This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Thoolen, B. Articles by Rutten, G. Search for Related Content PubMed PubMed Citation Articles by Thoolen, B. Articles by Rutten, G. Social Bookmarking                   What's this?

Who Participates in Diabetes Self-management Interventions?

Issues of Recruitment and Retainment

From the Department of Clinical and Health Psychology, Utrecht University, Utrecht, the Netherlands (Mr Thoolen, Dr de Ridder, Dr Bensing); Netherlands Institute for Health Services Research, Utrecht, the Netherlands (Dr Bensing); and the Julius Center for Health Sciences and Primary Care, Utrecht, the Netherlands (Dr Gorter, Dr Rutten).

Correspondence to Bart Thoolen, MSc, Department of Clinical and Health Psychology, Utrecht University, PO Box 80.140, 3508 TC Utrecht, the Netherlands (b.j.thoolen{at}fss.uu.nl).

Purpose

The purpose of this study was to examine reasons for nonparticipation and drop out in a diabetes self-management intervention.

Methods

A total of 468 recently screen-detected patients, receiving usual care or intensive pharmacological treatment, were invited and randomized into either a control or intervention condition, consisting of a brief self-management course. A nonresponse survey was conducted, and participants, nonparticipants, and dropouts were compared on sociodemographic variables, diabetes attitudes, and self-care.

Results

A total of 227 patients consented and were allocated to the control (n = 108) or intervention group (n = 119). Two hundred forty-one patients declined participation, 41 dropped out, and 78 completed the intervention. Major reasons for refusal and drop out were hesitancy toward research and practical barriers. Nonparticipants were less educated and reported higher self-management, while participation also varied by treatment and disease duration: intensively treated patients were more likely to participate in their first year, and usual-care patients participated more often 2 to 3 years after diagnosis. Dropouts had a lower education level but did not differ on any other measure.

Conclusion

Participants, nonparticipants, and dropouts did not differ in their attitudes toward diabetes, but the intervention did attract patients with lower self-care. Variations in participation by treatment and disease duration suggest that patients prefer self-management interventions at different times depending on their medical treatment. Finally, education appears to be the most important factor determining participation. Alternative strategies are needed to attract and retain patients with low education.

CiteULike

Connotea

Del.icio.us

Digg

Reddit

Technorati

This article has been cited by other articles:

				J. M. Robbins, G. E. Thatcher, D. A. Webb, and V. G. Valdmanis Nutritionist Visits, Diabetes Classes, and Hospitalization Rates and Charges: The Urban Diabetes Study Diabetes Care, April 1, 2008; 31(4): 655 - 660. [Abstract] [Full Text] [PDF]