TY - JOUR
T1 - 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
T2 - A randomized trial
AU - Fitzpatrick, Stephanie L.
AU - Golden, Sherita Hill
AU - Stewart, Kerry
AU - Sutherland, June
AU - De Gross, Sharie
AU - Brown, Tina
AU - Wang, Nae Yuh
AU - Allen, Jerilyn
AU - Cooper, Lisa A.
AU - Hill-Briggs, Felicia
PY - 2016
Y1 - 2016
N2 - 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.
AB - 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.
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U2 - 10.2337/dc16-0941
DO - 10.2337/dc16-0941
M3 - Article
C2 - 27879359
AN - SCOPUS:85006086138
SN - 0149-5992
VL - 39
SP - 2149
EP - 2157
JO - Diabetes care
JF - Diabetes care
IS - 12
ER -