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Chronic Illness, Vol. 2, No. 1, 27-38 (2006)
DOI: 10.1177/17423953060020011001
© 2006 SAGE Publications

Effects of a brief computer-assisted diabetes self-management intervention on dietary, biological and quality-of-life outcomes

Russell E. Glasgow

Kaiser Permanente Colorado, P.O.Box 378066, Denver, CO 80237-8066, USA, russg{at}ris.net

Paul A. Nutting

Center for Research Strategies LLC, 225 East 16th Ave, Suite 1150, Denver, CO 80203-1694, USA

Deborah J. Toobert

Oregon Research Institute, 1715 Franklin Blvd, Eugene, OR 97403, USA

Diane K. King

Kaiser Permanente Colorado, P.O.Box 378066, Denver, CO 80237-8066, USA

Lisa A. Strycker

Oregon Research Institute, 1715 Franklin Blvd, Eugene, OR 97403, USA

Marleah Jex

Kaiser Permanente Colorado, P.O.Box 378066, Denver, CO 80237-8066, USA

Caitlin O'Neill

Kaiser Permanente Colorado, P.O.Box 378066, Denver, CO 80237-8066, USA

Holly Whitesides

Kaiser Permanente Colorado, P.O.Box 378066, Denver, CO 80237-8066, USA

John Merenich

Kaiser Permanente Colorado, P.O.Box 378066, Denver, CO 80237-8066, USA

Objective: There is a need for practical, efficient and broad-reaching diabetes self-management interventions that can produce changes in lifestyle behaviours such as healthy eating and weight loss. The objective of this study was to evaluate such a computer-assisted intervention.

Methods: Type 2 diabetes primary care patients (n=335) from fee-for-service and health maintenance organization settings were randomized to social cognitive theory-based tailored self-management (TSM) or computer-aided enhanced usual care (UC). Intervention consisted of computer-assisted self-management assessment and feedback, tailored goal-setting, barrier identification, and problem-solving, followed by health counsellor interaction and follow-up calls. Outcomes were changes in dietary behaviours (fat and fruit/vegetable intake), haemoglobin A1c (HbA1c), lipids, weight, quality of life, and depression.

Results: TSM patients reduced dietary fat intake and weight significantly more than UC patients at the 2-month follow-up. Among patients having elevated levels of HbA1c, lipids or depression at baseline, there were consistent directional trends favouring intervention, but these differences did not reach significance. The intervention proved feasible and was implemented successfully by a variety of staff.

Conclusions: This relatively low-intensity intervention appealed to a large, generally representative sample of patients, was well implemented, and produced improvement in targeted behaviours. Implications of this practical clinical trial for dissemination are discussed.

Key Words: Diabetes • Self-management • Computer intervention • Dietary change • Randomized controlled trial


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