Evaluation of the 'Mastering your Diabetes' self management education program: Exploring the relationship between diabetes knowledge, patient self-efficacy and metabolic control

Literature demonstrates an unclear relationship between diabetes-related knowledge, patient self-efficacy, and metabolic control in persons with insulin-dependent diabetes. The purpose of this study was to quantitatively examine if diabetes-related knowledge, self-efficacy and metabolic control could be improved following patient participation in the Mastering Your Diabetes (MYD) education program, and if a relationship between these variables exists. Using the transtheoretical model and a prospective longitudinal quasi-experimental design, a non-randomized sample of 18 comparison and 41 MYD patients was evaluated before and after the MYD program. Patients were followed at 3, 6, and 12 months thereafter for metabolic control (by Hemoglobin A1c), and knowledge and self-efficacy (by four different diabetes-specific psychometric instruments). The transtheoretical model allowed for assessment of different stages of readiness for behavioral change in study participants. Linear mixed-model regression was used to assess differences in each outcome measure between and within groups, and the relationship between variables. Analyses demonstrated (a) that those in the intervention (MYD) group were more likely to be ready for change than those in the comparison group (b) significant improvements in diabetes-related knowledge and patient self-efficacy immediately after the MYD and throughout follow-up and (c) significantly improved metabolic control at the 3-month follow-up only. These data indicate that the MYD program is effective. Consistent evaluations of programs such as MYD may lead to positive social change as such programs may become a mainstay of diabetes control strategies, essential to reduce the health and financial burden of the disease.