title: The relative effectiveness of self-management programs for type 2 diabetes.
abstract: OBJECTIVE
  The objectives of the study were to investigate the effectiveness of 2 types of peer-led self-management programs in bringing about improvements in subjects with type 2 diabetes mellitus and to determine whether there were differences in effectiveness between the 2 programs.
  
  
  METHODS
  The study used a 3-arm randomized controlled trial design with clinical measures taken at baseline and at 6 and 12 months post-program. In total, 405 persons completed baseline questionnaires and were randomly allocated to a diabetes self-management program (n=130), to a general self-management program (n=109) or to a control group (n=122). A 2-way factorial analyses of variance was employed as the primary statistical analysis.
  
  
  RESULTS
  The findings showed that the self-management programs had affected 5 of the 30 measures: fatigue, cognitive symptom management, self-efficacy with regard to the disease in general, communication with physician, and the score on the Diabetes Empowerment Scale. In addition, 3 variables-social role limitations, total hospital nights and glycated hemoglobin levels-showed marginally significant interaction effects. The second analysis found similar results, with 4 of the 5 measures remaining statistically significant: fatigue, cognitive symptom management, communication with physician and diabetes empowerment, with neither program being more effective than the other.
  
  
  CONCLUSIONS
  The major findings are that although both programs were effective in bringing about positive changes in the outcome measures, there was little difference in effectiveness between the Diabetes Self-Management Program and the Chronic Disease Self-Management Program. This finding is consistent with the principle that behaviour-change strategies using self-efficacy are key components in health education programs.
authors.affiliation: School of Public Health and Social Policy, Faculty of Human and Social Development, University of Victoria, Delta, British Columbia, Canada. Electronic address: pmcgowan@uvic.ca.
authors.forename: Patrick
authors.initials: P
authors.lastname: McGowan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000523:psychology / Q000628:therapy; D003376:Counseling; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000523:psychology* / Q000628:therapy; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D012648:Self Care; D016896:Treatment Outcome
keywords: diabète de type 2; essai comparatif à répartition aléatoire; programme de prise en charge autonome; randomized controlled trial; self-management program; type 2 diabetes