An Evidence-Based Diabetes Self-Management Education and Support Program in Medically Underserved Adults
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Date
2019-05
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The Ohio State University
Abstract
Diabetes self-management is somewhat unique and challenging in the medically underserved
(MU) population who lack medical insurance and access to primary care services. The purpose of this project was to improve self-management in MU adults with T2DM by implementing an evidence-based diabetes self-management education and support program (DSMES) in a primary care free clinic. The objectives were to increase diabetes knowledge and adherence to self- management practices in MU patients with T2DM. This project was designed based on current clinical practice guidelines on DSMES incorporating two main strategies (1) weekly individualized face-to-face education and support sessions, and (2) weekly telephone calls for ongoing follow-up over an eight-week period. Eleven participants met the project inclusion criteria and completed the program. Knowledge of diabetes and adherence to self-management activities were evaluated by pre- and post- test measures using the diabetic knowledge questionnaire (DKQ) and the summary of diabetes self-care activities (SDSCA) tool. Using the Wilcoxon Signed-Rank test, findings demonstrated statistically significant improvements in knowledge (p = 0.0100), adherence to healthy eating (including general diet and specific diet choices) (p = 0.0100) and taking medications (p = 0.002). Additional improvements in self- management behaviors including exercise, self-monitoring of blood glucose (SMBG), and foot care were demonstrated. Ongoing follow-up and support for MU patients are crucial to sustain changes in behaviors, improve clinical outcomes, and reduce risks for disease complications.
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Keywords
medically underserved, type 2 diabetes, knowledge, adherence, self-management behaviors