Self-management Education Research Articles

People with type 2 diabetes experiences of using WhatsApp-based diabetes self-management education and support: The process evaluation.

Online Diabetes Self-Management Education and Support (DSMES) offers people with type 2 diabetes mellitus (T2DM) accessible and tailored education, utilising innovative and interactive tools such as social media to enhance engagement and outcomes. Despite the demonstrated effectiveness of social media-based DSMES in improving health outcomes, there remains a significant gap in qualitative insights regarding participants' experiences. This study aims to explore the experiences of people with T2DM who are using a newly developed WhatsApp-based DSMES. A qualitative descriptive approach was adopted. Data consisted of 23 semi-structured phone interviews with people with T2DM who had received the WhatsApp-based DSMES. Interviews were analysed using qualitative content analysis. The present study adheres to the COREQ guidelines. Four themes emerged from the data: (1) acceptability of the programme, (2) flexible accessibility of the programme, (3) promoting healthy lifestyle and (4) future preferences for the programme use. This study explored the experiences of people with T2DM participating in a 6-week WhatsApp-based DSMES. The findings indicated that the programme was acceptable, accessible, effectively revealing necessary self-management knowledge and skills, and provided essential support from professional and peer. The study also indicated that WhatsApp-based programmes could be feasibly implemented in various populations, healthcare settings and communities to support people with T2DM globally.

The effect of educational intervention based on the behavioral reasoning theory on self-management behaviors in type 2 diabetes patients: a randomized controlled trial

BackgroundDiabetes self-management education is necessary to improve patient outcomes and reduce diabetes-related complications. According to the theory of behavioral reasoning, the likelihood of performing a behavior is predicted by the link between beliefs, motivation, intention, and behavior. This study aimed to investigate the effect of an educational intervention based on the Behavioral Reasoning Theory (BRT) on self-management behaviors in patients with Type 2 Diabetes.MethodsA randomized controlled trial based on BRT was conducted on 113 patients with type 2 diabetes, with a control group and an intervention group followed for 3and 6 months. Data were collected using a researcher-made demographic questionnaire based on the constructs of BRT and behaviors related to self-management in patients with type 2 diabetes. In the intervention group were provided, 8 sessions of diabetes self-management education based on BRT. The control group only received the usual training of the center. Data was analyzed using SPSS26 software.ResultsAfter the educational interventions in the intervention group, there were statistically significant changes observed in the mean scores of all constructs, fasting blood sugar, and glycosylated hemoglobin. On the other hand, no statistically significant change was observed in the mean grades of the control group. All the observed changes were significant at the 0.05 level.ConclusionsThe results of this study were in favor of the effectiveness of an educational intervention that promotes diabetes self-management behaviors, using the principles of the behavioral reasoning theory. Which can be used in the design of health promotion programs for patients with diabetes.Trial registrationIranian Registry of Clinical Trials (IRCT), IRCT20131014015015N21.

Chronic breathlessness in fibrotic interstitial lung diseases-patient centered assessment and management in outpatient settings.

Chronic breathlessness (CB) or dyspnea is prevalent in fibrotic interstitial lung diseases (F-ILD). It is the main driver of a poor health-related quality of life (HRQOL). Timely and accurate assessment and management of CB are paramount in F-ILD care. This is reflected in latest American and European guidelines that recommend early integration of symptom-targeted therapies. Despite calls for improved CB care, evidence indicates that it remains under recognized and under treated. This narrative review focuses on the current evidence for CB assessment and management in F-ILD and proposes an algorithm for patient-centered management of CB in an outpatient setting. An overview of CB assessment tools is provided along with recommendations from guidelines and experts. The limited evidence base for CB interventions in ILD is reviewed; existing dyspnea guidelines recommend a hierarchical approach to therapies starting with the implementation of nonpharmacologic interventions (NPI). Pulmonary rehabilitation is the most common NPI in F-ILD, that improves function, dyspnea, and HRQOL. Oxygen can be prescribed to treat CB associated with exertional hypoxemia early in the course of F-ILD, with evidence suggesting short-term improvements in CB and HRQOL. For patients with severe, persistent CB despite optimization of NPI and oxygen, opioids can be prescribed, initially as short-acting, low-dose oral morphine with prophylactic doses for exertion and as needed for crises. Self-management education and written action plans may help improve patient confidence and control. Development of competency in symptom management and fostering a professional and institutional culture prioritizing CB will advance patient care and should be a priority for F-ILD patients.

