Effect of DECIDE (Decisionmaking Education for Choices in Diabetes Everyday) program delivery modalities on clinical and behavioral outcomes in urban African Americans with type 2 diabetes: A randomized trial

Stephanie L. Fitzpatrick, Sherita Hill Golden, Kerry Stewart, June Sutherland, Sharie De Gross, Tina Brown, Nae Yuh Wang, Jerilyn Allen, Lisa A. Cooper, Felicia Hill-Briggs

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE To compare the effectiveness of three delivery modalities of Decision-making Education for Choices In Diabetes Everyday (DECIDE), a nine-module, literacyadapted diabetes and cardiovascular disease (CVD) education and problem-solving training, compared with an enhanced usual care (UC), on clinical and behavioral outcomes among urban African Americans with type 2 diabetes. RESEARCH DESIGN AND METHODS Eligible participants (n = 182) had a suboptimal CVD risk factor profile (A1C, blood pressure, and/or lipids). Participants were randomized to DECIDE Self-Study (n = 46), DECIDE Individual (n = 45), DECIDE Group (n = 46), or Enhanced UC (n = 45). Intervention duration was 18-20 weeks. Outcomes were A1C, blood pressure, lipids, problem-solving, disease knowledge, and self-care activities, all measured at baseline, 1 week, and 6 months after completion of the intervention. RESULTS DECIDEmodalities and Enhanced UC did not significantly differ in clinical outcomes at 6 months postintervention. In participants with A1C ≥7.5% (58 mmol/mol) at baseline, A1C declined in each DECIDE modality at 1 week postintervention (P < 0.05) and only in Self-Study at 6months postintervention (b =20.24, P < 0.05). There was significant reduction in systolic blood pressure in Self-Study (b = 24.04) and Group (b = 23.59) at 6 months postintervention. Self-Study, Individual, and Enhanced UC had significant declines in LDL and Self-Study had an increase in HDL (b = 1.76, P < 0.05) at 6 months postintervention. Self-Study and Individual had a higher increase in knowledge than Enhanced UC (P < 0.05), and all arms improved in problem-solving (P < 0.01) at 6 months postintervention. CONCLUSIONS DECIDE modalities showed benefits after intervention. Self-Study demonstrated robust improvements across clinical and behavioral outcomes, suggesting program suitability for broader dissemination to populations with similar educational and literacy levels.

Original languageEnglish (US)
Pages (from-to)2149-2157
Number of pages9
JournalDiabetes care
Volume39
Issue number12
DOIs
StatePublished - 2016

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Fingerprint Dive into the research topics of 'Effect of DECIDE (Decisionmaking Education for Choices in Diabetes Everyday) program delivery modalities on clinical and behavioral outcomes in urban African Americans with type 2 diabetes: A randomized trial'. Together they form a unique fingerprint.

Cite this