Fact Sheet - Completed!
What is the Self-Management @ Stanford Online Healthier Living with Diabetes Study?
Self-Management @ Stanford: Healthier Living with Diabetes is an online workshop and study given on the Internet. Groups of about 25 people with type 2 diabetes participate together. Workshops are facilitated by two trained moderators, one or both of whom are peers with diabetes. Topics include: 1) blood glucose management, 2) healthy eating, 3) balancing food, exercise, medication and stress, 4) understanding A1C, lipids, body mass index, blood pressure numbers, 5) weight control, 6) exercise, 7) hypoglycemia, 8) managing sick days, 9) working with health care providers, 10) managing emotions and relationships.
It is the process in which the online workshop is presented that makes it unique. Sessions are highly participative through messaging and online discussion boards, where mutual support and success builds the participants’ confidence in their ability to manage their health and maintain active and fulfilling lives.
Each workshop is 6 weeks with new lessons each week. Participants are asked to log on at their convenience 2-3 times each week for a total of 1-2 hours. There are no requirements that participants log in at the same time.
Does the program replace existing programs and treatments?
The online workshop will not conflict with existing programs or treatment. It is designed to enhance regular treatment. In addition, many people with diabetes have more than one chronic health condition. The program is especially helpful for these people, as it gives them the skills to coordinate all the things needed to manage their health, as well as to help them keep active in their lives.
How was the program developed?
The Healthier Living with Diabetes workshop is the online version of the community-based Diabetes Self-Management Program which is currently being tested in English and Spanish. It also builds on the small group online Healthy Living with Ongoing Health Problems workshop. Our diabetes online workshop and study is funded by the Robert Wood Johnson Foundation and the National Institutes of Health. The original small group CDSMP study demonstrated that treatment patients compared to controls experienced improved health status and reduced health care utilization.*
Unpublished data from the ongoing Spanish small group diabetes program indicate six month improvements in health behaviors and symptoms, and a lowering of HbA1c. The process of both the online and community-based workshops are based on the experience of the investigators and others with self-efficacy, the confidence one has that he or she can master a new skill or affect one’s own health. The content of the workshop was the result of focus groups with people with type 2 diabetes, in which the participants discussed which content areas were the most important to them. In addition the content was reviewed by a leading diabatologist and diabetes educators, and the directors of two state diabetes programs
How will the online program be evaluated?
Stanford Patient Education Research Center (part of the Department of Medicine at the Stanford School of Medicine) will recruit 700 adult study participants in 2006-2007. All participants must have a physician-confirmed diagnosis of type 2 diabetes. Participants may not have received treatment for cancer in the past year or be pregnant. In addition, all study participants must reside in the U.S., have access to a computer with Internet access, and have an email account.
Qualified participants will be randomly assigned to one of three groups. 1) to receive the workshop, 2) to receive the workshop and participate in a one year long email discussion group or 3) to a usual care control group. All three groups will complete 4 online questionnaires about their health status, health care utilization, self-efficacy and self-management behaviors over a 24-month period. All participants will also receive home test kits to supply blood samples for hemoglobin A1c and lipid testing. These tests require a finger stick and the placement of two drops of blood on specially treated paper and mailing the paper to a central laboratory. All participants and their physicians will be sent the results of these tests. The control group will not receive the workshop, but will receive a gift certificate after completing each questionnaire and the book used in the workshop** at the end of the 24-month period. All data goes to a secure, encrypted server dedicated to this study. This will ensure privacy of our participants.
What about informed consent?
The study has received approval from the Stanford University Committee for the Protection of Human Subjects. Each participant will complete an informed consent. Who are the investigators? Kate Lorig RN, DrPH, Professor, Stanford School of Medicine, is the Principle Investigator. The research team includes Diana Laurent, MPH, Katy Plant, MPH, and Valarie Jernigan, MPH, all of whom are health educators with expertise in developing and monitoring online patient education programs. The Information Resources and Technology office at Stanford School of Medicine has built the online databases, web pages, and security measures.
For more information about the Self-Management @ Stanford Healthier Living with Diabetes workshop, please call, write, email or fax Kate Lorig, Diana Laurent, Katy Plant, or Valarie Jernigan at the address or numbers below.
Stanford Patient Education Research Center 1000 Welch Road, Suite 204 • Palo Alto CA 94304 voice: (650) 723-7935 • fax: (650) 725-9422 • email: diabetes@med.stanford.edu Program Web Site: http://diabetes.stanford.edu/
*Study outcomes are published in:
“Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization: a randomized trial”, by Lorig, Sobel, Stewart, Brown, Bandura, Ritter, González, Laurent and Holman. Medical Care, 37(1):5-14, 1999.
“One-year health status and health care utilization outcomes for a chronic disease self-management program in a managed care setting”, by Lorig, Sobel, Ritter, Laurent and Hobbs. Effective Clinical Practice, 4(6):256-262, 2001. A complete report on the measures used and their psychometric properties can be found in Outcome Measures for Health Education and Other Health Care Interventions, by Lorig, Stewart, Ritter, González, Laurent and Lynch, Sage Publications, 1996.
**Living a Healthy Life With Chronic Conditions by Lorig, Holman, Sobel, Laurent, González and Minor, Bull Publishing, 2006.
