The effect of a diabetes education, coping skills training, and care intervention on physiological and psychosocial outcomes in black women with type 2 diabetes.
An 11-week culturally relevant group diabetes self-management training (DSMT), coping skills training (CST), and diabetes care intervention was compared to a 10-week usual diabetes education and diabetes care intervention on physiological and psychosocial outcomes in 109 Black women (aged 48 +/- 10 years) with type 2 diabetes in primary care (PC). Strong time effects for hemoglobin A1c improvement were seen in both groups from baseline to 3 months and remained similar at 12 and 24 months (p < .0001). Systolic blood pressure (p =.01) and low-density lipoprotein cholesterol levels (p = .05) improved in both groups from baseline to 24 months. Baseline quality of life ([QOL]; Medical Outcome Study Short Form-36) was low. Social function, role-emotional, and mental health domains increased initially in both groups then declined slightly, with less decline for the experimental group at 12 months. At 24 months, experimental group scores increased. General health (p = .002), vitality (p = .01), role-physical, and bodily pain (p = .02) domains increased in both groups over time. Perceived provider support for diet (p = .0001) and exercise (p = .0001) increased in both groups over time. Diabetes-related emotional distress decreased in the experimental compared to the control group (group x time, p = .01). Findings suggest that both methods of diabetes education combined with care can improve metabolic control, QOL, and perceptions of provider care. CST may further assist in long-term improvements in health outcomes. Behavioral interventions are needed in addition to routine diabetes care, particularly in PC.
D'Eramo Melkus
Gail
G
New York University College of Nursing, NY 10003, USA. Gail.Melkus@nyu.edu
Chyun
Deborah
D
Vorderstrasse
Allison
A
Newlin
Kelley
K
Jefferson
Vanessa
V
Langerman
Susan
S
D000223:Adaptation, Psychological; D000328:Adult; D044383:Black People; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D010353:Patient Education as Topic; D011446:Prospective Studies; D011788:Quality of Life