title: Short and long-term outcomes from a multisession diabetes education program targeting low-income minority patients: a six-month follow up.
abstract: BACKGROUND
  A diabetes self-management education (DSME) program was offered to patients at a primary care clinic serving low-income people.
  
  
  OBJECTIVE
  The purpose of the analyses presented here was to understand the feasibility of the program and effectiveness of the intervention.
  
  
  METHODS
  The program was facilitated by a nurse and licensed dietician. Data were collected at baseline, after each class, and after 6 months. Patients were interviewed to identify diabetes self-care behaviors before the first class, after the fourth class, and at 6 months. Knowledge related to content areas was measured before and after each class. Glycosylated hemoglobin (HbA(1c)), blood pressure, weight, and body mass index (BMI) were collected at baseline and after 6 months. Medical records were reviewed for LDL levels, co-morbidity, and diabetes management. Frequencies, χ(2) and t tests, and repeated measures t tests were used to analyze data.
  
  
  RESULTS
  Patients were mostly non-Hispanic black or Hispanic (93.1%); mean BMI was 34.89 kg/m(2). About one-half (41.95%) completed the program. Significant improvements were observed for knowledge related to each of the 4 content areas: diet (P < 0.001), diabetes management (P = 0.003), monitoring blood glucose (P < 0.001), and preventing complications (P = 0.001). Among long-term outcomes, mean HbA(1c) was significantly reduced (0.82%), from 8.60% to 7.78% (P = 0.007), with 26.67% of patients reducing HbA(1c) from ≥7.0% at baseline to <7% at follow up (P < 0.001). Patients demonstrated a significant improvement in readiness to improve dietary behaviors (P = 0.016).
  
  
  CONCLUSIONS
  Outcomes suggested that minority patients with a high risk for poor diabetes outcomes might be retained in a multisession DSME program and benefit from increasing knowledge of diabetes content. Further evaluation is necessary to determine the cost-effectiveness of this intervention.
authors: Department of Family Medicine and Community Health, University of Miami Miller School of Medicine, Miami, FL, USA. johngryan@miami.edu
authors: John G
authors: JG
authors: Ryan
authors: Terri
authors: T
authors: Jennings
authors: Isabel
authors: I
authors: Vittoria
authors: Mark
authors: M
authors: Fedders
mesh_terms: D001741:Black or African American; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D001835:Body Weight / Q000208:ethnology; D016009:Chi-Square Distribution; D015897:Comorbidity; D003479:Curriculum; D048909:Diabetes Complications / Q000208:ethnology / Q000517:prevention & control; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis / Q000208:ethnology / Q000503:physiopathology / Q000628:therapy*; D004032:Diet / Q000009:adverse effects / Q000208:ethnology; D005240:Feasibility Studies; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006630:Hispanic or Latino; D006801:Humans; D008055:Lipids / Q000097:blood; D016015:Logistic Models; D008297:Male; D008913:Minority Groups; D054525:Minority Health / Q000208:ethnology*; D010349:Patient Compliance / Q000208:ethnology; D010353:Patient Education as Topic; D011203:Poverty / Q000208:ethnology*; D015397:Program Evaluation; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012648:Self Care; D062606:Tertiary Care Centers; D013781:Texas / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D008055:Lipids; C517652:hemoglobin A1c protein, human