Background
Diabetes is a chronic disease
Depression and diabetes
Chronic disease self-management and the Whole Person Model
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Enhance communications between people with diabetes and healthcare providers
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Promote team-based diabetes care
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Promote active self-management
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Overcome emotional barriers to effective therapy
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Enable better psychological care for people with diabetes.
Methods/Design
Study aims and hypotheses
Participant recruitment
Randomisation
Intervention
INSPIRED manual content | Health coach support |
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Diabetes information | Providing weekly support and education about: |
▪ General diabetes | |
▪ Diabetes complications | |
▪ Hypoglycaemia episodes | |
▪ Medication | |
▪ Diabetes and driving | |
▪ Diabetes and alcohol/smoking | |
▪ Importance of self-management | |
Healthy eating | Providing weekly support and education about: |
▪ Barriers to healthy eating | |
▪ Tips for healthy eating and snack choices | |
▪ Managing food cravings | |
▪ Home-grown experiments | |
▪ Emotions and eating | |
▪ Eating out | |
▪ Reading food labels | |
Becoming more physically active | Providing weekly support and education about: |
▪ Attitudes about different types of physical activity | |
▪ Benefits of physical activity | |
▪ Keeping track of your steps using your pedometer | |
▪ How to be more physically active | |
▪ Physical activity and blood glucose levels | |
Weight management | Providing weekly support and education about: |
▪ Your Body Mass Index | |
▪ Losing weight the healthy way | |
▪ Weight loss and maintenance tips | |
▪ Healthy eating tips for weight loss | |
Monitoring your diabetes | Providing weekly support and education about: |
▪ Keeping track of your diabetes using your Journal | |
▪ Paying attention to your blood glucose levels | |
Maintaining contact with your doctor and other health professionals | Providing weekly support and education about: |
▪ Choosing a doctor | |
▪ The importance of keeping in regular contact with your doctor | |
▪ How to get the most from your doctor’s visit | |
Family and social support | Providing weekly support and education about: |
▪ Carers and helpers | |
▪ Staying connected | |
▪ Making friends | |
Dealing with emotions (i.e., worry, anger) | Providing weekly support and education about: |
▪ Negative thoughts | |
▪ Managing distress | |
▪ Relaxation | |
▪ Reducing feelings of tension and worry – problem solving | |
▪ Tips to reduce the impact of anger | |
The Whole Person Model | Providing weekly support and education about: |
▪ The Whole Person Model | |
▪ Considering your body, feelings and thoughts when making an Action Plan | |
▪ Examining your thinking and talking back unhelpful thoughts | |
Toolbox for a healthy life | Providing weekly support and education about: |
▪ What to put in your tool box for a healthy life? | |
- Things I am going to try | |
- Things I am going to think about | |
- Other ideas |
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One face-to-face session, involving an orientation to the INSPIRED Manual and the Whole Person Model, conducted at the study headquarters.
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Six weekly phone coaching sessions. During these calls the Health Coach will support the participant working through the INSPIRED Manual, answering questions, helping with goal-setting, and discussing the homework exercises.
Outcomes assessments
Measures
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Social support: The Multidimensional Scale of Perceived Social Support Scale [39] is a 12-item scale that measures perceived social support from family, friends and significant others. This scale has proven to be psychometrically sound in diverse samples with strong test-retest reliability over a 2–3 month interval (r = 0.72 to 0.85), and internal consistencies of the total scale and sub-scales which are high (Cronbach’s Alpha = 0.79 to 0.98) [39].
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Self-efficacy: Diabetes Empowerment Scale – Short Form [40] is an 8-item self-report scale which is a valid and reliable measure of perceived ability to manage the psychological and social demands and challenges associated with diabetes [40]. Higher mean scores indicate greater level of confidence managing one’s diabetes.
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Level of exercise: Participants will be asked to record the total number of steps taken over any three days within a seven day period. This will be measured using a Be Active pedometer (Multifunction Pedometer, WWA2026, Reed Switch Technology) provided to them at the initial assessment. A three day period was noted by Tudor-Locke et al. [41] as a sufficient number of days to reliably measure physical activity in adults.