Effects of a family diabetes self-management education intervention on the patients’ supporters.

Abstract

Introduction: Diabetes self-management education (DSME) programs that engage the families of patients with diabetes have shown to be effective in improving diabetesrelated outcomes of the patients. The health effects of these "family models" of DSME on participating family members are rarely studied. Opportunity exists for the participating family members to benefit from the healthy lifestyle recommendations offered through such programs. Method: Using data from a randomized controlled trial to assess the effect of family DSME compared to standard DSME among Marshallese adults with Type 2 diabetes, this study examined baseline to 12-month changes in A1c, body mass index (BMI), food consumption, and physical activity among participating family members, comparing outcomes of family members based on attended at least 1 (n ϭ 98) versus attended no (n ϭ 44) DSME sessions. Results: Overall, family member attendance was low. There were no differences in the level of change from baseline to 12 months for A1c, BMI, food consumption, and physical activity between groups. After controlling for attendance and sociodemographic measures, lowering of BMI was the only significant predictor of not having an A1c level indicative of diabetes at 12 months. Discussion: Future research on family DSME should consider ways to improve family member attendance; have them set their own health improvement goals; and integrate healthy lifestyle education, such as healthy eating and being physically active, along with the DSME core content to create an added benefit of diabetes prevention for participating family members. The limitations of this study and recommendations for future research are provided.

Delivering the Same Intervention to Hispanic/Latinos With Pre-diabetes and Diabetes. Early Evidence of Success in a Longitudinal Mixed Method Study

“…In addition to their hesitation to seek medical care, H/L have the highest uninsured rates (32%), 62 making early diagnosis of asymptomatic conditions such as pre-diabetes a challenge. Moreover, despite recent interest in Family DSMES programs, 35 these interventions target individuals with diabetes, and requirements are more stringent than those in our study. Allowing for a mixed program approach would facilitate the process of addressing the needs of two important and potentially costly groups.…”

“…The concept of a “joint” program has been suggested and considered in the past, but concerns have been raised: fear of barriers between physicians and family members of patients with diabetes, the cost of involving family members in programs, and the challenge of keeping participants with pre-diabetes engaged. 35 - 37 However, in view of recent healthcare system trends, there is reason to believe that these obstacles may be surmountable, if still present.…”

Pilot Implementation of Adapted-Family Diabetes Self-Management Education Into a Clinical Setting

“…This is in contrast to the RCT that did not show family member improvements with regard to clinical indicators. 25 This finding demonstrates that clinical implementation has the potential to improve family member outcomes, as well as engagement in the intervention.…”

Correlates of diet-related spousal involvement among both members of couples managing diabetes.

“…There is evidence that spouses of chronically ill patients, particularly those with diabetes, experience distress (e.g., Franks et al, 2010), but not necessarily more than patients. As spouses are less likely than patients to have completed diabetes education (Felix et al, 2020), perhaps spouses may be unfamiliar with the realistic risks associated with diabetes and therefore may be more concerned and worried than patients themselves. Future efforts to include spouses in diabetes education thus may be beneficial in reducing spouses' levels of distress.…”