Understanding the Environmental Issues in Diabetes Self-Management Education Research: A Reexamination of 8 Studies in Community-Based Settings

1 June 2004 | Volume 140 Issue 11 | Pages 964-971

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.

Author and Article Information

From the National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California; and The Pennsylvania State University, University Park, Pennsylvania.

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, ljack{at}cdc.gov.

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.