Back
 Health  Vol.9 No.11 , October 2017
Preferences of Persons with Type 2 Diabetes for Diabetes Self-Management Education Interventions: An Exploration
Abstract: Objectives: Treatment preferences affect treatment engagement, adherence and outcomes. There is limited knowledge of patients’ preferences for Diabetes Self-Management Education (DSME). This study explored the preferences of Canadians with diabetes for components, mode and dose for implementing DSME interventions. Methods: A cross-sectional design was used. Adults with diabetes completed a questionnaire to assess participants’ preferences for components (i.e. content), mode (i.e. teaching strategies, delivering formats) and dose (i.e. number and length of sessions) of DSME. Descriptive statistics were used to analyze the data. Results: Participants (n = 100) were middle-aged men and women, who had diabetes for 6.1 years and previously received (95.0%) DSME. They indicated preference for DSME to include a combination of educational, behavioral and psychological components; to be delivered in individual, face-to-face sessions (4 sessions, 60 minutes each, given monthly) that allowed discussion with one diabetes educator to develop and carry out a care plan. Conclusions: Diabetes educators may consider eliciting patient’s preferences and tailoring DSME to fit patients’ preferences. Delivering interventions that are consistent with patients’ preferences increases their motivation to engage in intervention, satisfaction and adherence to treatment and achievement of desired outcomes.
Cite this paper: Fan, L. and Sidani, S. (2017) Preferences of Persons with Type 2 Diabetes for Diabetes Self-Management Education Interventions: An Exploration. Health, 9, 1567-1588. doi: 10.4236/health.2017.911115.
References

[1]   Canadian Diabetes Association. Canadian Diabetes Association (2013) Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Canadian Journal of Diabetes, 37, 1-3.

[2]   American Diabetes Association (2016) Standards of Medical Care in Diabetes 2016. Diabetes Care, 39, S1-S7.

[3]   Fan, L. and Sidani, S. (2009) Effectiveness of Diabetes Self-Management Education Intervention Elements: A Meta-Analysis. Canadian Journal of Diabetes, 33, 18-26.
https://doi.org/10.1016/S1499-2671(09)31005-9

[4]   Powers, M., Bardsley, J., Cypress, M., Duker, P., Funnell, M., Fischl, A.H., Maryniuk, M., Siminerio, L. and Vivian, E. (2015) Diabetes Self-Management Education and Support in Type 2 Diabetes: A Joint Position Statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics. Diabetes Care, 38, 1372-1382.
https://doi.org/10.2337/dc15-0730

[5]   Brunisholz, K.D., Briot, P., Hamilton, S., et al. (2014) Diabetes Self-Management Education Improves Quality of Care and Clinical Outcomes Determined by a Diabetes Bundle Measure. Journal of Multidisciplinary Healthcare, 7, 533-542.
https://doi.org/10.2147/JMDH.S69000

[6]   Weaver, R.G., Hemmelgarn, B.R., Rabi, D.M., et al. (2014) Association between Participation in a Brief Diabetes Education Programme and Glycaemic Control in Adults with Newly Diagnosed Diabetes. Diabetic Medicine, 31, 1610-1614.
https://doi.org/10.1111/dme.12513

[7]   Steinsbekk, A., Rygg, L.O., Lisulo, M., Rise, M.B. and Fretheim, A. (2012) Group Based Diabetes Self-Management Education Compared to Routine Treatment for People with Type 2 Diabetes Mellitus. A Systematic Review with Meta-Analysis. BMC Health Services Research, 12, 213.
https://doi.org/10.1186/1472-6963-12-213

[8]   Gucciardi, E., Demelo, M., Offenheim, A. and Stewart, D.E. (2008) Factors Contributing to Attrition Behavior in Diabetes Self-Management Programs: A Mixed Method Approach. BMC Health Services Research, 8, 33.
https://doi.org/10.1186/1472-6963-8-33

[9]   Gucciardi, E., Chan, V.W.S., Chuen, B.K., Fortugno, M., Horodezny, S. and Swartzack, S. (2012) Patient Factors and Perceived Barriers in Attending Diabetes Education Programs. Canadian Journal of Diabetes, 36, 214-217.
https://doi.org/10.1016/j.jcjd.2012.07.009

[10]   Sidani, S., Fox, M., Streiner, D.L., Miranda J., Fredericks, S. and Epstein, D. (2015) Examining the Influence of Treatment Preferences on Attrition, Adherence and Outcomes: A Protocol for a Two-Stage Partially Randomized Trial. BMC Nursing, 14, 1-8. https://doi.org/10.1186/s12912-015-0108-4