Could Online Education Replace Face-to-Face Education in Diabetes? A Systematic Review.

Diabetes Self-Management Education and Support (DSMES) is a critical component of diabetes care. This study aims to examine the effect of online-based educational interventions on diabetes management compared to face-to-face interventions. A systematic review was conducted by searching three databases for studies in English or Spanish between December 2023 and March 2024. The inclusion criteria were studies that compared face-to-face DSMES with online interventions. The follow-up duration of the trials ranged from 1 to 12months. Multidisciplinary teams delivered online DSMES through various means, including Short Message Service (SMS), telephone calls, video calls, websites, and applications. Online DSMES was found to be comparable to face-to-face interventions in terms of glycated hemoglobin (HbA1c) levels in people with type 1 diabetes (T1D). In contrast, online interventions that focus on weight management in people with type 2 diabetes (T2D) have shown a significant reduction in HbA1c compared to face-to-face interventions. Online DSMES was found to be superior in terms of quality of life and cost-effectiveness in both T1D and T2D. None of the analyzed studies explored the differences between individual and group methodologies. The current evidence indicates that online DSMES services provide at least comparable biomedical benefits to face-to-face interventions, suggesting that online interventions could be incorporated into clinical practice as a complement or reinforcement. However, further research is needed to explore the potential benefits and effectiveness of online group sessions in DSMES.

Understanding the preferences of young adults with type 2 diabetes mellitus with regard to diabetes self-management education: a qualitative study

AimYoung-onset type 2 diabetes (YOD) is associated with poorer clinical outcomes. To support the development of more effective diabetes self-management education (DSME) programmes, this study aimed to understand the preferences...

The Effectiveness of Diabetic Self-Management Education (DSME) on Dietary Habit, Obesity, and Physical Activity Among Patients with DM Type II

Diabetes mellitus and metabolic disorders are the priority programs in Indonesia. There is one program to reduce the fatality impact of diabetes which is diabetic self-management education (DSME). This study aimed to examine the effectiveness of Diabetes Self-Management Education (DSME) on dietary habits, physical activity, and obesity. This study is a quasi-experimental approach with one group pre-test post-test design. The sample in this study was 75 people with DM type II. The intervention for all samples was done for 4 sessions. Each session lasted 60 to 120 minutes/day with a maximum of 10 patients. The findings revealed that dietary habits were good from 56.0% to 69.3%, physical activity was good from 54.7% to 76.0%, and obesity decreased from 69.3% to 57.35, respectively for pre and post-test. The paired t-test result revealed that DSME correlates with dietary habits, physical activity, and obesity (obesity, physical activity, and dietary habit with p-values 0.024; 0.007; and 0.02, respectively). In conclusion, DSME has significantly influenced dietary habits, physical activity, and obesity. Education is crucial in promoting physical activity among individuals with diabetes. By enhancing self-efficacy, providing education on self-care behaviors, and emphasizing the importance of regular physical activity, these programs contribute to improving metabolic control, quality of life, and overall health outcomes in diabetic patients.

