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AADE7TM Self-Care Behaviors: Systematic ReviewsCorrespondence to Suzanne Austin Boren, PhD, MHA, Harry S. Truman Memorial Veterans Hospital, 800 Hospital Drive, Columbia, MO 65201 (borens{at}health.missouri.edu).
The 7 systematic reviews published in this issue of The Diabetes Educator draw on the best health services research principles and methods to address the following question: what is the state of the evidence regarding each of the AADE7TM Self-Care Behaviors (healthy eating, being active, monitoring, taking medication, problem solving, healthy coping, and reducing risks)? The AADE Research Committee commissioned these 7 systematic reviews as a step in developing the evidence base for self-care behaviors for those with diabetes. The systematic reviews are research pieces, and that is how they are intended to be used. Each systematic review is accompanied by a commentary that speaks about the state of evidence for applicability to practice and identifies gaps to guide future research. The translation from research to meaningful use in members' practices will occur over time with the valuable contribution of individual practicing diabetes educators. These 7 systematic reviews lay a very important cornerstone for evidence around self-care behaviors. The 7 reviews provide a systematic, explicit, and reproducible method for identifying, evaluating, and synthesizing the existing body of original published work produced by researchers, scholars, and practitioners. Systematic literature reviews are different from more subjective examinations of published information because they are done analytically with well-described and justified processes. This process enables others to reproduce the methods and to make a rational determination of whether to accept the results of the review. To identify articles, the authors searched several bibliographic databases (eg, PubMed/Medline, Cumulative Index to Nursing & Allied Health Literature [CINAHL], PsycINFO, Educational Resource Information Center [ERIC], International Pharmaceutical Abstracts [IPA], Health and Psychosocial Instruments [HaPI], Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials) using carefully selected search terms. Articles were selected for inclusion in the systematic reviews based on the following criteria: (1) published from 1990 to the present, (2) contained both type 1 and type 2 diabetes patients, (3) limited to English-language studies, and (4) were not limited to studies based only in the United States. The authors abstracted information such as participants' characteristics, details of the intervention and control groups, and outcomes or results from the eligible articles. Each author examined all of the specified categories of outcomes according to the diabetes self-management education core outcome measures continuum (learning, behavior change, clinical improvement, and improved health status).1 Applying the principles of health services research, the authors aimed to synthesize the abstracted information, summarize key findings, and interpret the results in light of the totality of available evidence to provide a concise statement on the overall state of evidence. In addition, the authors applied the American Diabetes Association's Evidence Grading System for Clinical Practice Recommendations to each of the eligible articles.2 We asked the authors and peer reviewers to use a modified version of the QUOROM Statement Checklist to ensure the quality and completeness of each of the systematic reviews.3 The QUOROM Statement Checklist is recognized by the International Committee of Medical Journal Editors as the reporting guidelines for systematic reviews and meta-analyses. The QUOROM Statement Checklist provides helpful guidance to authors, more objective refereeing, and higher quality systematic reviews for the readership/audience. These systematic reviews provide a scientific foundation for self-care behaviors that will be used to connect what we do as diabetes educators to the broader health care and reimbursement communities. There is a strong likelihood that future endeavors that grow out of this initial work will be highly relevant and applicable to the practice of diabetes education.
The views expressed in this article are those of the author and do not necessarily represent the views of the Department of Veterans Affairs.
The Diabetes Educator, Vol. 33, No. 6,
866-871 (2007) This article has been cited by other articles:
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