Purpose: The purpose of this retrospective, mixed methods study is to examine the relationship between participation in an interdisciplinary diabetes self-management education (DSME) program at an urban primary health care center and patients’ perceived knowledge and skills, as well as clinical markers, on four cohorts of patients over a two-year period. Methods: Participants, mainly African-American females, responded to survey questions including self-care behaviors, perceived knowledge, and self-efficacy. The researchers also reviewed the participants’ clinical records for glycosylated hemoglobin (HbA 1c) and body mass index (BMI) data and compared these to similar patients in the health center who had not participated in the DSME program. Additional analysis involved a cross comparison of earlier cohorts (2014-15) to later cohorts (2016-17). Results: Quantitative analysis showed strong statistical evidence that those in the DSME program had more control over their BMI as compared to the control group. The results also suggested that those in the program after 2016 had more control over their HbA1c than those in the program before 2016, although this evidence was more limited. Qualitative themes that emerged highlighted the participants’ valuing most what they learned about nutrition, exercise, and disease management. Conclusions: Population specific DSME programs can help produce both quality of life and clinical improvements that persist over time in underserved populations. This study was limited by a small sample size.

Author Bio(s)

William Lonneman, DNP, RN is Assistant Professor and Interim Director of the RN-to-BSN program at Western Washington University. He was previously part of the nursing faculty at Mount St. Joseph University in Cincinnati, Ohio.

Bethanne Brown PharmD, BCACP, is a Professor of Pharmacy Practice and Residency Program Director at the University of Cincinnati College of Pharmacy. Her clinical practice includes providing chronic disease state management services for underserved populations.

Chalee Engelhard, PT, EdD, MBA, is the University of Cincinnati Doctor of Physical Therapy Program Director in the College of Allied Health Sciences (CAHS). She also serves as CAHS’ IPE Leader and the Cincinnati VAMC’s Physical Therapy Geriatric Residency Academic Director.

Kimihiro Noguchi, PhD, is an Associate Professor in the Department of Mathematics at Western Washington University in Bellingham, WA. Grace McFarlane, B.S., is a graduate of the Department of Mathematics at Western Washington University. Diane Warner, RD, LD, is a Registered Dietician with the Cincinnati Health Department. She works at thePrice Hill Health Center WIC office. Akino Kishigawa, CDT, EFDA, RDH, is a dental hygienist at the Cincinnati Health Department. She works at the Deaconess Health Check at Western Hills, a school-based dental center, providing care to the underserved community.


The authors would like to thank the staff and patients at the Price Hill Health Center in Cincinnati, as well as the staff at the Cincinnati Health Department for their support of this study. The authors all approve of this article as it appears here. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors have indicated that they have no conflicts of interest regarding the content of this article.





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