Type 2 Diabetes Self-Management Education and Group Care at a Free Medical Clinic
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Aims: High risk populations face barriers and lack support when accessing healthcare increasing the progression of disease and complications. A diabetes self-management education (DSME) and support group was developed to increase access to education and support within a uninsured, high risk population at a free medical clinic in southeastern Nebraska with the purpose of improving self-efficacy and self-care behaviors.|Methods: Adults with type 2 diabetes were recruited to participate in a 12-week DSME and support group program. Self-efficacy and self-care behavior outcomes were measured using the Diabetes Self-Efficacy (DSE) Scale and Diabetes Self-Management Questionnaire (DMSQ) along with physiological measures of blood pressure, weight, waist circumference, and hemoglobin A1C as secondary outcomes.|Results: Two participants reported increased self-care behaviors and/or self-efficacy after partaking in the program. Hemoglobin A1C increased in all participants for which it was redrawn. This can be explained by poor glucose and dietary management reported by the participants.|Conclusions: Education alone was found to not be enough to address the health-related disparities faced by this high-risk population. Interventions must address communication and knowledge as well as psychosocial factors affecting self-care. Health-literacy addresses comprehensive, analytical, and decision-making skills and is one aspect of social determinates of health that can provide motivation and positively affect self-care behaviors. Engagement within this population was difficult to maintain as the length between sessions increased, but when present, participants were highly engaged in the sessions. The challenge is to find an appealing schedule that can capture this population to facilitate the provision of important diabetes self-management education.
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