Diabetes Mellitus, Type 2 Clinical Trial
Official title:
English Diabetes Self-Management Program
We propose a diabetes self-management program evaluation and dissemination project with
three components.
1. A six-month randomized trial to evaluate the effect of a community-based small group
Diabetes Self Management Program (DSMP) on the health related quality of life,
metabolic control and health care utilization of people with type 2 diabetes.
2. A long-term (12 month) longitudinal evaluation of the same program.
3. Two 5 day workshops to train others in California in how to lead and administer the
program.
1. Implement and evaluate in a 6-month randomized controlled evaluation an experimental
self-management program for patients with type 2 diabetes. Outcomes for evaluating the
intervention's impact include health status (health-related quality-of-life and
metabolic control) and health care utilization. Mediating outcomes are health behaviors
and self-efficacy.
2. Evaluate the same program in a one year longitudinal study using the same outcomes.
3. Disseminate the program to others in California by holding two five day workshops
during which we will prepare the participants to both offer the program and to train
others in their organization to offer the program.
This proposed evaluation will examine the following questions:
Hypothesis 1. People participating in the Diabetes Self-Management Program (SDSMP), when
compared six months after baseline to randomized wait-list controls receiving usual care,
will demonstrate:
1. Improvements in health-related quality of life (fatigue, physical discomfort, the
symptoms of hypoglycemia and hyperglycemia, activity limitations, health distress, and
self-rated health).
Improvements in metabolic measures of health status (body mass index, hemoglobin A1c,
total cholesterol/HDL ratio and blood pressure).
2. Changes in utilization of health services, specifically, increases in outpatient visits
to physicians and nurses, increases in the percentage of subjects having received an
eye examination in the past year, increases in the number of times a health
professional has examined subject's feet, and decreases in emergency room visits,
hospitalizations, and hospital days.
3. Improvements in beneficial self-management behaviors (aerobic exercise, communication
with physicians, diet, self-monitoring of blood glucose and self-examination of the
feet).
4. Increases in perceived self-efficacy to manage diabetes.
Hypothesis 2. The changes in health related quality of life, metabolic status, health
behaviors and health care utilization will be maintained for one year.
Hypothesis 3. Twelve to fifteen health care organizations in California will be interested
in disseminating the program. This will be demonstrated by their willingness to send 2-3
persons each to a 5 day training which will allow their organization to replicate and
perpetuate the program.
Hypothesis 4. 8-10 health care organizations in California will have offered at least two
Diabetes Self-Management Programs to people with Type 2 diabetes one year following the
above dissemination training. (It should be noted that this hypothesis can not be tested
during the funded portion of the program. However, it our intent to contact all
organizations participating in dissemination training one year following the training to
determine what they have done with the program). The results of this follow-up will be
reported to The Foundation.)
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label
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