THE EFFECT OF DIABETES SELF MANAGEMENT EDUCATION (DSME) ON SELF EFFICACY IN TYPE II DIABETES MELLITUS PATIENTS

Background: Diabetes mellitus (DM) is a health problem in the world. Currently, the number of DM cases globally has reached 537 million people, and Indonesia ranks fifth highest in the world. Low knowledge and dietary compliance are a problem that continues to contribute to new cases and relapses of old cases characterized by uncontrolled increases in blood sugar. This is caused by low self-efficacy which is characterized by feelings of hopelessness. Objectives: The aim of this research was to determine the effect of Diabetes Self-Management Education (DSME) on self-efficacy in type II Diabetes Mellitus patients. Methods: This study used a Quasy-experimental design, with a pretest posttest equivalent control group design, the sample size was 68 type II DM patients, consisting of 34 intervention groups and 34 control groups. Self-efficacy data was collected using the DMSES (Diabetes Management Self Efficacy Scale) questionnaire. Univariate analysis was used to describe the frequency distribution of respondents, mean, median and standard deviation. Next, bivariate analysis used the Wilcoxon test. Results: There was a significant difference in the difference in mean value self-efficacy between before and after intervention with p-value 0.000 < 0.05. Conclusion: Diabetes Management Self Efficacy Scale is effective increase self-efficacy. Thus, DSME can be an alternative intervention to overcome problems and prevent complications in DM patients.

Does Education Influence Self Care Management in Diabetes Mellitus Patients? : Systematic Review

Background: Diabetes mellitus is a major health problem in society. Indonesia ranks 7th out of 10 countries—metabolic disorders in the body cause diabetes. Several factors also influence the occurrence of diabetes mellitus, including genetic factors, age, and lifestyle (eating patterns and daily activities). This research aims to determine the effect of health education on self-care management in type 2 diabetes mellitus patients. Methods: The method used in this research is a systematic review with systematic reviews (PRISMA) using several journal databases from Google Scholar, Science Direct, and Pubmed. from 2020-2024 with the keywords " Diabetes mellitus, "" health education," or " self-care management." Articles that are ready to be reviewed are ten articles obtained using PRISMA. Results: The results of a systematic review study show that providing diabetes self-management education has an influence on self-care management in patients with type 2 diabetes mellitus. Conclusion: It is hoped that the presence of diabetes self-management education will increase knowledge and change the individual's mindset so that they can care. themselves and prevent complications and will improve their quality of life

Diabetes Telemedicine Mediterranean Diet (DiaTeleMed) Study: study protocol for a fully remote randomized clinical trial evaluating personalized dietary management in individuals with type 2 diabetes.

The Diabetes Telemedicine Mediterranean Diet (DiaTeleMed) Study is a fully remote randomized clinical trial evaluating personalized dietary management in individuals with type 2 diabetes (T2D). The study aims to test the efficacy of a personalized behavioral approach for dietary management of moderately-controlled T2D, versus a standardized behavioral intervention that uses one-size-fits-all dietary recommendations, versus a usual care control (UCC). The primary outcome will compare the impact of each intervention on the mean amplitude of glycemic excursions (MAGE). Eligible participants are between 21 to 80 years of age diagnosed with moderately-controlled T2D (HbA1c: 6.0-8.0%), and managed on lifestyle alone or lifestyle plus metformin. Participants must be willing and able to attend virtual counseling sessions and log meals into a dietary tracking smartphone application (DayTwo), and wear a continuous glucose monitor (CGM) for up to 12 days. Participants are randomized with equal allocation (n = 255, n = 85 per arm) to one of three arms: 1) Personalized, 2) Standardized, or 3) UCC. Measurements occur at 0 (baseline), 3, and 6 months. All participants receive isocaloric energy and macronutrients targets to meet Mediterranean diet guidelines plus 14 intervention contacts over 6 months (4 weekly then 10 biweekly) to cover diabetes self-management education. The first 4 UCC intervention contacts are delivered via synchronous videoconferences followed by educational video links. Participants in Standardized receive the same education content as UCC on the same schedule. However, all intervention contacts are conducted via synchronous videoconferences, paired with Social Cognitive Theory (SCT)-based behavioral counseling, plus dietary self-monitoring of planned meals using a mobile app that provides real-time feedback on calories and macronutrients. Participants in the Personalized arm receive all elements of the Standardized intervention, plus real-time feedback on predicted post-prandial glycemic response (PPGR) to meals and snacks logged into the mobile app. The DiaTeleMed study will address an important gap in the current landscape of precision nutrition by determining the contributions of behavioral counseling and personalized nutrition recommendations on glycemic control in individuals with T2D. The fully remote methodology of the study allows for scalability and innovative delivery of personalized dietary recommendations at a population level. The DiaTeleMed Study is registered with ClinicalTrials.gov (Identifier: NCT05046886).

