POSTER PRESENTATIONS

215 I Effectiveness of Self-Management Education

Interventions Elements: A Meta-Anal:'sis.

LIFENG FAN' , SOURAYA SIDANl, lawrence Bloomberg

Faculty of:.'ursing, Uni versi ty of Toronto, Toronto, 0 1\

Previous meta~anal)'1jc studies demonstrated the effectiveness of

diabetes self-management education (D5:1-1E) inter>ention in improving

self-management. However they did not e\'aluate the elements of

interventions that are associated with the achievement of intended

outcomes. This meta-analysis aimed to examine differences in

knov .. :ledge, self-management behaviors, and metabolic control in

relation to the DS1vtE intervention elements. 50 RCTs evaluating

DS:I-1E interventions in adults with type 2 diabetes, and publishcd in

English between 1990-2006 were included in the study. Data related to

including types of intervention: teaching method: mode of delivery, and

dose was extracted.

The results showed that the weighted mean efTect size was 1.29 for

knowledge, 0.51 for metabolic control outcomes, and 0.36 for

self-management behaviors. Mixed intervention type that combine

education, behavioral or psychological components, combining didactic

and patient-provider interactive teaching method, face to face strategy

for delivering the intervention, and mixed one-an-one and group

delivery format are the most effective to achieve knowledge, self-care

behaviors, and metabolic control in this study. Interventions with

increased number of session, duration of intervention yielded large

effect on all categories outcomes. The results provide researchers and

practitioners with evidence to develop specific guidelines for designing

DSYlE interventions that are most effective in improving knowledge,

behavior, and metabolic outcomes among patients with type 2 diabetes.

217 I Getting School Kids Moving! Results from the Sandy Lake School-Based Diabetes Intervention Study. IAN J. HAASE*, STEWART B. HARRIS, MEIZI HE , MARIAM NAQSHBANDI, SUSAN WEBSTER-BOGAERT, Centre for Studies in Family Medicine , Uni versity of Western Ontario, London,ON

The Sandy Lake First Nation is a remote Oji-Cree reserve located in NW Ontario that has reported one of the hi ghest prevalence rates of T2DM and chi ldhood obesity in the world. The culturally sensiti ve curriculum used for the intervention was developed llsing Aboriginal North American learn ing styles, targeted towards the Ojibway-Cree background of the students. In addition to the school curri culum, the intervention also included healthy lunches, daily physical activi ty, and a family component to inform parents of the healthy eating and physical activity messages being addressed in the school. We report here results from the School -Based Diabetes Prevention Program (SBPP) , a 2-year (Sept. 2005 - April 2007) diabetes intervention in Sandy Lake First Nation for chi ldren in grades 3 and 4.

Results of the intervention were comparable with other school -based diabetes intervention studies in Fi rst Nations communities. In terms of physical fitness, we observed a significant improvement for the maximal multistage 20m shuttle test score (2.13 - 2.39; P 0.036) , and also significant improvement with respect to the children ' s knowledge concerning healthy levels of television and video games (2.86 - 3. 11 , P 0.007). Several other variables showed positive trends, including knowledge of healthy foods , self efficacy , and intake of trans fats, total sugar and protein. Overall, we found no significant improvements for age-adj usted BMI percentiles over the 2 year period , rellected in part by a significant increase in caloric intake consumed by study participants (kcal). The SBPP was participatory in nature with a large after school component which resulted in several spin-off com munity programs including baseball , broomball, summer camp, and hockey leagues.

MONTREAL 2008 ABSTRACTS I 357

216 I Sun'e), Says: Let's Talk Abo!!! Sey •. , DARLENE MflLER-CASH*, LISA D. GALVEZ., ASHLEY niCKS, DALE CLAYTON, ALiSON MACKAY, W1iCHAEL PELKEY, Division of Endocrinology, QEII Health Sciences Centre, Haiifilx, NS

Sexual dysfunction (SD) has long been identified as a neurovascular complication of diabetes. Approximately 35-75% of men with diabetes experience erectile dysfunction (ED). As many as 35% of women with diabetes can also experience sexual health complications ranging from sexual discomfort to decreased libido. The fact that this issue often goes undiagnosed and therefore untreated is of concern. Psychological factors can further compound the problem. Depression is commonly at the root of SD in women with diabetes. Adequate blood glucose management is crucial in the prevention of these complications. We set out to examine this topic more closely amongst the population we serve.

A needs assessment was conducted by a voluntary and anonymous SUlVey. The su.rvey was developed to gather information on the educational needs of those with diabetes. Over a period of six weer..s, 93 clinic patients (62.3% female and 37.5% maie) participated. The survey showed 57.6% had Type 1 diabetes and 38% bad Type 2 diabetes. Of those surveyed 79.4% bave had diabetes for five years or more, with 35.4% of patients stating that they were interested in learning about SD. With the information currently displayed in our clinic, 852% read the information and 51 % felt that pamphlets were the most useful format Many clients were unaware of the location or services provided by the localCDA.

Based on our survey results a pamphlet on sexual health was developed. The goal wos to bring awareness to the topic as well as to break down the barriers in discussing sexual health with health care providers. The pamphlet covers sexual health for both men and women with diabetes as well as providing information on what can be done and a list of additional resources.

The pamphlet is currently being edited by our diabetes team witi input from clinic patients. AII' felt such a unique resource was needed to adequately address this topic. This prompted educational sessions with staff members involved in counselling patients on sexual health.

218 I Motivations and Barriers to Healthier Lifestyles. BEYOND THE BASICS WORKING GROUP, Canadian Diabetes Association, Toronto, ON

A project of the Canadian Diabetes Association assisted by an unrestricted educational grant from Novo Nordisk Canada Inc.

The Association conducted an on-line survey to explore: current lifestyle behaviours, awareness of what constitutes a healthy lifestyle and the motivations and barriers to undertaking a healthy lifestyle.

The Beyond the Basics subcommittee of the National Nutrition Committee guided the project. Environics Research group conducted the on-line survey from January 21 to February 2 , 2008. A total of 2,375 Canadians aged 18 or older including several hundred people with type 1 or type 2 diabetes were sampled. Results: Canadians may not be as healthy as they think and may be putting themselves at risk for chronic disease, Canadians understand the importance of diet for overall health , with more than half acknowledging that they should eat 5 to 10 servings of vegetables and fruit each day, However, only 1 in 5 are actually getting this many servings. Lack of willpower and lack of time were the top two reasons for not achieving a healthier diet. Almost half say they already exercise enough to be healthy, but less than a third are actually getting the amount of exercise recommended. Five in 10 state that the family physician was very influential. Although , 6 in 10 say the desire for more energy would motivate them , only 4 in 10 would be motivated by the threat of a serious illness.

Canadians have much of the knowledge they need about healthy lifestyle behaviours, but they perceive many barriers to taking action,