an issue about not being prepared for change (Bratzke et al, 2015;Fitzpatrick et al, 2016;Hoffmann et al, 2014). Future plans relate to coping (Hajdarevic, Schmitt-Egenolf, Sundbom, Isaksson, & Hörnsten, 2013) as well as needs to integrate illness and self-management in life (Jutterström, 2013), for example, practical activities such as self-monitoring, taking medication, adjusting diet and exercise if needed.…”

Section: The Smasc Instrumentmentioning

confidence: 99%

The Self‐Management Assessment Scale: Development and psychometric testing of a screening instrument for person‐centred guidance and self‐management support

2018

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Aim To develop and psychometrically test the Self‐Management Assessment Scale (SMASc), a screening instrument for person‐centred guidance and self‐management support of persons with type 2 diabetes (T2D). Background T2D is a common and globally increasing chronic condition. Improved self‐management is a vital and integral component of diabetes care to prevent complications from poorly managed diabetes. For diabetes nurses to better understand persons with diabetes experienced challenges and needs regarding self‐management and further for persons with T2D to take an active role in managing their condition, an instrument measuring this is needed. Design Instrument development and psychometric testing of the content and construct validity, factor structure and reliability. Method The SMASc was psychometric tested on a sample of participants (September 2017–November 2017) with a confirmed diagnosis of T2D ( N = 104). Results Psychometric findings were satisfactory and supported the scale´s reliability. Cronbach's alpha, CVI and goodness‐of‐fit were acceptable. Conclusion Self‐Management Assessment Scale is a short validated screening instrument, which can indicate possible barriers for self‐management that ought to be approached during the conversation between the person with T2D and the primary healthcare nurses. Therefore, it is a promising instrument to be used to facilitate person‐centred guidance and to improve self‐management of people living with T2D.

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Effect of DECIDE (Decision-making Education for Choices In Diabetes Everyday) Program Delivery Modalities on Clinical and Behavioral Outcomes in Urban African Americans With Type 2 Diabetes: A Randomized Trial

Cited by 40 publications

References 30 publications

Association of neighbourhood socioeconomic status and diabetes burden using electronic health records in Madrid (Spain): the HeartHealthyHoods study

Association of neighbourhood socioeconomic status and diabetes burden using electronic health records in Madrid (Spain): the HeartHealthyHoods study

5. Facilitating Behavior Change and Well-being to Improve Health Outcomes:Standards of Medical Care in Diabetes—2020

The Self‐Management Assessment Scale: Development and psychometric testing of a screening instrument for person‐centred guidance and self‐management support

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