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The Diabetes Educator
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FEATURES

Healthy ChangesTM for Living With Diabetes

An Evidence-Based Community Diabetes Self-management Program

Cindy Klug, MST, CHES, Deborah J. Toobert, PhD and Michaela Fogerty, MS

From the Providence Health System, Portland, Oregon (Ms Klug), and the Oregon Research Institute, Eugene (Dr Toobert).

Correspondence to Cindy Klug, MST, CHES, Providence Center on Aging, Providence Health System, 10150 SE 32nd Avenue, Portland, OR 97222 (cindy.klug{at}providence.org).

Purpose

This article addresses the gap between research and practice by describing the feasibility and outcomes of an evidence-based diabetes self-management health education program. The Healthy ChangesTM program used a peer-led group format to promote physical activity and healthful eating practices, using culturally relevant materials and measures.

Methods

Older adults (mean age = 69.2 years; SD = 10.7) with type 2 diabetes (N = 243) were recruited from 9 communities to participate in the Healthy ChangesTM program. Components included goal setting, problem solving, group support, and interactive lectures from experts. Measures of eating patterns, physical activity, body weight, community resources, self-rated health, and self-efficacy were administered at baseline, and at 4, 8, and 12 months.

Results

Participants attended on average 13 weekly sessions, and showed improvements in health behaviors, supportive resources, and self-efficacy at 4, 8, and 12 months.

Conclusions

The Healthy ChangesTM program can be successfully translated into community settings and led by trainedpeer leaders, yielding health improvements similar to those reported in efficacy trials. Trained peer leaders are key to effective program implementation. Peer-led groups enhance goal attainment by giving participants a venue to discuss obstacles and strategize solutions.

The Diabetes Educator, Vol. 34, No. 6, 1053-1061 (2008)
DOI: 10.1177/0145721708325886
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