A brief office-based intervention to facilitate diabetes dietary self-management

There is a pressing need for brief, practical interventions that address diabetes management. We have developed an office-based intervention to prompt both patients and providers to focus on behavioral issues relevant to dietary self-management that is being evaluated in a randomized trial. The intervention is designed to be broadly applicable to the majority of adult diabetes outpatients during medical visits; uses touchscreen computer assessment to provide immediate feedback on key issues to patients and providers just prior to their interaction; and provides goal setting and problem-solving assistance to patients following their meeting with the physician. Follow-up components include phone calls and videotape or interactive video instruction as needed. The program is described, and demographic and behavioral characteristics of participants are presented for the first 95 patients randomized. Initial process results suggest success in producing modest, targeted behavior changes among a broad cross-section of patients. If the long-term results are equally positive, this intervention could provide a prototype for a feasible, cost-effective way to integrate patient views and behavioral management into office-based care for diabetes.