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Increasing capacity to deliver diabetes self-management education: results of the DESMOND lay educator non-randomized controlled equivalence trial

Carey, M. E., Mandalia, P. K., Daly, H., Gray, Laura J., Hale, R., Stacey, L. Martin, Taub, Nick, Skinner, Timothy C., Stone, Margaret, Heller, S., Khunti, K. and Davies, M. J. (2014). Increasing capacity to deliver diabetes self-management education: results of the DESMOND lay educator non-randomized controlled equivalence trial. Diabetic Medicine,31(11):1431-1438.

Document type: Journal Article
Citation counts: Altmetric Score Altmetric Score is 15
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IRMA ID 75039815xPUB584
Title Increasing capacity to deliver diabetes self-management education: results of the DESMOND lay educator non-randomized controlled equivalence trial
Author Carey, M. E.
Mandalia, P. K.
Daly, H.
Gray, Laura J.
Hale, R.
Stacey, L. Martin
Taub, Nick
Skinner, Timothy C.
Stone, Margaret
Heller, S.
Khunti, K.
Davies, M. J.
Journal Name Diabetic Medicine
Publication Date 2014
Volume Number 31
Issue Number 11
ISSN 0742-3071   (check CDU catalogue  open catalogue search in new window)
Start Page 1431
End Page 1438
Total Pages 8
Place of Publication United Kingdom
Publisher Wiley-Blackwell Publishing Ltd.
HERDC Category C1 - Journal Article (DIISR)
Abstract Aim
To develop and test a format of delivery of diabetes self-management education by paired professional and lay educators.

Methods
We conducted an equivalence trial with non-randomized participant allocation to a Diabetes Education and Self Management for Ongoing and Newly Diagnosed Type 2 diabetes (DESMOND) course, delivered in the standard format by two trained healthcare professional educators (to the control group) or by one trained lay educator and one professional educator (to the intervention group). A total of 260 people with Type 2 diabetes diagnosed within the previous 12 months were referred for self-management education as part of routine care and attended either a control or intervention format DESMOND course. The primary outcome measure was change in illness coherence score (derived from the Diabetes Illness Perception Questionnaire-Revised) between baseline and 4 months after attending education sessions. Secondary outcome measures included change in HbA1c level. The trial was conducted in four primary care organizations across England and Scotland.

Results
The 95% CI for the between-group difference in positive change in coherence scores was within the pre-set limits of equivalence (difference = 0.22, 95% CI 1.07 to 1.52). Equivalent changes related to secondary outcome measures were also observed, including equivalent reductions in HbA1c levels.

Conclusion
Diabetes education delivered jointly by a trained lay person and a healthcare professional educator with the same educator role can provide equivalent patient benefits. This could provide a method that increases capacity, maintains quality and is cost-effective, while increasing access to self-management education.
DOI http://dx.doi.org/10.1111/dme.12483   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
 
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