There were no significant mean reductions for body mass index or serum cholesterol .
Nurse-led interventions produced greater improvements than ' usual care ' for HbA1c , serum triglyceride and smoking cessation and support an increased independent role for nurses in diabetes management
Seeing in 3-D: Examining the Reach of Diabetes Self-Management Support Strategies in a Public Health Care System
The authors examined whether tailored self-management support ( SMS ) strategies reach patients in a safety net system and explored variation by language , literacy , and insurance . English- , Spanish- , and Cantonese-speaking diabetes patients were r and omized to weekly automated telephone disease  management ( ATDM ) or monthly group medical visits . The SMS programs employ distinct communication methods but share common objectives , including behavioral “ action plans . ” Reach was measured using three complementary dimensions : ( a ) participation among clinics , clinicians , and patients ; ( b ) patient representativeness ; and ( c ) patient engagement with SMS . Participation rates were high across all levels and preferentially attracted Spanish- language speakers , uninsured , and Medicaid recipients . Although both programs engaged a significant proportion in action planning , ATDM yielded higher engagement , especially among those with limited English proficiency and limited literacy . These results provide important insights for health communication and translational research with respect to realizing the public health benefits of SMS and can inform system-level planning to reduce health disparities
There were no significant mean reductions for body mass index or serum cholesterol .
Nurse-led interventions produced greater improvements than ' usual care ' for HbA1c , serum triglyceride and smoking cessation and support an increased independent role for nurses in diabetes management