[11]   Sidani, S., Epstein, D.R., Bootzin, R.R., Moritz, P. and Miranda, J. (2009) Assessment of Preferences for Treatment: Validation of a Measure. Research in Nursing & Health, 32, 419-431.
https://doi.org/10.1002/nur.20329

[12]   Sidani, S., Epstein, D. and Miranda, J. (2006) Eliciting Patient Treatment Preferences: A Strategy to Integrate Evidence-Based and Patient-Centered Care. Worldviews on Evidence-Based Nursing, 3, 116-23.
https://doi.org/10.1111/j.1741-6787.2006.00060.x

[13]   Sidani, S., Miranda, J., Epstein, D. and Fox, M. (2009) Influence of Treatment Preferences on Validity: A Review. Canadian Journal of Nursing Research, 41, 52-67.

[14]   Gucciardi, E., DeMelo, M., Offenheim, A. and Stewart, D. (2008) Factors Contributing to Attrition Behavior in Diabetes Self-Management Programs: A Mixed Method Approach. BMC Health Services Research, 8, 1-11.
https://doi.org/10.1186/1472-6963-8-33

[15]   Whittemore, R. (2007) Culturally Competent Interventions for Hispanic Adults with Type 2 Diabetes: A Systematic Review. Journal of Transcultural Nursing, 18, 157-166.
https://doi.org/10.1177/1043659606298615

[16]   Houle, J., Villaggi, B., Beaulieu, M.D., Lespérance, F., Rondeau, G. and Lambert, J. (2013) Treatment Preferences in Patients with First Episode Depression. Journal of Affective Disorders, 147, 94-100.
https://doi.org/10.1016/j.jad.2012.10.016

[17]   Awad, M.A., Shapiro, S.H., Lund, J.P. and Feine, J.S. (2000) Determinants of Patients' Treatment Preferences in a Clinical Trial. Community Dentistry and Oral Epidemiologh, 28, 119-125.
https://doi.org/10.1034/j.1600-0528.2000.028002119.x

[18]   Dwight-Johnson, M., Sherbourne, C., Liao, D. and Wells, K. (2000) Treatment Preferences Among Depressed Primary Care Patients. Journal of General Internal Medicine, 15, 527-534.
https://doi.org/10.1046/j.1525-1497.2000.08035.x

[19]   Chou, C.P. and Bentler, P.M. (1995) Estimates and Tests in Structural Equation Modeling. In: Hoyle, R.H., Ed., Structural Equation Modeling: Issues and Application, SAGE Publications, Newbury, 37-55.

[20]   Baig, A.A., Locklin, C.A., Wilkes, A.E., et al. (2012) “One Can Learn from Other People’s Experiences”: Latino Adults' Preferences for Peer-Based Diabetes Interventions. Diabetes Educator, 38, 733-741.
https://doi.org/10.1177/0145721712455700

[21]   Sarkar, U., Piette, J., Gonzales, R., Lessler, D., et al. (2008) Preferences for Self-Management Support: Findings from a Survey of Diabetes Patients in Safety-Net Health Systems. Patient Education and Counseling, 70, 102-110.
https://doi.org/10.1016/j.pec.2007.09.008

[22]   Gorter, K.J., Tuytel, G.H., de Leeuw, J.R.J., et al. (2010) References and Opinions of Patients with Type 2 Diabetes on Education and Self-Care: A Cross-Sectional Survey. Diabetic Medicine, 27, 85-91.
https://doi.org/10.1111/j.1464-5491.2009.02886.x

[23]   King, M., Nazzareth, I., Lampe, F., Bower, P., Chandler, M., Morou, M., Sibbald, B. and Lai, R. (2005) Impact of Participant and Physician Intervention Preferences on Randomized Trials A Systematic Review. Journal of the American Medical Association, 293, 1089-1099.
https://doi.org/10.1001/jama.293.9.1089

[24]   Macias, C., Barreira, P., Hargreaves, W., Bickman, L., Fisher, W. and Aronson, E. (2005) Impact of Referral Source and Study Applicants’ Preference for Randomly Assigned Service on Research Enrollment, Service Engagement, and Evaluation Outcomes. American Journal of Psychiatry, 162, 781-787.
https://doi.org/10.1176/appi.ajp.162.4.781

[25]   Purnell, T.S., Joy, S., Little, E, Bridges J, and Maruthur, N. (2014) Patient Preferences for Noninsulin Diabetes Medications: A Systematic Review. Diabetes Care, 37, 2055-2062.
https://doi.org/10.2337/dc13-2527

