Self-management support in "real-world" settings: An empowerment-based intervention

Objective: This study examined the impact of a 6-month, empowerment-based diabetes self-management support (DSMS) intervention on clinical outcomes, self-care behaviors, and quality of life (QOL) compared to a 6-month control period. Methods: This control-intervention cohort study recruited 77 African-American adults with type 2 diabetes. Baseline, 6-month, and 12-month assessments measured A1C, weight, body mass index (BMI), blood pressure, lipids, self-care behaviors, and QOL. During the control period, participants received weekly educational newsletters. During the intervention period, participants attended weekly DSMS groups as frequently as they needed. Sessions were guided by participants' self-management questions and concerns, and also emphasized experiential learning, coping, problem-solving, and goal-setting. Results: The control period found significant improvements for diastolic BP (p < 0.05), serum cholesterol (p < 0.001), following a healthy diet (p < 0.01), and monitoring blood glucose (p < 0.01). The intervention period found significant additional improvements for A1C (p < 0.001), weight (p < 0.05), BMI (p < 0.05), and LDL (p < 0.001). Compared to the control period, participation in the intervention led to a significant reduction in A1C (p < 0.01). Conclusion: Findings suggest that an empowerment-based, DSMS intervention is promising for improving and/or maintaining diabetes-related health, particularly A1C. Practical implications: Incorporating empowerment principles in DSMS interventions may be useful for supporting patients' self-management efforts in "real-world" settings. (C) 2009 Elsevier Ireland Ltd. All rights reserved.