Article Text

  1. J. P. Lemos,
  2. R. Koshi
  1. Puget Sound Neighborhood Health Centers, Seattle, WA; University of Washington School of Medicine, Seattle, WA


A pilot test was conducted to evaluate effectiveness of a new group model for improving self-efficacy in the self-management of diabetes. Self-management is the main component to improving long-term diabetes outcomes. Patients need to have on average a level of self-efficacy of 7/10 in order to be successful in behavior change. The Lorig model of self-management has been tested among low-income and Hispanic populations with equal success in improving diabetes outcomes. In both of those studies, participants had a level of self-efficacy at or above 7.0. This study sought to identify people with low self-efficacy scores to participate in a new group model aimed at improving self-efficacy in self-management of diabetes. The study intervention involved a single group visit with a multidisciplinary team aimed at problem-solving barriers to behavior change. The aim was to measure pre- and post-intervention self-efficacy scores with a validated self-efficacy scale developed by Lorig and colleagues.

Methods This was a pilot study using a pre-test/post-test design to see if the group intervention improved self-efficacy scores. The group meeting was held as a single session, facilitated by a behavioral health specialist. The session lasted 1.5 hours and followed self-efficacy theory and problem-solving techniques. Six questions were presented. Participants broke into diads, taking turns to listen and respond to each other. Then they would present their findings to the group. The final result was a self-management goal set by participants, with the study team providing support and recording goals into the diabetes registry.

Results The study had 7 participants in two groups. The sample was drawn from one community health clinic serving uninsured, low-income populations. The study was limited to English-speaking participants. All participants were Caucasian. The average self-efficacy score before class was 5.65; the average after the class was 6.1. The average change was .45 (p < .10); however, sample size was small.

Conclusions An improvement in self-efficacy was noted (p < .10), but it is not entirely clear whether this change is due to a change in group format or educational content. There was timely information and assistance to participants in setting self-management goals. Participants were able to receive answers to questions they raised when multiple different providers were present. The content of the group session was not focused on a particular didactic topic but rather worked participants through a problem-solving session about barriers they identified to achieving behavior change. The solutions were the results of the group discussion.

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