Effects of a brief computer-assisted diabetes self-management intervention on dietary, biological and quality-of-life outcomes.
OBJECTIVE
There is a need for practical, efficient and broad-reaching diabetes self-management interventions that can produce changes in lifestyle behaviours such as healthy eating and weight loss. The objective of this study was to evaluate such a computer-assisted intervention.


METHODS
Type 2 diabetes primary care patients (n=335) from fee-for-service and health maintenance organization settings were randomized to social cognitive theory-based tailored self-management (TSM) or computer-aided enhanced usual care (UC). Intervention consisted of computer-assisted self-management assessment and feedback, tailored goal-setting, barrier identification, and problem-solving, followed by health counsellor interaction and follow-up calls. Outcomes were changes in dietary behaviours (fat and fruit/vegetable intake), haemoglobin Alc (HbA1c), lipids, weight, quality of life, and depression.


RESULTS
TSM patients reduced dietary fat intake and weight significantly more than UC patients at the 2-month follow-up. Among patients having elevated levels of HbA1c, lipids or depression at baseline, there were consistent directional trends favouring intervention, but these differences did not reach significance. The intervention proved feasible and was implemented successfully by a variety of staff.


CONCLUSIONS
This relatively low-intensity intervention appealed to a large, generally representative sample of patients, was well implemented, and produced improvement in targeted behaviours. Implications of this practical clinical trial for dissemination are discussed.
Glasgow
Russell E
RE
Kaiser Permanente Colorado, P.O. Box 378066, Denver, CO 80237-8066, USA. russg@ris.net
Nutting
Paul A
PA
Toobert
Deborah J
DJ
King
Diane K
DK
Strycker
Lisa A
LA
Jex
Marleah
M
O'Neill
Caitlin
C
Whitesides
Holly
H
Merenich
John
J
D003201:Computers; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D003927:Diet, Diabetic; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D011788:Quality of Life; D012648:Self Care; D015431:Weight Loss