Implementing PDSA Cycles to Expand Reach of Self-Management Education in the Post-COVID Era

ABSTRACT Background COVID-19 reduced participation in our region’s evidence-based chronic disease self-management program (SMP), despite having expanded offerings to include diverse delivery modes (e.g. virtual, mailed toolkit, phone-based group support). Purpose The purpose was to test various approaches of disseminating the mailed toolkit (an independent study version of the SMP) to expand reach of the program. Methods We ran three process improvement (PDSA) cycles. We used electronic health record data, a participant survey, and implementer feedback to guide our decision-making process throughout the iterations. Results Toolkits reached populations that had not previously been exposed to SMPs: individuals with type 2 diabetes who did not attend diabetes education in the past year; individuals being discharged from acute care with an admitting diagnosis related to a chronic disease; and individuals referred by their provider to the program. Discussion Toolkit utilization will remain low for those who are not ready to make a behavior change. Running PDSA cycles provided the necessary information for our team to make decisions about future dissemination of the mailed toolkits. Translation to Health Education Practice Engaging in PDSA cycles can be a helpful tool for health educators when considering how to expand reach or engage new populations of interest.

The feasibility of a social media-based foot self-management education and support program for adults with diabetes: A partially randomized preference trial

AimTo assess the feasibility of Diabetic Foot Care Group (DFCG), a social media-based self-management education and support intervention, for people with diabetes (PWD) empowerment in diabetes-related foot ulceration prevention. MethodsA partially randomized preference trial was conducted among 32 PWD. DFCG was implemented through Facebook. Participants in the intervention group joined the DFCG in addition to their usual care, while the control group received usual care. Data were collected online using questionnaires on participants' DFCG acceptance, engagement and preliminary efficacy on nine diabetes foot care-related outcomes at baseline, one, and three months post-intervention. ResultsThe participants' study intervention acceptability and engagement rates were 84.2% and 55.2%, respectively. DFCG efficacy rate compared to usual care was 88.9% to 22.2%. Three diabetes foot care-related outcomes increased significantly in the intervention group three-month post-intervention: foot self-care adherence (p = 0.001, ηp2 = 0.35), preventive foot self-care practice (p = 0.002, ηp2 = 0.33), and physical health status (p < 0.02, ηp2 = 0.23). ConclusionDFCG is feasible and could effectively improve diabetes foot care-related outcomes. InnovationSocial media is an innovative approach healthcare professionals could utilize to virtually support PWD in ongoing learning and engagement in optimal foot self-care activities. Trial registrationClinicalTrials.gov, Identifier: NCT04395521

Interventions that have potential to help older adults living with social frailty: a systematic scoping review

BackgroundThe impact of social frailty on older adults is profound including mortality risk, functional decline, falls, and disability. However, effective strategies that respond to the needs of socially frail older adults are lacking and few studies have unpacked how social determinants operate or how interventions can be adapted during periods requiring social distancing and isolation such as the COVID-19 pandemic. To address these gaps, we conducted a scoping review using JBI methodology to identify interventions that have the best potential to help socially frail older adults (age ≥65 years).MethodsWe searched MEDLINE, CINAHL (EPSCO), EMBASE and COVID-19 databases and the grey literature. Eligibility criteria were developed using the PICOS framework. Our results were summarized descriptively according to study, patient, intervention and outcome characteristics. Data synthesis involved charting and categorizing identified interventions using a social frailty framework. ResultsOf 263 included studies, we identified 495 interventions involving ~124,498 older adults who were mostly female. The largest proportion of older adults (40.5%) had a mean age range of 70-79 years. The 495 interventions were spread across four social frailty domains: social resource (40%), self-management (32%), social behavioural activity (28%), and general resource (0.4%). Of these, 189 interventions were effective for improving loneliness, social and health and wellbeing outcomes across psychological self-management, self-management education, leisure activity, physical activity, Information Communication Technology and socially assistive robot interventions. Sixty-three interventions were identified as feasible to be adapted during infectious disease outbreaks (e.g., COVID-19, flu) to help socially frail older adults.ConclusionsOur scoping review identified promising interventions with the best potential to help older adults living with social frailty.

