Feasibility and Impact of "ABCs of Diabetes" Self-Management Education Program at an Urban Public Library

Feasibility and Impact of of "ABC's of Diabetes" Self Management Education (DSME) Program for African Americans at an Urban Public Library on A1C, Lipid Lowering Agent Prescriptions and Emergency Department Visits

A concise diabetes self-management education (DSME) program on the "ABCs of Diabetes" will be placed in an urban public library to assess the feasibility of using this community setting for the delivery of health care education in an urban African American population. Impact on knowledge of, prescriptions for, and control of blood sugar (A1C), blood pressure (BP) and LDL cholesterol (LDL-C)before and after participation in the program will be assessed. We will also examine the frequency of emergency department (ED) visits and hospitalizations for uncontrolled diabetes at 6 months post-DSME intervention.

Study Overview

• Status: Completed
• Conditions: Cardiovascular Disease; Diabetes
• Intervention / Treatment: Behavioral: Diabetes Self-Management Education

Detailed Description

A free, community-based Diabetes Learning Center was placed in a public library. Adults with diabetes (N=360) consented to participate in this prospective cohort study with historic self-controls. The small group, interactive DSME (two 2-1/2 hour classes) focused on improving CVD risk factors and enabling communication with the primary care physician. Knowledge, prescriptions, diabetes-related testing and clinical outcomes were assessed.

"ABCs of Diabetes" DSME Program

Class #1: A1C, Aspirin & Blood Pressure

A. Curriculum Content Areas:

• What is diabetes?
• A1C and blood glucose targets
• Diabetes medications
• Hypoglycemia
• Managing Blood Pressure
• Taking your medications
• Preventing vascular complications
• Monitoring your diabetes health
• "How to Talk to your Doctor"

B. Education strategies & tools

• Role playing from "How To Talk to Your Doctor"
• Ask for test results and how to get to targets
• Prompts to schedule appointments for ADA recommended exams, tests and discuss diabetes with primary care provider

Class #2 Cholesterol and Meal Planning

A. Curriculum Content Areas:

• Managing cholesterol
• Diet, exercise & weight management
• Cholesterol medications
• Smoking cessation
• Family Meal Planning:

consistent carbohydrate

• heart healthy meals

B. Education strategies & tools

• View "Cut the Fat Back" video†
• Interactive portion size & meal planning strategies
• Prompts to query PCP for LDL-C results;
• Flyers with questions to focus PCP on ADA goals † Produced by the Health Promotion Council, Philadelphia PA hpcpa@phmc.org

• Study Type: Interventional
• Enrollment (Actual): 360
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • District of Columbia
    • Washington, District of Columbia, United States, 20010
      • Washington Hospital Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

1. Diagnosis of Diabetes Mellitus, type 1 or type 2 for at least one month prior to taking the first educational class.
2. 18 years old or older.
3. Females and Males
4. All ethnic groups.
5. Must be able to read and speak English.
6. Must be willing to sign informed consent to participate in the research component of the program.
7. Plan on living in the District of Columbia for the next 6 to 8 months.
8. Willing to attend 2 core interactive education sessions within a 6-week period.
9. Willing to have a fingerstick performed to obtain blood for A1C and cholesterol determinations prior to and 6 months after completion of the educational sessions.
10. Willing to attend both a pre- and a post-study outcomes data collection visit, each of which will last approximately 1 - 1 ½ hours.
11. Ability and willingness to adhere to all study requirements.
12. Participant must have active health insurance coverage or self pay and have regular visits to their primary care physician. Interested parties who do not have health insurance will be referred to DHHS for assistance in applying for Medicare or Medicaid when applicable.
13. Have access to telephone in residence to receive reminder calls for up upcoming visits.

Exclusion Criteria:

1. Pregnancy.
2. Non-English speaking.
3. Untreated mental illness.
4. History of substance abuse or alcohol abuse in the past 12 months.
5. Individuals participating in a drug research study.
6. Presence of concomitant condition or circumstances which, in the opinion of the investigator, could interfere with participation in the study, glycemic control or interpretation of the data collected. (e.g. active malignance; HIV/AIDS)
7. Chronic concomitant use of oral steroids.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Non-Randomized
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: Diabetes Self-Management Education; Education intervention with historic self-controls.	Behavioral: Diabetes Self-Management Education; DSME intervention consisting of two interactive 2-1/2 hour classes taught by a diabetes educator focusing on the "ABCs of diabetes" and training in how to talk to your doctor.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Improvement in the percent of subjects correctly identifying guideline-recommended treatment targets for the "ABC's of Diabetes", where A = A1C < 7%; B = BP <130/80mmHg and; and C = LDL-C < 100mg/dl.	6 months following program completion

Secondary Outcome Measures

Outcome Measure	Time Frame
increase the percentage of subjects taking medications for A1C, BP and LDL-C management and aspirin;	6 months following DSME program completion
increase scores on the diabetes self-efficacy scale (DES);	6 months following DSME program completion
increase percentage of patients with A1C, BP and LDL-C at recommended targets;	6 months following program completion
Decrease the percentage of participants with self-reported ED visits and hospitalizations for severe hypoglycemia and hyperglycemia.	6 months following DSME program completion

Collaborators and Investigators

• Sponsor: Medstar Health Research Institute
• Collaborators: Eli Lilly and Company; Novo Nordisk A/S; Bayer; Pfizer; Medstar Diabetes Institute; American Diabetes Association; CareFirst BlueCross Blue Shield; District of Columbia, Department of Health Block Grants Program; Charles and Mary Latham Trust Fund; Hewlett-Packard; Meltzer Entities; NBC Washington; Aventis Pharmaceuticals; Takeda Pharmaceuticals North America, Inc.
• Investigators: Principal Investigator: Michelle F. Magee, MD, LRCPSI, MedStar Health Research Institute

Study record dates

Study Major Dates

• Study Start: January 1, 2003
• Primary Completion (Actual): January 1, 2005
• Study Completion (Actual): July 1, 2005

Study Registration Dates

• First Submitted: January 12, 2009
• First Submitted That Met QC Criteria: January 13, 2009
• First Posted (Estimate): January 14, 2009

Study Record Updates

• Last Update Posted (Actual): August 25, 2020
• Last Update Submitted That Met QC Criteria: August 21, 2020
• Last Verified: August 1, 2020

More Information

Terms related to this study

• Keywords: Diabetes; Prevention; Self-Management Education; Library; Emergency Department Visits; African American; CVD prevention; Uncontrolled diabetes
• Additional Relevant MeSH Terms: Glucose Metabolism Disorders; Metabolic Diseases; Endocrine System Diseases; Cardiovascular Diseases; Diabetes Mellitus
• Other Study ID Numbers: 2002-288

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No