Effectiveness of using group visit model to support diabetes patient self-management in rural communities of Shanghai: a randomized controlled trial

BMC Public Health

Research Article

Dongbo Fu¹  Hua Fu¹  Xiaoying Ma²  Wei Luo³  Shengsheng Liu³  Anhua Bi³  Liyan Zhuang⁴ 

[1] Department of Preventive Medicine, School of Public Health, Fudan University, 138 Yi Xue Yuan Road, 20032, Shanghai, China;Fangsong Community Health Centre, Shanghai, China;Songjiang District Centre for Disease Prevention and Control, 1050 North Xi Lin Road, 201620, Shanghai, China;Zhongshan Community Health Centre, Shanghai, China;

关键词: Diabetes;    Group visits;    Self-management;    Community health services;    Randomized controlled trials;    China;   

DOI  :  10.1186/1471-2458-12-1043

 received in 2012-05-22, accepted in 2012-11-29,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundDiabetes has become a major public health problem in China. Support of patient self-management is a key component of effective diabetes care and improved patient outcomes. A series of peer-led community-based disease-specific self-management programs including diabetes have been widely disseminated in urban communities of Shanghai since 1999. However, the strategy of using trained lay leaders to support patient self-management faces challenges in rural communities in Shanghai. This study developed a Chinese diabetes group visit program as an alternative approach to support patient self-management and examined its effectiveness on self-management behaviors, self-efficacy and health status for patients with type 2 diabetes in rural communities of Shanghai.Methods208 patients with type 2 diabetes aged 35–80 years were randomly assigned to the intervention group (n=119) of 12 monthly group visit sessions or to a control group (n=89) of usual care. The trial was undertaken in two rural communities in Shanghai, China. Randomization and allocation to study group were carried out by using a random number table. Analysis of covariance was used to compare changes in the 17 self-management behavior, self-efficacy and health status related variables in two groups at 12 months’ follow-up based on 176 patients (n=98; n=78).ResultsCompared with controls, the intervention patients, on average, increased their duration of aerobic exercise by more than 40 minutes per week (p=0.001); had significant increase of 0.71 in mean score on self-efficacy to manage diabetes (p=0.02); and had significant improvements in measures of illness intrusiveness and systolic blood pressure. The intervention patients attended an average of 10.1 of the 12 program sessions with 75.6% of them attended 10 and more sessions.ConclusionThe Chinese diabetes group visit model is a feasible, acceptable and effective alternative for supporting diabetes patient self-management in Chinese rural communities. The model requires larger studies to determine its effect on blood glucose control and health care utilization.Trial registrationISRCTN87909028

【 授权许可】

Unknown   
© Liu et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.