1826-LB: Enhancing Diabetes Self-Management Education—Perspectives of Patients and Primary Care Providers on Influencing Factors of Binge Eating in Black Adults with Type 2 Diabetes

1826-LB: Enhancing Diabetes Self-Management Education—Perspectives of Patients and Primary Care Providers on Influencing Factors of Binge Eating in Black Adults with Type 2 Diabetes

21-OR: Use of Electronic Best Practice Advisories (BPA) to Increase Referral to Diabetes Self-Management Education and Support (DSMES) Services

21-OR: Use of Electronic Best Practice Advisories (BPA) to Increase Referral to Diabetes Self-Management Education and Support (DSMES) Services

541-P: Medicare’s Initial or Annual Wellness Visits and Participation of Diabetes Self-Management Education and Support among Medicare Beneficiaries with Type 2 Diabetes

541-P: Medicare’s Initial or Annual Wellness Visits and Participation of Diabetes Self-Management Education and Support among Medicare Beneficiaries with Type 2 Diabetes

A community health worker led diabetes self-management education program: Reducing patient and system burden

AimsConduct a secondary analysis of the TIME (Telehealth-supported, Integrated Community Health Workers (CHWs), Medication access, diabetes Education) made simple trial (SIMPLE) to evaluate healthcare utilization and explore variables that may have influenced HbA1c. MethodsParticipants (N = 134 [67/group]) were low-income, uninsured Hispanics with or at risk for type 2 diabetes mellitus. We included in-person and telehealth clinician visits, other visits, missed visits, orders placed, and guideline-adherence (e.g., vaccinations, quarterly HbA1c for uncontrolled diabetes). Using multivariable models, we explored for associations between HbA1c changes and these measures. ResultsThe control arm had higher missed visits rates (intervention: 45 %; control: 56 %; p = 0.007) and missed telehealth appointments (intervention: 10 %; control: 27.4 %; p = 0.04). The intervention group received more COVID vaccinations than the control (p = 0.005). Other health measures were non-significant between groups. Intervention individuals' HbA1c improved with more missed visits (−0.60 %; p < 0.01) and worsened with improved guideline-adherent HbA1c measurements (HbA1c: 1.2 %; p = 0.057). The control group had non-significant HbA1c associations. ConclusionsFindings suggest that the SIMPLE trial's improved HbA1c levels stemmed from a CHW-driven intervention and not additional healthcare contact. Exploratory outcomes resulted in seemingly counterintuitive HbA1c associations with missed visits and guideline-adherent measurements; these may suggest that an intervention that enhances communication provides support to reduce the amount of follow-up needed by participants without sacrificing clinical improvements.

Healthcare and health situation of adults with type 2 diabetes in Germany: The study GEDA 2021/2022-Diabetes.

The nationwide study German Health Update (GEDA) 2021/2022-Diabetes was conducted to assess the current healthcare and health situation of adults with diabetes in Germany. GEDA 2021/2022-Diabetes comprises a sample of adults with diagnosed diabetes from the general population. The analysis focuses on adults aged 45 years and over with type 2 diabetes (N = 1,448) and provides selected indicators on diabetes care as well as mental, social and general health. 87.5 % of participants aged 45 years and over with type 2 diabetes are treated with blood glucose-lowering medication. 36.5 % receive insulin alone or in combination with other antidiabetics; 0.7 % use an insulin pump. Almost 96 % had an HbA1c measurement in the last year and about two thirds each report annual foot and eye examinations, participation in a diabetes self-management education programme and self-monitoring of their feet and of blood glucose (12.0 % with continuous glucose monitoring). On average, the quality of diabetes care is perceived as moderate. 23.8 % rate their mental health as excellent/very good. More than a tenth each have anxiety or depressive symptoms and feelings of loneliness. Half rate their general health as very good/good. There is a potential for improvement in the quality of diabetes care and the mental and physical health of adults with type 2 diabetes.

