“Sticking to it—Diabetes Mellitus”: A Pilot Study of an Innovative Behavior Change Program for Women with Type 2 Diabetes

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Abstract
The goal of this project was to evaluate an innovative educational program for women with type 2 diabetes facilitated by trained lay health advisors from the local university extension service. The program focused on adherence to behaviors recommended to achieve optimal blood glucose control. We evaluated whether primary care physicians would refer to this program, whether the program would reach diabetic women in rural areas, and whether the program improved health behaviors and glycemic control. Women over 40 with type 2 diabetes were recruited through their primary care physician's offices. Eligible participants were randomly assigned to intervention (program) or control (usual care) groups. The six-session educational program focused on encouraging behavior change through instructor and group support, learning specific behavior change skills, and developing a confident attitude about self-management of diabetes. Physicians supported referral to the program, and the utilization of a lay health advisor for delivery of the program in rural areas was feasible. At 6-month follow-up the mean change in hemoglobin A1c and body mass index did not differ significantly between the intervention (n=67) and control (n=65) groups. However, participants felt better about their ability to control their diabetes and demonstrated an improvement in behaviors related to control.