[26]   Hauber, A.B., Mohamed, A.F., Johnson, F.R. and Falvey, H. (2009) Treatment Preferences and Medication Adherence of People with Type 2 Diabetes Using Oral Glucose-Lowering Agents. Diabetic Medicine, 26, 416-424.
https://doi.org/10.1111/j.1464-5491.2009.02696.x

[27]   Joy, S.M., Little, E., Marthur, N.M., Purnell, T.S. and Bridges, J.F.P. (2013) Patient Preferences for the Treatment of Type 2 Diabetes: A Scoping Review. PharmacoEconomics, 31, 877-892.
https://doi.org/10.1007/s40273-013-0089-7

[28]   Brown, S.A. (1992) Meta-Analysis of Diabetes Patient Education Research: Variations in Intervention Effects across Studies. Research in Nursing & Health, 15, 409-419.
https://doi.org/10.1002/nur.4770150603

[29]   Mulcahy, K., Maryniuk, M., Peeples, M., Peyrot, M., Tomky, D., Weaver, T. and Yarborough, T. (2003) Standards for Outcomes Measurement of Diabetes Self-Management Education. Position Statement. The Diabetes Educator, 29, 804-816.
https://doi.org/10.1177/014572170302900509

[30]   Irons, B.K., Vickers, P., Esperat, C., Valdez, G.M., Dadich, K.A., Boswell, C. and Cannon, S. (2007) The Need for a Community Diabetes Education Curriculum for Healthcare Professionals. Journal of Continuing Education in Nursing, 35, 227-231.
https://doi.org/10.3928/00220124-20070901-07

[31]   Zheng, Y., Wu, L., Su, Z. and Zhou, Q. (2014) Development of a Diabetes Education Program Based on Modified AADE Diabetes Education Curriculum. International Journal of Clinical and Experimental Medicine, 7, 758-763.

[32]   Jusko Friedman, A., Cosby, R., Boyko, S., Hatton-Bauer, J., Turnbull, G. and the Patient Education Panel (2009) Effective Teaching Strategies and Methods of Delivery for Patient Education. Evidence-Based Series 20-2 IN REVIEW.
https://www.cancercare.on.ca/common/pages/UserFile.aspx?fileId=60065

[33]   Adams, R. (2010) Improving Health Outcomes with Better Patient Understanding and Education. Risk Management and Healthcare Policy, 3, 61-72.
https://doi.org/10.2147/RMHP.S7500

[34]   Theis, S.L. and Johnson, J.H. (1995) Strategies for Teaching Patients: A Meta-Analysis. Clinical Nurse Specialist, 9, 100-120.
https://doi.org/10.1097/00002800-199503000-00010

[35]   Tang, T., Funnell, M. and Anderson, R. (2006) Group Education Strategies for Diabetes Self-Management. Diabetes Spectrum, 19, 100-105.
https://doi.org/10.2337/diaspect.19.2.99

[36]   Hwee, J., Cauch-Dudek, K., Victor, C., Ng, R. and Shah, B. (2014) Diabetes Education through Group Classes Leads to Better Care and Outcomes than Individual Counselling in Adults: A Population-Based Cohort Study. Canadian Journal of Public Health, 105, 192-197.
https://doi.org/10.17269/cjph.105.4309

[37]   Rickheim, P., Weaver, T., Flader, J. and Kendall, D. (2002) Assessment of Group versus Individual Diabetes Education: A Randomized Study. Diabetes Care, 25, 269-274.
https://doi.org/10.2337/diacare.25.2.269

[38]   Duke, S.A., Colagiuri, S. and Colagiuri, R. (2009) Individual Patient Education for People with Type 2 Diabetes Mellitus. The Cochrane Database of Systematic Reviews, 21, CD005268.
https://doi.org/10.1002/14651858.CD005268.pub2

[39]   Norris, S.L., Lau, J. and Smith, C.H. (2002) Self-Management Education for Adults with Type 2 Diabetes: A Meta-Analysis of the Effect on Glycemic Control. Diabetes Care, 25, 1159-1171.
https://doi.org/10.2337/diacare.25.7.1159

[40]   Kulzer, B., Hermanns, N. and Reinhecker, H. (2007) Effects of Self-Management Training in Type 2 Diabetes: A Randomized Prospective Trial. Diabetic Medicine, 24, 415 423.
https://doi.org/10.1111/j.1464-5491.2007.02089.x

