Background
Methods
Procedure
Participants
Intervention
HOPE sessions and modules
Session# | Week | Session Content | Session Goals |
---|---|---|---|
Core Sessions
| |||
Session 1
|
1
|
Getting to Know HOPE and Your Coach
| |
·General introduction to the HOPE Program | ·To build rapport between participant/coach | ||
·Outline of program structure and module content | ·To encourage open discussion | ||
·Definition of roles/expectations of participant and coach are defined | ·To customize a program to participants’ needs | ||
Session 2
|
2
|
Setting Goals and Making Action Plans
| |
· Introduction to the concept of goal setting and action planning | · For participant to have a foundational understanding of goal setting/action planning | ||
· 3 rules to follow in developing a high-quality goal | · To make first attempt at setting a high -quality goal | ||
· Action Plan Checklist | |||
Elective Sessions
| |||
Module A: Managing Your Medications
| |||
· Knowing Your Medications | · For participant to better understand medication outcomes (benefits vs. side-effects) | ||
· Choosing the Right Medication for You | · To build skill: improve communication with PCP/healthcare team | ||
· Keeping a Schedule for Taking Your Medications | · To set/adjust a medication-adherence goal | ||
Module B: Using Thoughts to Improve Wellness
| |||
· Recognizing How Thoughts Affect Mood and Behaviors | · For participant to understand the impact thoughts have on feelings and actions | ||
· Using Coping Statements to Improve Wellness | · To build skill: coping, alternative thinking | ||
· Increasing Positive Thinking/Decreasing Negative Thinking | · To set/adjust a goal for practicing thought- monitoring strategies | ||
Module C: Eating a Healthy Diet
| |||
· Controlling Carbohydrate Intake | · To improve participant’s knowledge of nutrition and dietary recommendations | ||
· Increasing Fruit And Vegetable Intake | · To build skill: balanced food-group servings, portion control, healthy food substitutions | ||
· Reducing Unhealthy Fat Intake | |||
· Limiting Portion Sizes | · To set/adjust a healthy diet goal | ||
Sessions 3-8
|
3-8
|
Module D: Increasing Pleasant Activities
| |
· Recognizing How Behaviors Affect Thoughts and Moods | · For participant to understand the impact actions can have on thoughts and feelings | ||
· Identifying Meaningful Activities | · To build skill: resuming or beginning new activities of interest | ||
· Engaging In Pleasant Activities and Being Active | · To set/adjust a behavioral activation goal | ||
Module E: Getting Fit
| |||
· Improving Endurance Through Cardiovascular Exercise | · To educate participant about recommended exercise guidelines | ||
· Improving Flexibility Through Stretching | |||
· Improving Strength and Muscle Tone Through Strength Training | · To set/adjust a fitness goal, considering participant’s physical limitations | ||
Module F: Learning How to Relax
| |||
· Understanding What Stress, Worry, and Anxiety Are | · To identify stressors that impact health | ||
· How to Use Deep Breathing to Reduce Stress and Tension | · To build skill: practicing deep breathing and/or imagery exercises | ||
· How to Use Imagery to Reduce Stress and Tension | · To set/adjust a goal for incorporating relaxation techniques into participant’s daily routine | ||
Follow-Up Sessions
| |||
Session 9
|
10
|
Adjusting Your Action Plans and Overcoming Obstacles
| |
· Review all previous goals and assess goal progress | · For participant to reflect on accomplishments realized through the HOPE Program | ||
· Discussion of remaining barriers/obstacles to goal success and identification of strategies for overcoming them | · To build skill: overcoming barriers/obstacles | ||
· To make final adjustments to Action Plans | |||
Session 10
|
12
|
Managing Your Resources and Final Discussions
| |
· Final discussions: | · For participant to reflect on diabetes-care skills acquired in HOPE | ||
· Diabetes ABCs | · To prepare participant to continue goal development on his/her own, following HOPE | ||
· Resources/support system | · For participant to be satisfied with program outcomes and committed to achieving long-term health goals | ||
· Monitoring Action Plans/tracking goal progress | |||
· Closing remarks |
Core sessions (sessions 1 and 2)
Elective sessions (sessions 3 to 8)
Follow-up sessions (sessions 9 and 10)
HOPE coaches (providers)
Intervention fidelity
Measures
Glycated Hemoglobin (HbA1c)
Depression
Diabetes distress
Results
Quantitative data
Characteristics
|
Value
|
---|---|
Age in years,
M (SD)
| 62.1 (2.85) |
White race,
n (%)
| 4 (57) |
Male gender,
n (%)
| 6 (86) |
Body mass index (BMI),
M (SD)
| 34.1 (6.47) |
Years living with diabetes,
M (SD)
| 17.4 (7.39) |
Distance to PCP (in miles),
M (SD), R
| 33.6 (17.6), 15-70 |
Prior mental health treatment,
n (%)
| 5 (71) |
Receiving depression treatment,
n (%)
| 4 (57) |
Receiving insulin therapy,
n (%)
| 6 (86) |
Data-Collection Timeframe
|
Outcome Measures
| ||
---|---|---|---|
HbA1c
|
PHQ-9
|
PAID
| |
Baseline, M (SD)
| 9.73 (2.62) | 14.6 (2.99) | 46.8 (6.29) |
3-month, M (SD)
| 8.60 (3.56) | 9.43 (3.91) | 28.9 (15.6) |
Change from baseline to 3-month, M (SD)
| 1.13 (1.70) | 5.14 (2.27) | 17.7 (10.7) |
Effect Size, Cohen’s d
| 0.36 | 1.48 | 1.50 |
6-month, M (SD)
| 8.89 (3.35) | 7.57 (5.03) | 26.9 (25.9) |
Change from baseline to 6-month, M (SD)
| 0.84 (1.62) | 7.03 (4.43) | 20.4 (20.7) |
Effect Size, Cohen’s d
| 0.28 | 1.69 | 1.06 |