Characteristics associated with perceived level of confidence managing diabetes among United States adults with diabetes: A retrospective cross-sectional study.

Identifying characteristics associated with patients' confidence managing diabetes may aid the primary care provider in offering diabetes self-management education and support to patients. This analysis assessed the relationship between demographic, health, economic, access to care, satisfaction with care, and healthcare utilization characteristics with patients' confidence managing diabetes. United States adults with diabetes in the 2020 Medical Expenditure Panel Survey were included in this retrospective cross-sectional analysis. Characteristics related statistically to patients' confidence managing diabetes in multivariable logistic regression analysis were reported. Among the 1,516 eligible individuals, 76.3% stated they were very confident/confident with their diabetes management. Adults who perceived their health positively (odds ratio 2.3, 95% confidence interval [CI] 1.3-3.9), completed ≥30 min moderate/vigorous exercise five times weekly (odds ratio 1.6, 95% CI 1.0-2.6), had at least one inpatient discharge in 2020 (odds ratio 3.5, 95% CI 1.5-8.1), said it was not difficult to telephone their usual provider (odds ratio 3.3, 95% CI 1.4-7.8), and had no emergency room visits in 2020 (odds ratio 2, 95% CI 1.1-3.3) had higher odds of stating they were very confident or confident with their diabetes management. The characteristics associated with being very confident/confident managing diabetes should be considered by primary healthcare physicians and other healthcare professionals when helping patients manage diabetes.

Self-Management of Type 2 Diabetes

Topic to be searched: Self-Management Education Program’s Impact on Glycaemic Control in type 2 diabetes mellitus Rationale for topic: According to the Royal College of Nursing(2022), more than 3.8 million individuals across the UK have been diagnosed with diabetes mellitus. Also, approximately one million of the population have the condition, but are not aware. Thus, I wanted to explore the impact of diabetes self-management education program in enhancing patient’s self-care behaviours like controlling glycaemic.

Informing Digital Programs for Lupus Self-Management Education: A Systematic Scoping Review.

We describe the characteristics, content, and effectiveness of digital self-management (SM) education programs for lupus and other chronic conditions to identify gaps and inform the improvement of future programs in lupus. Three bibliographic databases were searched for articles published between May 2012 and April 2022. The search was cast to capture the breadth of digital SM education programs in the following conditions: lupus, epilepsy, fibromyalgia, multiple sclerosis, sickle cell anemia, Sjögren syndrome, psoriatic arthritis, and rheumatoid arthritis. Title and abstract screening, as well as full-text review, was conducted by two independent reviewers. Data extraction was first completed by one author charting all studies and then, a second time, by four members of the research team charting collaboratively. Of the 1,969 articles identified through the search, 14 met inclusion criteria. Two additional articles were included following bibliography review. The 16 articles represented 12 unique digital SM education programs. Programs covered five conditions: epilepsy (n = 3), fibromyalgia (n = 2), multiple sclerosis (n = 4), lupus (n = 1), and rheumatoid arthritis (n = 2). Most programs were asynchronous and internet-based (n = 9) with a prescribed sequence of content (n = 8). Peer, technical, or specialist support was offered in seven programs. Most programs demonstrated statistically significant improvement of symptoms in the intervention group (n = 8). This scoping review summarizes the current landscape for digital SM education programs in lupus and similar conditions. In lupus, further investigation will fill in the gaps around digital SM education needs, user experience, and evaluation of outcomes.