Horm Metab Res 2014; 46(13): 933-938
DOI: 10.1055/s-0034-1389952
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

Enhancing the Effectiveness of Diabetes Self-Management Education: The Diabetes Literacy Project

S. Van den Broucke
1   Université catholique de Louvain, Louvain-La-Neuve, Belgium
,
G. Van der Zanden
1   Université catholique de Louvain, Louvain-La-Neuve, Belgium
,
P. Chang
2   Taipei Medical University, Taipei Hospital, MOHW, Taipei, Taiwan
,
G. Doyle
3   University College Dublin, Dublin, Ireland
,
D. Levin
4   Clalit Health Services & University of Haifa, Tel Aviv, Israel
,
J. Pelikan
5   Ludwig Boltzman Institute of Health Promotion Research, Vienna, Austria
,
D. Schillinger
6   University of San California at San Francisco, San Francisco, USA
,
P. Schwarz
7   Technical University Dresden, Dresden, Germany
,
K. Sørensen
8   Maastricht University, Maastricht, The Netherlands
,
L. Yardley
9   University of Southampton, Southampton, UK
,
H. Riemenschneider
7   Technical University Dresden, Dresden, Germany
› Author Affiliations
Further Information

Publication History

received 02 May 2014

accepted 20 August 2014

Publication Date:
22 October 2014 (online)

Abstract

Patient empowerment through self-management education is central to improving the quality of diabetes care and preventing Type 2 Diabetes. Although national programs exist, there is no EU-wide strategy for diabetes self-management education, and patients with limited literacy face barriers to effective self-management. The Diabetes Literacy project, initiated with the support of the European Commission, aims to fill this gap. The project investigates the effectiveness of diabetes self-management education, targeting people with or at risk of Type 2 Diabetes in the 28 EU Member States, as part of a comprehensive EU-wide diabetes strategy. National diabetes strategies in the EU, US, Taiwan, and Israel are compared, and diabetes self-management programs inventorized. The costs of the diabetes care pathway are assessed on a per person basis at national level. A comparison is made of the (cost)-effectiveness of different methods for diabetes self-management support, and the moderating role of health literacy, organization of the health services, and implementation fidelity of education programs are considered. Web-based materials are developed and evaluated by randomized trials to evaluate if interactive internet delivery can enhance self-management support for people with lower levels of health literacy. The 3-year project started in December 2012. Several literature reviews have been produced and protocol development and research design are in the final stages. Primary and secondary data collection and analysis take place in 2014. The results will inform policy decisions on improving the prevention, treatment, and care for persons with diabetes across literacy levels.

