Leonard Jack Jr., PhD, MS; Leandris Liburd, MPH; Tirzah Spencer, PhD, MPH; Collins O. Airhihenbuwa, PhD, MPH
Acknowledgments: The authors thank Susan Norris, MD, MPH, and Dawn Satterfield, PhD, MSN, RN, CDE, for their reviews and comments on this manuscript.
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Leonard Jack Jr., PhD, MS, Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Mailstop K-10, 4770 Buford Highway NE, Atlanta, GA 30341; e-mail, email@example.com.
Current Author Addresses: Dr. Jack: Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Mailstop K-10, 4770 Buford Highway, NE, Atlanta, GA 30341.
Dr. Liburd: Community Health and Program Services Branch, Division of Adult and Community Health, Centers for Disease Control and Prevention, Mailstop K-30, 4700 Buford Highway, NE, Atlanta, GA 30341.
Dr. Spencer: Stanford Prevention Research Center, Stanford University School of Medicine, Hoover Pavilion, Room N229, 211 Quarry Road, Stanford, CA 94305-5705.
Dr. Airhihenbuwa: Department of Biobehavioral Health, College of Health and Human Development, The Pennsylvania State University, University Park, PA 16802.
Eight studies included in a recent systematic review of the efficacy of diabetes self-management education were qualitatively reexamined to determine the presence of theoretical frameworks, methods used to ensure cultural appropriateness, and the quality of the instrument. Theoretical frameworks that help to explain complex pathways that produce health outcomes were lacking; culture indices were not incorporated into diabetes self-management education; and the instruments used to measure outcomes were inadequate. We provide recommendations to improve research on diabetes self-management education in community settings through use of a contextual framework that encourages targeting multiple levels of influence—individual, family, organizational, community, and policy.
Analytical framework for diabetes self-management education interventions (DSME).American Journal of Preventive Medicine
A summary of effect measure (i.e., difference between the intervention and comparison groups) was calculated for outcomes of interest. Absolute and relative differences were presented for outcomes with consistent measurement scales and relative differences for outcomes with consistent measurement scales. Pooled estimates of effect were calculated if there was sufficient number of studies with comparable outcomes and if exploratory data analysis revealed potentially diverse results in the body of literature, or if confidence intervals frequently overlapped zero. The Community Guide rules evidence characterized effectiveness as strong, sufficient, or insufficient on the basis of the number of available studies, the suitability of study designs for evaluating effectiveness, the quality of execution, the consistency of the results and the effect sizes (2).
Table. Diabetes Self-Management in Community Settings
Cultural, environmental, and biomedical synthesis of diabetes self-management.The Diabetes Educator
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Jack L, Liburd L, Spencer T, et al. Understanding the Environmental Issues in Diabetes Self-Management Education Research: A Reexamination of 8 Studies in Community-Based Settings. Ann Intern Med. 2004;140:964–971. doi: 10.7326/0003-4819-140-11-200406010-00038
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Published: Ann Intern Med. 2004;140(11):964-971.
Cardiology, Coronary Risk Factors, Diabetes, Endocrine and Metabolism.
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