Posted Aug 10 , 2017 04:12 AM

Assessment of a National Diabetes Education Program diabetes management booklet: The GRADE experience

Devchand R, et al. J. Amer Assoc of Nurse Practitioners 2017;29:255

What were the findings (excerpted from the Abstract)?

The National Diabetes Education Program created the 4 Steps to Manage Your Diabetes for Life (4 Steps) booklet to help people with diabetes learn the basics of self-management and care recommendations. The purpose of this study is to explore the impact of 4 Steps on participants’ diabetes management knowledge and self-efficacy in the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE). A sample of 348 adults with type 2 diabetes enrolled in GRADE was included in this analysis. Participants took a pretest, were sent home with ‘4 Steps’, and took a posttest at their next visit. The Wilcoxon signed rank test was used to detect differences in knowledge and self-efficacy between scale scores pre- and posttest. Analyses revealed significant increases in participants’ diabetes management knowledge and self-efficacy from pre- to posttest. Participants who reported no formal previous diabetes education showed a significant increase in knowledge scores compared to those with previous diabetes education.

Why is this important?

Appropriate, relevant diabetes education materials may improve self-management knowledge and self-efficacy among adults with type 2 diabetes to improve outcomes. While it is clear a detailed curriculum available through recognized Diabetes Self-Management Education (DSME) programs may produce these results, the vast majority of people with diabetes do not have access to such programs. Having a well-respected booklet that teaches self-management principles is important to all practitioners. This study evaluates the “4 Steps” educational booklet in terms of its contributions to diabetes education, and the resultant potential changes in self-efficacy that such knowledge often brings. Because of constraints in time and funding, investigators were not able to expand the study to follow participants longer term to assess whether changes in knowledge or self-efficacy early in the trial impacted long-term knowledge and self-efficacy or clinical outcomes. The National Diabetes Education Program will consider this expansion and more robust evaluation approach in the future. Education is important to diabetes self-management, but education alone does not necessarily change behavior. Where possible, use of the “4-Steps” booklet should be augmented with one or more behavior change approaches to help people with diabetes better cope with their disease and improve their health. Have you used this booklet with your patients? What are your thoughts on its value? 

Read the Abstract:
Link to the booklet “4 Steps to Manage Your Diabetes for Life” [also available in 12 other languages on the National Diabetes Education Program (NDEP) website]