Identifying and Prioritizing the Barriers and Facilitators to the Self-Management of Type 2 Diabetes Mellitus: A Community-Centered Approach

Allison H. Oakes, Vincent S. Garmo, Lee R Bone, Daniel R. Longo, Jodi Segal, John F.P. Bridges

Research output: Contribution to journalArticle

Abstract

Objective: Self-management of type 2 diabetes mellitus is crucial to controlling the disease and preventing harm. Multiple factors have been identified in the literature as potential barriers and facilitators to self-management, but the magnitude and directionality of these factors are seldom studied. We sought to develop and test an instrument to identify and quantify the barriers and facilitators to self-management of type 2 diabetes. Methods: A community-centered approach was used to design, implement, and interpret the results of a stated-preference study. All activities were guided by a diverse stakeholder board. Based on previously reported development work, a novel survey instrument consisting of 13 potential barriers and facilitators was pretested and piloted in our local community. Participants were asked to discuss, rate, and rank each factor. A simple self-explicated method was used to quantify the data and Z scores were used for hypothesis testing. Results: In total, 25 patients with self-reported type 2 diabetes (64% female; 92% minorities) participated in the pretest and pilot. Time commitments (Z = −3.72), lack of active support groups (Z = −3.39) and other resources in the local community (Z = −2.96), and language/culture (Z = −2.69) were identified as barriers to self-management. Access to healthy food (Z = +5.68), personal understanding (Z = +4.81), and communication with healthcare providers (Z = +4.62) were identified as facilitators. Conclusion: We demonstrate that factors impacting self-management can be quantified and categorized as barriers and facilitators. While further refinement to some factors and investigation into alternative prioritization methods is necessary, our stakeholder board endorsed moving this to a large nationally representative study to see how these factors vary across different people.

Original languageEnglish (US)
Pages (from-to)1-11
Number of pages11
JournalPatient
DOIs
StateAccepted/In press - May 16 2017

Fingerprint

Self Care
Type 2 Diabetes Mellitus
Self-Help Groups
Health Personnel
Language
Communication
Food

ASJC Scopus subject areas

  • Nursing (miscellaneous)

Cite this

Identifying and Prioritizing the Barriers and Facilitators to the Self-Management of Type 2 Diabetes Mellitus : A Community-Centered Approach. / Oakes, Allison H.; Garmo, Vincent S.; Bone, Lee R; Longo, Daniel R.; Segal, Jodi; Bridges, John F.P.

In: Patient, 16.05.2017, p. 1-11.

Research output: Contribution to journalArticle

@article{98fd865f667f4c07a7f1e6c902a2f703,
title = "Identifying and Prioritizing the Barriers and Facilitators to the Self-Management of Type 2 Diabetes Mellitus: A Community-Centered Approach",
abstract = "Objective: Self-management of type 2 diabetes mellitus is crucial to controlling the disease and preventing harm. Multiple factors have been identified in the literature as potential barriers and facilitators to self-management, but the magnitude and directionality of these factors are seldom studied. We sought to develop and test an instrument to identify and quantify the barriers and facilitators to self-management of type 2 diabetes. Methods: A community-centered approach was used to design, implement, and interpret the results of a stated-preference study. All activities were guided by a diverse stakeholder board. Based on previously reported development work, a novel survey instrument consisting of 13 potential barriers and facilitators was pretested and piloted in our local community. Participants were asked to discuss, rate, and rank each factor. A simple self-explicated method was used to quantify the data and Z scores were used for hypothesis testing. Results: In total, 25 patients with self-reported type 2 diabetes (64{\%} female; 92{\%} minorities) participated in the pretest and pilot. Time commitments (Z = −3.72), lack of active support groups (Z = −3.39) and other resources in the local community (Z = −2.96), and language/culture (Z = −2.69) were identified as barriers to self-management. Access to healthy food (Z = +5.68), personal understanding (Z = +4.81), and communication with healthcare providers (Z = +4.62) were identified as facilitators. Conclusion: We demonstrate that factors impacting self-management can be quantified and categorized as barriers and facilitators. While further refinement to some factors and investigation into alternative prioritization methods is necessary, our stakeholder board endorsed moving this to a large nationally representative study to see how these factors vary across different people.",
author = "Oakes, {Allison H.} and Garmo, {Vincent S.} and Bone, {Lee R} and Longo, {Daniel R.} and Jodi Segal and Bridges, {John F.P.}",
year = "2017",
month = "5",
day = "16",
doi = "10.1007/s40271-017-0248-6",
language = "English (US)",
pages = "1--11",
journal = "Patient",
issn = "1178-1653",
publisher = "Springer Science + Business Media",

