A Comparison of Two Diabetes Self-Management Education Programs for the Reduction of Participant A1c Levels

  • Sharpless, Edward DSc
  • Borkowski, Nancy DBA
  • O’Connor, Stephen J. PhD
  • Hearld, Larry PhD
  • Szychowski, Jeffery PhD

  • 1Department of Health Services Administration, 48654School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA

    2Department of Biostatics, 48654School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA

Nancy Borkowski, DBA, Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, 1720 2nd Avenue S., SHP 554, Birmingham, AL 35294, USA. Email: [email protected]

American Journal of Health Promotion 35(7):p 988-990, September 2021. | DOI: 10.1177/08901171211003829

Purpose:

Compare the effectiveness of two educational teaching methods for diabetic patients.

Design:

Quasi-experimental study comparing two interventions using a pretest/post-test design.

Setting:

Three clinics within a western U.S. regional health system.

Subjects:

818 adult diabetic participants (60.5 mean age, 52% female) attended one to four sessions between 2013-2017, and had A1c tests within 180 days of first attended session and 30 to 365 days after last attended session.

Intervention:

A group-based, highly interactive learning experience (n = 561) and a traditional, lecture-style class (n = 257).

Measures:

Pre and post measures of A1c.

Analysis:

Paired t-tests measured change within each group pre-post intervention. Two-sample t-tests measured mean change pre-post intervention between the two groups. Multivariable linear regression measured mean change in A1c between groups, adjusted for pre-test scores and controlling for demographic variables.

Results:

Both interactive and traditional teaching interventions were effective at significantly reducing patient A1c levels by 1.3 (p < 0.001) and 1.0 (p < 0.001) points respectively. The between groups difference in A1c was not significant, t(512) = 1.66, p = 0.0985, but when controlling for age, pre-A1c and days post-A1c, the interactive intervention was significantly (p < 0.05) more effective reducing patient A1c levels by 0.19 points than the traditional intervention.

Conclusion:

Group-based, interactive diabetes self-management education programs may be an effective model for reducing patient A1c levels.

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