title: Improving the implementation of diabetes self-management: findings from the Alliance to Reduce Disparities in Diabetes.
abstract: To enhance the health and well-being of patients managing type 2 diabetes, the five grantees comprising the Alliance to Reduce Disparities in Diabetes implemented evidence-based approaches to patient self-management education as part of their programs. This article describes strategies implemented by the grantees that may help explain program success, defined as improvement in clinical values and patient-reported outcomes. A process evaluation of grantee programs included interviews and document review at the beginning, midpoint, and end of the Alliance initiative. A total of 97 interviews were conducted over time with 65 program representatives. The Alliance programs served 2,328 people from diverse racial and ethnic backgrounds and provided 36,826 diabetes self-management sessions across the intervention sites. Framework analysis of the interviews identified four key themes that emerged across time and program sites that may help account for program success: empowerment, increasing access and support, addressing local needs and barriers, and care coordination. The overall evaluation findings may help other diabetes self-management programs seeking to translate and implement evidence-based approaches to reduce disparities and enhance patient well-being.
authors.affiliation: RTI International, Research Triangle Park, NC, USA melewis@rti.org.
authors.forename: Megan A
authors.initials: MA
authors.lastname: Lewis
authors.affiliation: RTI International, Research Triangle Park, NC, USA.
authors.forename: Pam A
authors.initials: PA
authors.lastname: Williams
authors.affiliation: RTI International, Research Triangle Park, NC, USA.
authors.forename: Tania M
authors.initials: TM
authors.lastname: Fitzgerald
authors.affiliation: RTI International, Research Triangle Park, NC, USA.
authors.forename: Christina L
authors.initials: CL
authors.lastname: Heminger
authors.affiliation: RTI International, Research Triangle Park, NC, USA.
authors.forename: Connie L
authors.initials: CL
authors.lastname: Hobbs
authors.affiliation: RTI International, Research Triangle Park, NC, USA.
authors.forename: Rebecca R
authors.initials: RR
authors.lastname: Moultrie
authors.affiliation: RTI International, Research Triangle Park, NC, USA.
authors.forename: Olivia M
authors.initials: OM
authors.lastname: Taylor
authors.affiliation: RTI International, Research Triangle Park, NC, USA.
authors.forename: Sidney
authors.initials: S
authors.lastname: Holt
authors.affiliation: RTI International, Research Triangle Park, NC, USA.
authors.forename: Shawn A
authors.initials: SA
authors.lastname: Karns
authors.affiliation: RTI International, Research Triangle Park, NC, USA.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Burton
authors.affiliation: Robert Graham Center for Policy Studies, Washington, DC, USA.
authors.forename: Douglas B
authors.initials: DB
authors.lastname: Kamerow
mesh_terms: D000293:Adolescent; D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D005006:Ethnicity; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D036301:Qualitative Research; D058996:Quality Improvement; D012648:Self Care; D014481:United States; D055815:Young Adult
keywords: diabetes; disparities; process evaluation