Identifying Best Practices of Diabetes Self-Management: A Mixed Methods Approach

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DESCRIPTION (provided by applicant): Diabetes is a growing public health concern. Although we know that lifestyle modifications such as proper diet, exercise, medication, and glucose testing are effective in improving glycemic control, there is little known about how patients who have been successful at maintaining A1c have implemented specific strategies in everyday life. The hypothesis is that effective diabetes self-management practices can be identified using qualitative research to study individuals who have been successful, and can be used in healthcare interventions. The aims of this proposal are: (1) identify the self-management practices of people with type 2 diabetes that are associated with successful glucose control (A1c <=7) through qualitative research (in- depth interviews, journals); (2) develop and optimize a survey of successful practices; and (3) validate the survey in a cross-sectional study with type 2 diabetes patients. The career objective of this K01 proposal is to become an independent investigator who specializes in qualitative research within behavioral health and chronic illnesses, such as diabetes. The proposal is novel because no survey of self-management practices has been developed using rigorous qualitative methods from successful diabetes patients, nor created using a comprehensive database of how those practices could be implemented into everyday life for those with type 2 diabetes. PUBLIC HEALTH RELEVANCE: Diabetes affects at least 23.6 million adults in the US and, despite evidence-based guidelines, the majority still have uncontrolled blood glucose (A1c > 7.0, ADA). Poor self-management leads to poor glucose control; however, there is little information about the relationship of specific patient self-care practices to glycemic control. Determining the practices that contribute to A1c success could have a substantial public health impact on managing the diabetes epidemic and improve the treatment of diabetes that drive the field.