Diabetes Self-Management Program (DSMP) Program Synopsis

Implemented widely by the Administration on Aging, the Center for Disease Control and Prevention, and the National Council on Aging. Web Site: http://patienteducation.stanford.edu/programs/diabeteseng.html I. General description of program

The DSMP is a peer-led and self-management program that assists individuals in gaining and developing the knowledge, skills, and motivation they need to manage the day-to-day realities of their diabetes. The program provides information and teaches practical skills on Type II Diabetes that will benefit both individuals with Type II Diabetes and those at risk for developing Type II Diabetes. The DSMP gives people the confidence and motivation they need to manage the challenges of living with diabetes.

II. Program goal

The overall goal is to enable participants to build self-confidence to take part in maintaining their health and managing their diabetes and/or reduce the risk of developing diabetes.

III. Reasoning behind the program design and elements:

People with diabetes have similar concerns and problems; People with diabetes must deal not only with their disease(s), but also with the impact on their lives and emotions; Lay people with diabetes, when given a detailed leader's manual, can teach the CDSMP as effectively, if not more effectively, than health professionals (Lorig et al, 1999); The process or the way the CDSMP is taught is as important, if not more important, than the subject matter that is taught.

IV. Target population

Adults with Type II Diabetes and adults at-risk for developing Type II Diabetes

V. Essential program components and activities

The DSMP focuses on problems common to individuals suffering from diabetes. Coping strategies such as action planning and feedback, behavior modeling, problem-solving techniques, and decision making are applicable to all chronic diseases. Individuals are taught to control their symptoms through:

 Breathing techniques Healthy eating Thinking activities Action planning Problem solving Medication management

Physical activity Stress management Monitoring blood sugar Communication Working with health care providers

The DSMP covers the following topics: Healthy eating and meal planning; Monitoring blood sugar levels; Preventing low blood sugar; Preventing and delaying complications from diabetes; Guidelines for safely exercising and maintaining balance of blood sugar; Reading nutrition labels; Foot care; Dealing with anger, depression, and other negative emotions; Communication with family/friends/physicians; Strategies for sick days; and Developing decision-making and problem-solving skills.

VI. Length/Timeframe of program 2.5 hours per week over a 6 week period. VII. Recommended class size 10-16 people VIII. Desired outcomes Increases in healthy behaviors (i.e., exercise and cognitive symptom management techniques, such as relaxation); Positive changes in health status (less pain, fatigue, and worry; less health distress); Increased self-efficacy; Better communications with health providers; Fewer visits to physicians and emergency rooms. IX. Program effectiveness The DSMP was originally written in Spanish for a research project funded by the National Institute of Nursing Research. The study was completed in 2007. Results showed that participants, as compared with people who did not take the workshop, demonstrated improved health status, health behavior, and selfefficacy, as well as fewer emergency room visits. At one year, the improvements were maintained.

Shortly after the Spanish study, the California Healthcare Foundation funded a similar study for the English version of the program. The study is complete. Participants made changes in health status, health behaviors, and self-efficacy.