Spanish Diabetes Self-Management With and Without Automated Telephone Reinforcement
Abstract
OBJECTIVE—To determine 1) whether participants in the Spanish Diabetes Self-Management Program (SDSMP), when compared at 6 months to randomized control subjects, would demonstrate improvements in health status, health behaviors, and self-efficacy; and 2) whether SDSMP participants receiving monthly automated telephone reinforcement would maintain improvements at 18 months better than those not receiving reinforcement. RESEARCH DESIGN AND METHODS—A total of 567 Spanish-speaking adults with type 2 diabetes were randomized to a usual-care control group or 6-week community-based, peer-led SDSMP. SDSMP participants were re-randomized to receive 15 months of automated telephone messages or no reinforcement. A1C was measured at baseline and 6 and 18 months. All other data were collected by self-administered questionnaires. RESULTS—At 6 months SDSMP participants compared with control subjects demonstrated improvements in A1C (−0.4%), health distress, symptoms of hypo- and hyperglycemia, and self-efficacy (P < 0.05). At 18 months all improvements persisted (P < 0.05). SDSMP participants also demonstrated improvements in self-rated health and communication with physicians, had fewer emergency room visits (−0.18 visits in 6 months, P < 0.05), and trended toward fewer visits to physicians. At 18 months the only difference between reinforced and nonreinforced participants was increased glucose monitoring for the reinforcement group. CONCLUSIONS—The SDSMP demonstrated effectiveness in lowering A1C and improving health status. Reinforcement did not add to its effectiveness. Given the high needs of the Spanish-speaking population, the SDSMP deserves consideration for implementation.
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A small trial of cognitive behavioral therapy adapted to address diabetes-relevant behavior change improved both glycemic control and diabetes distress in adults with poorly controlled type 1 diabetes, compared with a control condition, with benefits maintained over 1 year of follow-up.
“For example, a small trial of cognitive behavioral therapy adapted to address diabetes-relevant behavior change improved both glycemic control and diabetes distress in adults with poorly controlled type 1 diabetes, compared with a control condition, with benefits maintained over 1 year of follow-up (23).”
From Depression in diabetes: have we been missing something important? (2011) · cites this paper as [23]
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- Authors
- Lorig, K., Ritter, P. L., Villa, F., & Piette, J. D.
- Affiliations
- Stanford Medicine (US)
- University of Michigan (US)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2008-03-01
- Volume
- 31
- Issue
- 3
- Pages
- 408-414
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2114234563
- Cited by
- 255
- References
- 29
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 7 · 2023: 5 · 2022: 12 · 2021: 11 · 2020: 16 · 2019: 22 · 2018: 13 · 2017: 10 · 2016: 23 · 2015: 24 · 2014: 24 · 2013: 20 · 2012: 16
- FWCI
- 10.15
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Institute of Nursing Research (NR053250)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- type 2 diabetes, diabetes self-management program, peer-led intervention, Spanish-speaking adults, glycemic control, HbA1c, self-efficacy, health behavior, glucose monitoring, emergency department visits, health status
- MeSH terms
- Adult, Aged, Aged, 80 and over, Diabetes Mellitus, Type 2, Female, Hispanic or Latino, Humans, Male, Middle Aged, Self Care, Telephone, Health Behavior, Outcome Assessment, Health Care, Disease Management
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