Alliance to Reduce Disparities in Diabetes

Health Literacy Conference - Memphis Site

Diabetes Conversation Maps: Journey to Better Diabetes Education
Patria Johnson, MSSW

Diabetes for Life (DFL) is a project of the Healthy Memphis Common Table and Memphis Healthy Churches.  DFL  is a self-management program aimed at reducing health disparities among African Americans with Type II diabetes in Memphis and Shelby County.  This project identifies and implements best practice models for evidenced-based chronic disease self-management.

Prior to beginning the education sessions, patients were administered a comprehensive survey that covered several domains of behavioral and situational factors related to diabetes self-management, such as: health care utilization, trust in health care provider, self-efficacy and perceived competence for diabetes self-management, resources and supports for diabetes self-management, as well as health-related quality of life.

In addition to case management, Participants attended three 2-hour sessions over a 3 week period using one of the three different
Conversation Map visuals at each visitConversation Map content is based on current clinical practice guidelines that represent the best interventions approaches and national standards for diabetes self-management education (DSME).  While the maps are designed to educate participants about some of the basics of diabetes, the sessions allow participants to ask questions about what they are most interested in learning.  Participants were instructed in an open forum on making Action Plans to set and reach self-management goals. The CDE facilitator encourages the participants to share stories and dialogue among group participants.

In preliminary analysis, participants showed statistically significant decreases in average total cholesterol and A1C, the gold standard for assessing diabetes management, over a 12-month timeline. Additionally, a significantly greater percentage of DFL participants reported being more physically active at follow-up than at intake., and the number of times participants had their A1C checked or their feet checked for sores increased significantly from intake to follow-up.

Participants were also significantly more likely at follow-up than at intake to say that a doctor had told them that diabetes had affected their eyes or that they had retinopathy., as well as to report having prepared a list of questions for their doctor and asked questions about things they wanted to know and things they didn’t understand about their treatment.

This research indicates that conversation maps are effective tools for teaching diabetes self-management to individuals at varying literacy levels, as it can encourage peer-to-per learning and self-efficacy in patients with diabetes, particularly those who are newly diagnosed, or have longer standing diagnoses, but may not understand the serious nature of chronic illness.