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Evaluating the Implementation of the Diabetes Self-Management Program in a Rural Population.

Kristin Pullyblank1, Melissa Scribani1, Lynae Wyckoff1

  • 1Bassett Research Institute, Bassett Medical Center, Cooperstown, NY.

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Summary

The Diabetes Self-Management Program (DSMP) improved patient-reported outcomes like distress and activation in rural areas. While A1C levels did not significantly change overall, a subset showed a positive trend, supporting DSMP implementation in rural diabetes care.

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Area of Science:

  • Public Health
  • Chronic Disease Management
  • Health Services Research

Background:

  • The evidence-based Diabetes Self-Management Program (DSMP) enhances health outcomes but faces implementation challenges in rural settings.
  • Low dissemination rates in rural areas limit access to effective diabetes self-management support.
  • Addressing these disparities is crucial for improving diabetes care in underserved populations.

Purpose of the Study:

  • To evaluate the impact of implementing the DSMP on patient-reported outcomes within a rural region.
  • To assess changes in diabetes distress, self-management behaviors, and patient activation post-intervention.
  • To explore secondary effects on A1C levels in participants with type 2 diabetes.

Main Methods:

  • Collaboration with multiple partners to deliver 28 DSMP workshops between 2017 and 2019.
  • Collected patient-reported outcome data on diabetes distress, self-management, and patient activation.
  • Secondary analysis of A1C values from medical records for participants completing at least four sessions.

Main Results:

  • Statistically significant improvements observed in the Diabetes Distress Scale (P = 0.0017), Diabetes Self-Management Questionnaire (P < 0.0001), and Patient Activation Measure (P < 0.0001).
  • No significant overall change in A1C levels (P = 0.5875).
  • A nonsignificant trend towards A1C decline (P = 0.1087) was noted in participants with baseline A1C ≥ 8%.

Conclusions:

  • The DSMP demonstrates effectiveness in improving key self-reported outcomes for individuals with diabetes in rural areas.
  • Preliminary evidence supports integrating the DSMP into comprehensive rural diabetes care plans.
  • Further research may explore strategies to optimize A1C reduction in this population.