 
  • References

  • 1 Health Service Executive. National Service Plan. 2011
  • 2 Hjartaker A, Langseth H, Weiderpass E. Obesity and diabetes epidemics: cancer repercussions. Adv Exp Med Biol 2008; 630: 72-93
  • 3 Blüher S, Molz E, Wiegand S, Otto KP, Sergeyev E, Tuschy S, l’Allemand-Jander D, Kiess W. Holl R for the APV initiative and the German Competence Net Obesity . Body Mass Index, waist circumference, and waist-to-height ratio as predictors of cardiometabolic risk in childhood obesity depending on pubertal development. J Clin Endocrinol Metab 2013; 98: 3384-3393
  • 4 The diabetes pandemic. Lancet 2011; 378: 99
  • 5 Schwarz PE, Lindstrom J, Kissimova-Scarbeck K, Szybinski Z, Barengo NC, Peltonen M, Tuomilehto J. The European perspective of type 2 diabetes prevention: diabetes in Europe – prevention using lifestyle, physical activity and nutritional intervention (DE-PLAN) project. Exp Clin Endocrinol Diabetes 2008; 116: 167-172
  • 6 Schwarz PE, Muylle F, Valensi P, Hall M. The European perspective of diabetes prevention. Horm Metab Res 2008; 40: 511-514
  • 7 Pajunen P, Landgraf R, Muylle F, Neumann A, Lindström J, Schwarz PE. Peltonen M on behalf of the IMAGE Study Group . Quality indicators for the prevention of type 2 diabetes in Europe – IMAGE. Horm Metab Res 2010; 42 (Suppl. 01) S56-S63
  • 8 Lindstrom J, Neumann A, Sheppard KE, Gilis-Januszewska A, Greaves CJ, Handke U, Pajunen P, Puhl S, Pölönen A, Rissanen A, Roden M, Stemper T, Telle-Hjellset V, Tuomilehto J, Velickiene D, Schwarz PE. on behalf of the IMAGE Study Group . Take action to prevent diabetes – the IMAGE toolkit for the prevention of type 2 diabetes in Europe. Horm Metab Res 2010; 42 (Suppl. 01) S37-S55
  • 9 Paulweber B, Valensi P, Lindstrom J, Lalic NM, Greaves CJ, McKee M, Kissimova-Skarbek K, Liatis S, Cosson E, Szendroedi J, Sheppard KE, Charlesworth K, Felton A-M, Hall M, Rissanen A, Tuomilehto J, Schwarz PE. Roden M on behalf of the IMAGE Study Group . A European evidence-based guideline for the prevention of type 2 diabetes. Horm Metab Res 2010; 42 (Suppl. 01) S3-S36
  • 10 Schwarz PE, Greaves CJ, Lindstrom J, Yates T, Davies MJ. Nonpharmacological interventions for the prevention of type 2 diabetes mellitus. Nat Rev Endocrinol 2012; 8: 363-373
  • 11 Fond-Harmant L. Diabetes plans in six European countries and in Canada. Sante Publique 2011; 23: 41-53
  • 12 Boren SA, Fitzner KA, Panhalkar PS, Specker JE. Costs and benefits associated with diabetes education: a review of the literature. Diabetes Educ 2009; 35: 72-96
  • 13 Minet L, Moller S, Vach W, Wagner L, Henriksen JE. Mediating the effect of self-care management intervention in type 2 diabetes: a meta-analysis of 47 randomised controlled trials. Patient Educ Couns 2010; 80: 29-41
  • 14 Carroll C, Patterson M, Wood S, Booth A, Rick J, Balain S. A conceptual framework for implementation fidelity. Implement Sci 2007; 2: 40
  • 15 Boren SA. A review of health literacy and diabetes: opportunities for technology. J Diabetes Sci Technol 2009; 3: 202-209
  • 16 Wallace AS, Seligman HK, Davis TC, Schillinger D, Arnold CL, Bryant-Shilliday B, Freburger JK, DeWalt DA. Literacy-appropriate educational materials and brief counseling improve diabetes self-management. Patient Educ Couns 2009; 75: 328-333
  • 17 Schwarz PEH, Gallein G, Ebermann D, Müller A, Lindner A, Rothe U, Tibor Nebel I, Müller G. Global Diabetes Survey – An annual report on quality of diabetes care. Diabetes Res Clin Pract 2013; 100: 11-18
  • 18 Massi-Benedetti M. The cost of diabetes Type II in Europe: the CODE-2 Study. Diabetologia 2002; 45: S1-S4
  • 19 International Diabetes Federation . Diabetes Atlas. 6th edition International Diabetes Federation; 2013
  • 20 Anderson W. Managing costs and cost structure throughout the value chain: research on strategic cost management. Handbooks of Management Accounting Research 2006; 2: 481-506
  • 21 Kaplan RS, Porter ME. How to solve the cost crisis in health care. Harvard Business Review 2011; 89: 46-52
  • 22 Chapman CS, Kern A, Laguecir A, Angele-Halgand N, Angert A, Campanele C, Cinquini L, Doyle G, Garrot T, Hansen A, Hartmann F, Hinz V, Mateus C, Perego P, Sikkut R, Tenucci A, Quentin Q. International approaches to clinical costing, Healthcare Financial Management Association. London: 2013
  • 23 Healthcare Financial Management Association . Acute health clinical costing standards 2012/13. London: 2012
  • 24 AADE7 . Self-Care Behaviors. Diabetes Educ 2008; 34: 445-449
  • 25 Sorensen K, Van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z. Brand H for the European Health Literacy Conortium . Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health 2012; 12: 80
  • 26 Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K. Low health literacy and health outcomes: an updated systematic review. Ann Intern Med 2011; 155: 97-107
  • 27 Schillinger D, Grumbach K, Piette J, Wang F, Osmond D, Daher C, Palacios J, Diaz Sullivan G, Bindman AB. Association of health literacy with diabetes outcomes. JAMA 2002; 288: 475-482
  • 28 Sarkar U, Schillinger D, Lopez A, Sudore R. Validation of self-reported health literacy questions among diverse English and Spanish-speaking populations. J Gen Intern Med 2011; 26: 265-271
  • 29 HLS-EU Consortium. Comparative report of health literacy in eight EU Member States. The European Health Literacy Survey HLS-EU. http://www.health-literacy.eu.2012 (22 June 2014 last accessed)
  • 30 Hasson H. Systematic evaluation of implementation fidelity of complex interventions in health and social care. Implement Sci 2010; 5: 67
  • 31 Norris SL, Engelgau MM, Venkat-Narayan KM. Effectiveness of self-management training in type 2 diabetes. A systematic review of randomized controlled trials. Diabetes Care 2001; 24: 561-587
  • 32 Schinckus L, Van den Broucke S, Housiaux M. Assessment of implementation fidelity in diabetes self-management education programs: A systematic review. Patient Educ Couns 2014; 96: 13-21
  • 33 Morrison L, Joseph J, Andreou P, Yardley L. Application of the lifeGuide: a think-aloud study of users’ experiences of the ‘internet doctor’. In 5th International Conference on e-Social Science, Cologne, Germany, 24–26 Jun 2009; 2010: 4
  • 34 Charters E. The use of Think-aloud Methods in Qualitative Research An Introduction to Think-aloud Methods. Brock Education 2003; 12: 68-82