American Association of Diabetes Educators – Phase 2

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aade2

Locations: Tucson, Arizona; Cape Girardeau, Missouri; High Point, North Carolina; Scott Depot, West Virginia

The American Association of Diabetes Educators (AADE) aimed to provide culturally appropriate diabetes education, ongoing support for diabetes self-management, and create an operationalized model of diabetes self-management support (DSMS) in this phase of their efforts. The AADE conducted a randomized controlled trial across four sites in order to evaluate the efficacy of these supports. A total of 512 patients across four sites were enrolled in the study. All patients received diabetes self-management education (DSME) that lasted up to 6 months per patient. After the delivery of DSME, half of the patients (64 at each partner site) were randomly selected to also receive DSMS. DSMS consisted of at least monthly telephone-based contact with patient supporters as well as personalized support for achieving individual diabetes self-management goals.

Context

This project took place in four sites serving geographic areas and target populations with disproportionately high rates of type 2 diabetes. These sites were selected to integrate the intervention with existing programs that had the capacity to deliver and achieve outcomes in high disparity populations. Sites were selected based on the results of readiness and capabilities assessments.

Action

A certified diabetes educator at each partner site delivered the diabetes self-management education (DSME) curriculum to all patients within six months. This curriculum focused on the AADE7 Self-Care BehaviorsTM, which consists of the following behaviors: 1) healthy eating, 2) being active, 3) monitoring, 4) taking medication, 5) problem solving, 6) reducing risks, and 7) healthy coping. After DSME, half of the participants also received the diabetes self-management support (DSMS) intervention for an additional 12 months. DSMS consisted of telephone-based support that occurred at least once a month and focused on personalized support to improve long-term participant outcomes.

Learnings

Key learnings from this project include:

  • Patience and tenacity are necessary during the partner recruitment process
  • Limiting the number of implementation sites can reduce variability between sites
  • Employing a single call center across all sites ensures the intervention will be delivered the same way to all