title: Promoting glycemic control through diabetes self-management: evaluating a patient activation intervention.
abstract: This study compared an activation intervention to passive education in a randomized attention-control trial of 232 patients with type 2 diabetes. The activation intervention was based on Expanding Patient Involvement in Care (EPIC) trials, and was compared to time-matched passive education viewing of ADA video-tapes. Patient demographics and clinical characteristics of their diabetes were assessed with questionnaires, active involvement was assessed via ratings of taped interactions between patients and providers, and serum samples were analyzed for HbA1c. Patients in the activation condition were rated as more actively involved in discussions of diabetes self-management, and rated active involvement was predictive of improvement in glycemic control. No effect of the activation intervention was found on HbA1c. Thus, the activation intervention increased the active involvement of patients with type 2 diabetes in visits with practitioners, and active involvement led to improved glycemic control. However, the activation intervention did not improve glycemic control directly.
authors.affiliation: Department of Clinical & Social Sciences in Psychology, University of Rochester, P.O. Box 270266, Rochester, NY 14627-0266, USA. geoffrey_williams@urmc.rochester.edu
authors.forename: Geoffrey C
authors.initials: GC
authors.lastname: Williams
authors.forename: Holly
authors.initials: H
authors.lastname: McGregor
authors.forename: Allan
authors.initials: A
authors.lastname: Zeldman
authors.forename: Zachary R
authors.initials: ZR
authors.lastname: Freedman
authors.forename: Edward L
authors.initials: EL
authors.lastname: Deci
authors.forename: Daniel
authors.initials: D
authors.lastname: Elder
mesh_terms: D015190:Blood Glucose Self-Monitoring; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism / Q000517:prevention & control*; D019468:Disease Management; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods* / Q000592:standards; D006801:Humans; D007004:Hypoglycemic Agents; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009042:Motivation; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic / Q000379:methods* / Q000592:standards; D010358:Patient Participation; D011237:Predictive Value of Tests; D015397:Program Evaluation; D012044:Regression Analysis; D012648:Self Care / Q000379:methods* / Q000523:psychology; D011795:Surveys and Questionnaires; D014743:Videotape Recording
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents