872-P: Impact of Psychosocial Factors and Nutrition Using a 12-Week Course on Diabetes Management for Veterans

Abstract

U.S veterans are at considerable risk for complications from diabetes. It affects nearly 25 percent of VA's population. Many veterans report suffering from psychosocial complications particularly lack of management success and symptoms of depression. The Diabetes Empowerment Group (DEG), a 12-week interdisciplinary group for diabetes management. Curriculum includes values assessment, goal setting, biofeedback, problem solving, mindful eating, and other management skills. A registered dietician provides nutritional education and coaching each session. Based on feedback, program changes are implemented to each new group cycle for quality improvement (QI) purposes. Methods: Hemoglobin A1c levels for veterans were measured via on-site laboratory services. They completed Diabetes Empowerment Scale - Short Form and Patient Health Questionnaires-9 at the beginning and end of their respective group session cycles. Scores were used to determine whether group content impacted veterans' HbA1c, depressive symptoms and empowerment in managing their diabetes. Paired sample t-tests were utilized to compare pre- and post-session cycle values. Fifty-nine veterans completed lab work and QI measures. Mean HbA1c levels (t(58) = 2.55, p<0.01) and depressive symptoms scores (t(54) = 3.11, p<0.001) decreased from the beginning (M = 8.11, SD = 3.60; M = 11.31, SD = 43.55) of the group to the end (M = 7.74, SD = 1.97; M = 9.22, SD = 38.77). Mean empowerment scores increased (t(55) = -3.08, p<0.001 from the beginning (M = 3.56, SD = 0.58) of the group to the end (M = 4.02, SD = 1.24). These findings demonstrate the efficacy of DEG in helping veterans manage diabetes. We expect successive improvements toward a more integrative, standardized curriculum will result in increased empowerment and reduced HbA1c levels and depressive symptomatology. Future directions for QI include increasing access to care by initiating access by starting a new cycle of DEG every six weeks. Disclosure N. Farrell: None.