The Robert Wood Johnson Foundation Diabetes Initiative: demonstration projects emphasizing self-management.

Full Abstract

PURPOSE:
The purpose of the Diabetes Initiative of the Robert Wood Johnson Foundation is to demonstrate feasible and sustainable approaches to promoting diabetes self-management in primary care and community settings.

METHODS:
The Diabetes Initiative of the Robert Wood Johnson Foundation includes 14 demonstration projects in primary care settings and in community-clinical partnerships. Projects serve predominantly indigent populations from varied cultural and linguistic backgrounds in urban, rural, and frontier settings around the United States. This report describes the Initiative, its ecological perspective on self-management, and implications for program development, sustainability, and dissemination.

RESULTS:
Ecological perspectives stress varied levels of influence ranging from individuals to communities and policies. Based on this, the Initiative has identified key resources and supports for self-management (individualized assessment, collaborative goal setting, enhancing skills, follow-up and support, community resources, and continuity of quality clinical care). Lessons learned include the central roles of community health workers, integration of healthy coping and attention to negative emotion and depression in self-management, community partnerships, approaches to ongoing follow-up and support, organizational factors in sustaining programs, and the utility of a collaborative learning network for program development. Sustainability stresses organizational and policy supports for the program. Dissemination of lessons learned will stress collaboration among interested parties, stimulating consumer understanding and demand for self-management services as central to diabetes care.

CONCLUSIONS:
The Diabetes Initiative demonstrates that effective self-management programs and supports can be implemented in real-world clinical and community settings, providing models of worthwhile, sustainable programs.

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Author information

Author/s: Fisher, Edwin B (EB); Brownson, Carol A (CA); O'Toole, Mary L (ML); Shetty, Gowri (G); Anwuri, Victoria V (VV); Fazzone, Patricia (P); Housemann, Robyn A (RA); Hampton, Andrea D (AD); Kamerow, Douglas B (DB); McCormack, Lauren A (LA); Burton, Joseph A (JA); Orleans, C Tracy (CT); Bazzarre, Terry L (TL);

Affiliation: Department of Health Behavior and Health Education, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7440, USA. fishere(-atsign-)email.unc.edu

Grants: DK 20579 (Agency:NIDDK NIH HHS)

Journal and publication information

Publication Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't

Journal: The Diabetes educator (Diabetes Educ), published in United States. (Language: eng)

Reference: -2007 Jan-Feb; vol 33 (issue 1) : pp 83-4, 86-8, 91-2, passim

Dates: Created 2007/02/02; Completed 2007/09/17; Revised 2007/11/15;

PMID: 17272795, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Diabetes Mellitus - prevention & control; rehabilitation
Foundations
Humans

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