Assessment of group-based diabetes education using the "continuing your journey with diabetes" conversation map in the veteran population.

Abstract

Both type 1 and type 2 diabetes have been recognized as serious health concerns. The majority of cases of type 2 diabetes are preventable, and, after diagnosis, various complications can be prevented by effective self-management. Although there are multiple pharmacological interventions for the treatment of diabetes, it is difficult to achieve target A1C levels with drug therapy alone. Most patients must also implement various lifestyle modifications such as following a healthy diet and getting adequate physical activity, both of which require willingness and motivation. Therefore, patient education is an important component of diabetes management. Each patient’s unique needs and barriers require an individualized strategy for diabetes management (1). Diabetes self-management education is listed as one of seven crucial elements in the Joint Commission standards of care addressing diabetes care (2). The National Standards for Diabetes Self-Management Education (3) states that group education can be effective and that programs using behavioral and psychosocial strategies result in improved outcomes. A 2009 Cochrane review (4) concluded that group-based training helped participants improve fasting blood glucose and A1C, decreasing the need for diabetes medications. Such programs may also help decrease blood pressure and body weight, although studies evaluating such outcomes are limited. The Conversation Map education tool was developed by Healthy Interactions to empower patients with diabetes and help them proactively manage their health. Reaney et al. (5) recently reviewed this tool in more detail. The Conversation Map promotes effective communication among patients with type 2 diabetes, their health care providers, and their support network. This learner-centered approach is intended to improve health literacy, a significant predictor of health status. A conversation with other patients, led by a facilitator using a Socratic approach, is meant to encourage participants to share personal knowledge and experiences, ultimately engaging and motivating patients to take control of …