Healthier Living With Diabetes

The Self-Management @ Stanford Healthier Living with Diabetes program is an online workshop and study given on the Internet. It is based on the earlier Living With Ongoing Health Problems online program. Groups of about 24 people with type 2 diabetes participate together. Workshops are facilitated by two trained moderators, one or both of whom are peers with diabetes. Topics covered include: 1) healthy eating and menu planning, 2) managing blood glucose, 3) techniques to deal with problems such as fatigue, frustration and isolation, 4) appropriate exercise for managing blood glucose and for maintaining and improving strength, flexibility, and endurance, 5) appropriate use of medications, 6) communicating effectively with family, friends, and health professionals, 7) goal-setting, and, 8) disease related problem solving.

Because of the impact of diabetes on the Native American population, we are running a sub-study of this program with American Indians and Alaskan Natives. The sub-study is being conducted by a doctoral fellow from University of California Berkeley, Valarie Jernigan, an enrolled member of the Choctaw nation.

It is the process in which the online workshop is presented that makes it unique. Sessions are highly participative through email 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. Each participant in the workshop receives a copy of the companion book, Living a Healthy Life with Chronic Conditions, 3rd Edition.*

How was the Program developed?

The Healthier Living with Diabetes online program has been developed and we have completed enrollment for the study . The research study is funded by the National Institutes of Health and the Robert Wood Johnson Foundation. It is based on our experience with the Healthier Living With Ongoing Health Problems online workshop.

The process of the online workshop is 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 diabetes, in which the participants discussed which content areas were the most important to them, as well as from interviews with diabetes educators and physicians..

How will the online program be evaluated?

We recruited about 800 adult study participants in 2006-2007. All participants had a diagnosis of type 2 diabetes and lived in the United States. Qualified participants were randomly assigned to either participate in the workshop or to a control group. The control group receives gift certificates with each data collection point and the book used in the workshop at the end of their participation. Both groups complete 4 home blood tests for A1C and lipids and online questionnaires about their health status, health care utilization, self-efficacy and self-management behaviors over a 2-year period.

Once the participants have completed the workshop, they are randomly assigned again to either participate in an email discussion group or to a control group. The purpose of this phase of the study is to determine if reinforcement through discussion with others with diabetes will strengthen or maintain any beneficial changes resulting from the workshop.

*Living a Healthy Life with Chronic Conditions (3rd edition) by Kate Lorig, Halsted Holman, David Sobel, Diana Laurent, Virginia González, and Marian Minor. Bull Publishing, 2006