title: Diabetes Conversation Map™ and health outcomes: A systematic literature review.
abstract: OBJECTIVE
  To identify, describe, and assess the evidence regarding the effects that the Diabetes Conversation Map™ program, an educational tool that engages patients with diabetes in group discussions about diabetes-related topics, has over a range of patient outcomes.
  
  
  METHODS
  A systematic review.
  
  
  METHODS
  Five databases, including PubMed, CINAHL, Scopus, EMBASE, and Cochrane Collaboration, were utilized to identify studies that evaluated the Conversation Map™ program. Additionally, the reference lists of the identified studies were manually reviewed.
  
  
  METHODS
  Studies that evaluated the Conversation Map™ program since 2005 were included. Non-English languages, non-journal papers, and studies that only included a description of the program were excluded. A quality assessment of relevant studies was performed. Outcomes were grouped into: objective (e.g., HbA1c levels), subjective (e.g., self-efficacy), and health behaviors (e.g., medication adherence).
  
  
  RESULTS
  Of the 85 studies originally identified, 24 studies were included in the final sample. The overall methodological quality of the studies was intermediate (score: 17 of 28). Almost all studies examined objective health measures, with most indicating non-significant differences between the Conversation Map™ intervention and the control groups. Conflicting results were found regarding the influence the program had on HbA1c. The majority of studies reported no significant change in blood pressure and mixed results were found regarding other health indicators. Twelve studies examined subjective measures and 11 assessed the effects on health behaviors, mostly reporting non-significant or positive findings.
  
  
  CONCLUSIONS
  Our review shows that although the Diabetes Conversation Map™ program holds the potential to improve patient behaviors and outcomes, current research on the program provides limited support as to their relationship with positive patient outcomes. Larger, more sophisticated studies are needed in order to determine the potential influence Conversation Map™ can have on long-term health outcomes.
authors.affiliation: School of Nursing, University of Haifa, Haifa, Israel; Clalit Research Insitute, Clalit Health Services, Tel Aviv, Israel. Electronic address: esrulovici@univ.haifa.ac.il.
authors.forename: Einav
authors.initials: E
authors.lastname: Srulovici
authors.affiliation: Community Nursing Division, Clalit Health Services, Tel Aviv, Israel.
authors.forename: Calanit
authors.initials: C
authors.lastname: Key
authors.affiliation: Community Nursing Division, Clalit Health Services, Tel Aviv, Israel.
authors.forename: Mina
authors.initials: M
authors.lastname: Rotem
authors.affiliation: School of Nursing, University of Pennsylvania, PA, USA.
authors.forename: Nadya
authors.initials: N
authors.lastname: Golfenshtein
authors.affiliation: Clalit Research Insitute, Clalit Health Services, Tel Aviv, Israel.
authors.forename: Ran D
authors.initials: RD
authors.lastname: Balicer
authors.affiliation: School of Nursing, University of Haifa, Haifa, Israel; Clalit Research Insitute, Clalit Health Services, Tel Aviv, Israel.
authors.forename: Efrat
authors.initials: E
authors.lastname: Shadmi
mesh_terms: D003920:Diabetes Mellitus / Q000503:physiopathology*; D006801:Humans; D017063:Outcome Assessment, Health Care
keywords: Diabetes; Health education; Self care