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 K. Allen, Lisa A Cooper, Felicia Hill-Briggs

Research output: Contribution to journalArticle

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

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ASJC Scopus subject areas

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

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