Welcome to The Community Guide! Let us know what you think of the website by completing this quick survey.

Diabetes: Self-Management Education In Community Gathering Places – Adults with Type 2 Diabetes - Inactive

Tabs

What the CPSTF Found

About The Systematic Review

The CPSTF finding is based on evidence from a systematic review of 8 studies (search period through December 2000). The review was conducted on behalf of the CPSTF by a team of specialists in systematic review methods, and in research, practice, and policy related to diabetes prevention and control.

Context

There is no information for this section.

Summary of Results

Detailed results from the systematic review are available in the CPSTF finding pdf icon [PDF - 136 kB].

Eight studies were included in the systematic review.

  • Glycated hemoglobin (GHb) levels: mean decrease of 1.9 percentage points (95% CI:–2.4, –1.4; 4 studies)
  • Fasting blood glucose (mmol/L): median decrease of 2.0 (range: –1.3 to –4.0; 4 studies)
  • Weight (lbs): median decrease of 5.2 lbs (range: –9.0 to 1.6; 6 studies)
  • Blood pressure (mmHg): decreases in favor of the intervention (2 studies)
  • Cholesterol (mg/dL): inconsistent findings (3 studies)

Summary of Economic Evidence

An economic review of this intervention did not find any relevant studies.

Applicability

This review should be applicable to adults with type 2 diabetes with a range of racial and ethnic backgrounds and in a variety of settings. Applicability is limited, however, by the self-selected nature of study populations, high attrition rates, and high baseline GHb levels.

Evidence Gaps

Each Community Preventive Services Task Force (CPSTF) review identifies critical evidence gaps—areas where information is lacking. Evidence gaps can exist whether or not a recommendation is made. In cases when the CPSTF finds insufficient evidence to determine whether an intervention strategy works, evidence gaps encourage researchers and program evaluators to conduct more effectiveness studies. When the CPSTF recommends an intervention, evidence gaps highlight missing information that would help users determine if the intervention could meet their particular needs. For example, evidence may be needed to determine where the intervention will work, with which populations, how much it will cost to implement, whether it will provide adequate return on investment, or how users should structure or deliver the intervention to ensure effectiveness. Finally, evidence may be missing for outcomes different from those on which the CPSTF recommendation is based.

Identified Evidence Gaps

More studies are needed to examine the effectiveness of DSME interventions in community gathering places.

  • Which settings are optimal?
  • What is the best way to recruit people with diabetes to these interventions?
  • Who is the ideal provider in these settings?
  • What is the optimal intensity and duration of interventions in community gathering places?
  • What type of maintenance-phase interventions are best?
  • How do DSME interventions in community gathering places compare with those delivered in the clinical setting with respect to effectiveness, ease of implementation, barriers, long-term maintenance capabilities, and cost-effectiveness?
  • Which characteristics of community gathering places affect adoption and outcomes of DSME interventions?
  • How are these interventions best coordinated with primary care?
  • Are there racial or ethnic groups that perceive a relatively greater need for DSME in alternative settings?
  • Are there racial or ethnic groups that may benefit more from community interventions compared with interventions delivered in the clinic setting?

Study Characteristics

Included studies evaluated a variety of outcomes, such as changes in knowledge, physical activity, dietary intake, weight, blood pressure, lipid concentrations, fasting blood glucose, and GHb levels.

  • The mean age of participants ranged from 43 to 71 years in the seven studies that reported age; nearly all of the studies included males and females.
  • All of the studies were performed in the U.S.; three were done in rural areas.
  • Evaluated interventions took place in faith-based institutions (2 studies), community centers (5 studies), and a residential treatment center (1 study).
  • Included studies reported a wide range of attrition rates among participants (0% to 79%); in four studies these rates exceeded 20%.

Publications