title: Stage of change advancement for diabetes self-management behaviors and glucose control.
abstract: This study was conducted to evaluate whether patients with type 2 diabetes who participated in diabetes education advanced through stages of change for self-management behaviors and to determine if movement was related to glucose control.
  
  
  
  A cohort of 428 patients with type 2 diabetes participated in a traditional diabetes education program in a large urban center in the Southwest. The sample was predominantly female with less than a high school education, a mean age of 52 years, and a mean duration of diabetes of 7 years. Two interviews were conducted approximately 9 months apart, at 1 to 4 weeks before the educational program and at 6 months after completing it. Blood specimens were collected at each interview to measure hemoglobin A1C (A1C) levels.
  
  
  
  Most of the patients advanced 1 or more stages of change for at least 1 self-management behavior. Those with diabetes for less than 2 years were significantly more likely to advance at least 1 stage of change for diet and exercise than those with diabetes for more than 2 years. Such advancement was significantly associated with a decline in A1C.
  
  
  
  Patients with type 2 diabetes who participated in diabetes education advanced through stages of change for self-care behaviors. The intervention was more effective for those with a shorter duration of diabetes.
authors.affiliation: The Department of Family & Com­munity Medicine, University of Texas Health Sciences Center-San Antonio (Drs Parchman and Larme)
authors.forename: Michael L
authors.initials: ML
authors.lastname: Parchman
authors.affiliation: The School of Public Health, University of Texas Health Sciences Center-San Antonio (Dr Arambula-Solomon)
authors.forename: Teshia G
authors.initials: TG
authors.lastname: Arambula-Solomon
authors.affiliation: The VERDICT Center, Audie L. Murphy Division of the South Texas  Veterans Health Care System (Drs Noel and Pugh)
authors.forename: Polly Hitchcock
authors.initials: PH
authors.lastname: Noël
authors.affiliation: The Department of Family & Com­munity Medicine, University of Texas Health Sciences Center-San Antonio (Drs Parchman and Larme)
authors.forename: Anne C
authors.initials: AC
authors.lastname: Larme
authors.affiliation: The VERDICT Center, Audie L. Murphy Division of the South Texas  Veterans Health Care System (Drs Noel and Pugh)
authors.forename: Jacqueline A
authors.initials: JA
authors.lastname: Pugh
mesh_terms: D001786:Blood Glucose; D003479:Curriculum; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology / Q000628:therapy*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D012044:Regression Analysis; D012648:Self Care / Q000523:psychology*; D015206:Southwestern United States
chemical_list: D001786:Blood Glucose