}

TY - JOUR

T1 - Identifying and Prioritizing the Barriers and Facilitators to the Self-Management of Type 2 Diabetes Mellitus

T2 - A Community-Centered Approach

AU - Oakes, Allison H.

AU - Garmo, Vincent S.

AU - Bone, Lee R

AU - Longo, Daniel R.

AU - Segal, Jodi

AU - Bridges, John F.P.

PY - 2017/5/16

Y1 - 2017/5/16

N2 - Objective: Self-management of type 2 diabetes mellitus is crucial to controlling the disease and preventing harm. Multiple factors have been identified in the literature as potential barriers and facilitators to self-management, but the magnitude and directionality of these factors are seldom studied. We sought to develop and test an instrument to identify and quantify the barriers and facilitators to self-management of type 2 diabetes. Methods: A community-centered approach was used to design, implement, and interpret the results of a stated-preference study. All activities were guided by a diverse stakeholder board. Based on previously reported development work, a novel survey instrument consisting of 13 potential barriers and facilitators was pretested and piloted in our local community. Participants were asked to discuss, rate, and rank each factor. A simple self-explicated method was used to quantify the data and Z scores were used for hypothesis testing. Results: In total, 25 patients with self-reported type 2 diabetes (64% female; 92% minorities) participated in the pretest and pilot. Time commitments (Z = −3.72), lack of active support groups (Z = −3.39) and other resources in the local community (Z = −2.96), and language/culture (Z = −2.69) were identified as barriers to self-management. Access to healthy food (Z = +5.68), personal understanding (Z = +4.81), and communication with healthcare providers (Z = +4.62) were identified as facilitators. Conclusion: We demonstrate that factors impacting self-management can be quantified and categorized as barriers and facilitators. While further refinement to some factors and investigation into alternative prioritization methods is necessary, our stakeholder board endorsed moving this to a large nationally representative study to see how these factors vary across different people.

AB - Objective: Self-management of type 2 diabetes mellitus is crucial to controlling the disease and preventing harm. Multiple factors have been identified in the literature as potential barriers and facilitators to self-management, but the magnitude and directionality of these factors are seldom studied. We sought to develop and test an instrument to identify and quantify the barriers and facilitators to self-management of type 2 diabetes. Methods: A community-centered approach was used to design, implement, and interpret the results of a stated-preference study. All activities were guided by a diverse stakeholder board. Based on previously reported development work, a novel survey instrument consisting of 13 potential barriers and facilitators was pretested and piloted in our local community. Participants were asked to discuss, rate, and rank each factor. A simple self-explicated method was used to quantify the data and Z scores were used for hypothesis testing. Results: In total, 25 patients with self-reported type 2 diabetes (64% female; 92% minorities) participated in the pretest and pilot. Time commitments (Z = −3.72), lack of active support groups (Z = −3.39) and other resources in the local community (Z = −2.96), and language/culture (Z = −2.69) were identified as barriers to self-management. Access to healthy food (Z = +5.68), personal understanding (Z = +4.81), and communication with healthcare providers (Z = +4.62) were identified as facilitators. Conclusion: We demonstrate that factors impacting self-management can be quantified and categorized as barriers and facilitators. While further refinement to some factors and investigation into alternative prioritization methods is necessary, our stakeholder board endorsed moving this to a large nationally representative study to see how these factors vary across different people.

UR - http://www.scopus.com/inward/record.url?scp=85019256056&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85019256056&partnerID=8YFLogxK

U2 - 10.1007/s40271-017-0248-6

DO - 10.1007/s40271-017-0248-6

M3 - Article

C2 - 28510080

AN - SCOPUS:85019256056

SP - 1

EP - 11

JO - Patient

JF - Patient

SN - 1178-1653

ER -