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Impact of the Home and Community Environment on Diabetes Management

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Impact of the Home and Community Environment on Diabetes Management

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  1. Impact of the Home and Community Environment on Diabetes Management Presenter-Hayley Kermond Supervisor-Dr Kieran Broome

  2. (

  3. Literature Review Strong evidence for; • Physical activity • Healthy diet • Stress reduction • Medications Difficult to make necessary lifestyle changes (Booth et al., 2013;Snowling & Hopkins, 2006; Surwit et al., 2002)

  4. Role of Occupational Therapists

  5. Aim of Study • Determine how the home and community environment can act as a facilitator or barrier to diabetes self-management. • Develop preliminary diabetes-friendly guidelines from the collected and analysed data.

  6. Research Design • Mixed methods design • 2 part study • First part Nominal Group Technique (NGT) • Second part Experienced Sampling Methods (ESM)

  7. Nominal Group Technique • Input from all participants • Diverse opinions • Several ideas for set topic • Identifies priorities (Allen, Dyas & Jones, 2004)

  8. Data Sample- NGT

  9. Experience Sampling Methods • Gains immediate lived experience • Gains perspective over time • Reduces need for recall • Convenient (Barrett & Barrett, 2001)

  10. Data Sample-ESM

  11. Sample

  12. Recruitment • Diabetes support groups • Community health centres • Diabetes Queensland • Medical centres • Retirement villages • University of the third age • Libraries • Social media

  13. Results- NGT

  14. Preliminary Results-ESM

  15. “The routine of the work day makes managing programs, whether they be diets, exercise or medication programs, easier.” “I was busy doing tasks so I forgot to do my exercises and walk.” “I manage exercise well now that routine is being re-established.” “Routine always makes managing lifestyle easier.”

  16. Preliminary Guidelines • Establish routine • Strategies for routine changes • Education for social networks • Education on time management

  17. Discussion • Guidelines to improve diabetes self-management. • Evidence base to implement necessary environmental changes. • Evidence base for future research.

  18. Limitations • Small sample size • Exclusion of people who don’t have/use mobile phones • Voluntary sample

  19. Aims Achieved Were the aims of the study achieved? • Barriers and facilitators to diabetes self-management in the home and community environment were identified. • Preliminary diabetes-friendly guidelines were developed.

  20. Conclusion Shift from reactive to proactive role

  21. References Allen, J., Dyas, J., & Jones, M. (2004). Building consensus in health care: a guide to using the nominal group technique. British Journal of Community Nursing, 9(3), 110-114. Retrieved from CINAHL Booth, A.O., Lowis, C., Dean, M., Hunter, S.J., & McKinley, M.C. (2013). Diet and physical activity in the self-management of type 2 diabetes: barriers and facilitators identified by patients and health professionals. Primary Health Care Research & Development, 14, 293-306. Dunstan, D. W., Zimmet, P. Z., Welborn, T. A., Courten, P. D., Cameron, A. J., Sicree, R. A., Dwyer, T., Colagiuri, S., Jolley, D., Atkins, R., & Shaw, J. E. (2002). The rising prevalence of diabetes and impaired glucose control: The Australian diabetes, obesity and lifestyle study. Diabetes Care, 25(5), 829-834. Retrieved from ProQuest Herman, W.H. (2013). The economic costs of diabetes: is it time for a new treatment paradigm? Diabetes Care, 36(4), 775-6. Jones, L., Crabb, S., Turnbull, D., & Oxlad, M. (2013). Barriers and facilitators to effective type two diabetes management in a rural context: a qualitative study with diabetes patients and health professionals. Journal of Health Psychology, in press. Kuntsche, E., & Labhart, F. (2013). Using personal cell phones for ecological momentary assessment. European Psychologist, 18(1), 3-11.

  22. References Lee, C.M.Y., Colagiuri, R., Magliano, D.J., Cameron, A.J., Shar, J., Zimmet, P., & Colagiuri, S. (2013). The cost of diabetes in adults in Australia. Diabetes Research & Clinical Practice, 99(3), 385-90. Novo Nordisk. (2012). Diabetes: the silent pandemic and its impact on Australia. Retrieved from Rendle, K.A.S., May, S.G., Uy, V., Tietbohl, C.K., Mangione, C.M., & Frosch, D.L. (2013). Persistent barriers and strategic practices: why (asking about) the everyday matters in diabetes care. The Diabetes Educator, 39(4), 560-7. Snowling, N. J., & Hopkins, W. G. (2006). Effects of different modes of exercise training on glucose control and risk factors for complications in type 2 diabetic patients. Diabetes Care, 29(11), 2518-2527. doi: 10.2337/dc06-1317 Surwit, R. S., Tilburg, M. A. L. V., Zucker, N., Parekh, P., Feinglos, M. N., Edwards, C. L., Lane, J. D. (2002). Stress management improves long-term glycemic control in type 2 diabetes. Diabetes Care, 25(1), 30-34. doi: 10.2337/diacare.25.1.30 World Health Organization (2007). Global Age-friendly Cities: A Guide. World Health Organization: Geneva. Worrall, L., Rose, T., Howe, T., McKenna, K., & Hickson, L. (2007). Developing an evidence-base for accessibility for people with aphasia. Aphasiology, 21(1), 124-36.