[41]   Krishna, S. and Boren, S. (2008) Diabetes Self-Management Care via Cell Phone: A Systematic Review. Journal of Diabetes Science Technology, 2, 509-517.
https://doi.org/10.1177/193229680800200324

[42]   Goode, A.D., Winkler, E.A., Lawler, S.P., Reeves, M.M., Owen, N. and Eakin, E.G., (2011) A Telephone-Delivered Physical Activity and Dietary Intervention for Type 2 Diabetes and Hypertension: Does Intervention Dose Influence Outcomes? American Journal of Health Promotion, 25, 257-263.
https://doi.org/10.4278/ajhp.090223-QUAN-75

[43]   Goode, A.D., Winkler, E.A., Reeves, M.M. and Eakin, E.G. (2015) Relationship between Intervention Dose and Outcomes in Living Well with Diabetes—A Randomized Trial of a Telephone-Delivered Lifestyle-Based Weight Loss Intervention. American Journal of Health Promotion, 30, 120-129.
https://doi.org/10.4278/ajhp.140206-QUAN-62

[44]   Agurs-Collins, T.D., Kumanyika, S.K., Ten Have, T.R., et al. (1997) A Randomized Controlled Trial of Weight Reduction and Exercise for Diabetes Management in Older African-American Subjects. Diabetes Care, 20, 1503-1511.
https://doi.org/10.2337/diacare.20.10.1503

[45]   Fisher, E.B., Brownson, C.A., O’Toole, M.L., et al. (2007) Ongoing Follow-Up and Support for Chronic Disease Management in the Robert Wood Johnson Foundation Diabetes Initiative. Diabetes Educator, 33, 201S-207S.
https://doi.org/10.1177/0145721707304189

[46]   Fisher, E.B., Thorpe, C., DeVellis, B.M., et al. (2007) Healthy Coping, Negative Emotions and Diabetes Management: A Systematic Review and Appraisal. Diabetes Educator, 33, 1080-1103.
https://doi.org/10.1177/0145721707309808

[47]   Fisher, E.B., Brownson, C.A., O’Toole, M.L., et al. (2007) Ongoing Follow-Up and Support for Chronic Disease Management in the Robert Wood Johnson Foundation Diabetes Initiative. Diabetes Educator, 33, 201S-207S.
https://doi.org/10.1177/0145721707304189

[48]   Mensing, C.R. and Norris, S.L. (2003) Group Education in Diabetes: Effectiveness and Implementation. Diabetes Spectrum, 16, 96-103.
https://doi.org/10.2337/diaspect.16.2.96

[49]   Sidelinger, R.J, Bolen, D.M., Frisby, B.N. and McMullen, A.L. (2012) Instructor Compliance to Student Requests: An Examination of Studentto-Student Connectedness as Power in the Classroom. Communication Education, 61, 290-308.
https://doi.org/10.1080/03634523.2012.666557

[50]   Peyrot, M. and Rubin, R.R. (2008) Access to Diabetes Self-Management Education. Diabetes Educator, 34, 90-97.
https://doi.org/10.1177/0145721707312399

[51]   Gucciardi, E., Chan, V.W., Fortugno, M., Khan, S., Horodezny, S. and Swartzack, S.S. (2011) Primary Care Physician Referral Patterns to Diabetes Education Programs in Southern Ontario, Canada. Canadian Journal of Diabetes, 35, 26-268.
https://doi.org/10.1016/S1499-2671(11)53009-6

[52]   Shaw, K., Killeen, M., Sullvian, E. and Bowman, P. (2011) Disparities in Diabetes Self-Management Education for Uninsured and Underinsured Adults. Diabetes Educator, 37, 813-819.
https://doi.org/10.1177/0145721711424618

[53]   Cauch-Dudek, K., Victor, J.C., Sigmond, M. and Shah, B.R. (2013) Disparities in Attendance at Diabetes Self-Management Education Programs after Diagnosis in Ontario, Canada: A Cohort Study. BMC Public Health, 13, 85.
https://doi.org/10.1186/1471-2458-13-85

[54]   Active Learning Classrooms: Creative Spaces for Innovative Pedagogy at the University of Victoria.

[55]   Centre for the Enhancement of Learning and Teaching (1998) Team Teaching. City University of Hong Kong.
http://teaching.polyu.edu.hk/datafiles/R27.html

[56]   American Association of Diabetes Educators (2010) A Sustainable Model of Diabetes Self-Management Education/Training Involves a Multi-Level Team That Can Include Community Health Workers.

 
 
Top