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

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.