Providing evidence from practice: Evaluating 4.5 years of implementing diabetes education support program in carbohydrate management

Enrique L P Mergelsberg; Jenny L Olson; Sheryl Moore; Jessica F Jensen; Hayley Seivwright; Richard Norman; Natasha A Watson

doi:10.1016/j.pec.2022.02.001

Providing evidence from practice: Evaluating 4.5 years of implementing diabetes education support program in carbohydrate management

Patient Educ Couns. 2022 Jul;105(7):2225-2233. doi: 10.1016/j.pec.2022.02.001. Epub 2022 Feb 22.

Authors

Enrique L P Mergelsberg¹, Jenny L Olson², Sheryl Moore³, Jessica F Jensen⁴, Hayley Seivwright⁴, Richard Norman⁵, Natasha A Watson⁶

Affiliations

¹ National Evaluation Team, National Diabetes Services Scheme (NDSS), Diabetes Australia, 3/322 Hay Street Subiaco, Western Australia 6008, Australia; School of Population Health, Curtin University, Kent Street, Perth, Western Australia 6102, Australia. Electronic address: enrique@enberganalytics.com.au.
² National Evaluation Team, National Diabetes Services Scheme (NDSS), Diabetes Australia, 3/322 Hay Street Subiaco, Western Australia 6008, Australia.
³ Diabetes Educator, Health Services, Diabetes WA, 3/322 Hay Street Subiaco, Western Australia 6008, Australia.
⁴ Research and Evaluation Team, Diabetes WA, 3/322 Hay Street Subiaco, Western Australia 6008, Australia.
⁵ School of Population Health, Curtin University, Kent Street, Perth, Western Australia 6102, Australia.
⁶ National Evaluation Team, National Diabetes Services Scheme (NDSS), Diabetes Australia, 3/322 Hay Street Subiaco, Western Australia 6008, Australia; Research and Evaluation Team, Diabetes WA, 3/322 Hay Street Subiaco, Western Australia 6008, Australia.

PMID: 35221169
DOI: 10.1016/j.pec.2022.02.001

Abstract

Objective: To evaluate personal and economical outcomes of CarbSmart, a 3-hour person-centered, theory-based program implemented throughout Australia, targeting optimal dietary carbohydrate management.

Methods: More than 500 CarbSmart programs were implemented over 4.5 years. Pre-, post-, (N = 4656) and 3-month follow-up assessments (N = 188) of knowledge, empowerment, confidence, and patient activation were collected from people with diabetes. Participant satisfaction and potential annual cost-savings were calculated.

Findings: Repeated measures ANCOVAs showed large improvements pre- to post-program in all outcome variables (d = 0.80-1.68), which were maintained at 3-month follow-up in a sub-sample. Participant satisfaction was high (Net Promoter Score = 72.3). Potential annual cost-savings nation-wide were estimated at US$512million.

Conclusion: This paper provides evidence that CarbSmart is effective in improving behavioral indicators of self-management outcomes in Australians living with diabetes.

Practice implications: CarbSmart has the potential to prevent diabetes-related complications. However, not engaging people living with diabetes with lower levels of patient activation at baseline was recognized as a future opportunity to improve the impact of our service. Strategies are needed to engage people with lower activation levels to improve outcomes in vulnerable and at-risk populations.

Funding: The development of CarbSmart was funded by Diabetes WA, the national implementation of CarbSmart by the National Diabetes Services Scheme, an initiative of the Australian Government.

Keywords: Behavior change; Community program; Cost-analysis; Diabetes; Patient Education; Patient activation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Australia
Carbohydrates
Diabetes Mellitus* / therapy
Health Education
Humans
Self-Management*

Substances

Carbohydrates