title: Healthy Changes for living with diabetes: an evidence-based community diabetes self-management program.
abstract: This article addresses the gap between research and practice by describing the feasibility and outcomes of an evidence-based diabetes self-management health education program. The Healthy Changes program used a peer-led group format to promote physical activity and healthful eating practices, using culturally relevant materials and measures.
  
  
  
  Older adults (mean age = 69.2 years; SD = 10.7) with type 2 diabetes (N = 243) were recruited from 9 communities to participate in the Healthy Changes program. Components included goal setting, problem solving, group support, and interactive lectures from experts. Measures of eating patterns, physical activity, body weight, community resources, self-rated health, and self-efficacy were administered at baseline, and at 4, 8, and 12 months.
  
  
  
  Participants attended on average 13 weekly sessions, and showed improvements in health behaviors, supportive resources, and self-efficacy at 4, 8, and 12 months.
  
  
  
  The Healthy Changes program can be successfully translated into community settings and led by trained peer leaders, yielding health improvements similar to those reported in efficacy trials. Trained peer leaders are key to effective program implementation. Peer-led groups enhance goal attainment by giving participants a venue to discuss obstacles and strategize solutions.
authors.affiliation: The Providence Health System, Portland, Oregon (Ms Klug)
authors.forename: Cindy
authors.initials: C
authors.lastname: Klug
authors.affiliation: The Oregon Research Institute, Eugene (Dr Toobert)
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Toobert
authors.forename: Michaela
authors.initials: M
authors.lastname: Fogerty
mesh_terms: D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology* / Q000534:rehabilitation*; D004522:Educational Status; D005260:Female; D006798:Housing; D006801:Humans; D007857:Leadership; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009820:Ohio; D010353:Patient Education as Topic / Q000379:methods*; D010865:Pilot Projects; D044469:Racial Groups; D012648:Self Care