Comparative effectiveness of telehealth-delivered family and standard models of diabetes self-management education and support for persons with type 2 diabetes mellitus

IF 4.6 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice Pub Date : 2026-02-01 Epub Date: 2025-12-20 DOI:10.1016/j.diabres.2025.113063

Jennifer A. Andersen , Pearl A. McElfish , James P. Selig , Ji Li , Brett Rowland , Jonell Hudson , Shashank Kraleti , Joseph Henske , Lindsay S. Mayberry

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引用次数: 0

Abstract

Aims

Family members/support persons can shape the self-management decisions of persons with T2DM (PWDs), and their inclusion in DSMES may lead to improved outcomes. However, research on the effectiveness of family models of DSMES (Family-DSMES) is limited. We conducted a comparative effectiveness-implementation RCT of Family-DSMES and a standard model of DSMES (Standard-DSMES) delivered via telehealth.

Methods

550 diverse adult PWDs and their family members/support persons were recruited from eight primary care clinics in both rural and urban areas. Process data was collected to evaluate implementation characteristics. Biometric, behavioral, and psychosocial measures were collected from PWDs.

Results

Mean attendance was slightly higher for PWDs in Family-DSMES than Standard-DSMES (62 % vs. 57 %, p = 0.096). Engagement (p = 0.319) and class time (p = 0.145) were similar across arms. PWDs in both arms experienced a decrease in HbA1c at all time points (p < 0.005). No statistically significant between-arm differences were found for biometric outcomes or behavioral outcomes including HbA1c. For diabetes-related helpful family involvement, the improvement in the Family-DSMES arm was significantly greater than in the Standard-DSMES arm (p = 0.024).

Conclusions

Results demonstrate the ability to engage rural and diverse PWDs in a telehealth intervention with high fidelity to achieve clinically and statistically significant improvements in HbA1c.

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远程保健提供的糖尿病自我管理教育和支持的家庭和标准模式对2型糖尿病患者的比较效果

目的：家庭成员/支持人员可以影响T2DM （PWDs）患者的自我管理决策，将他们纳入DSMES可能会改善结果。然而，对中小企业家庭模型有效性的研究却非常有限。我们对家庭DSMES和通过远程医疗提供的DSMES标准模型（standard -DSMES）进行了比较有效性实施的随机对照试验。方法：从农村和城市的8个初级保健诊所招募了550名不同类型的成年残疾人及其家庭成员/支持人员。收集过程数据以评估实施特征。收集了PWD患者的生物特征、行为和社会心理测量数据。结果：家庭- dsmes中pwd的平均出勤率略高于标准- dsmes（62 %对57 %，p = 0.096）。两组受试者的参与度（p = 0.319）和上课时间（p = 0.145）相似。两组残疾患者的HbA1c在所有时间点均出现下降（p ）。结论：研究结果表明，能够让农村和不同类型的残疾患者参与远程医疗干预，以高保真度实现临床和统计学上显著的HbA1c改善。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes research and clinical practice 医学-内分泌学与代谢

CiteScore

10.30

自引率

3.90%

发文量

862

审稿时长

32 days

期刊介绍： Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.