DESMOND Down Under: the benefits of quality development for structured diabetes self management programs in Western Australia

Mitchell H. Diabetes WA.
Schofield D. Diabetes WA
Fung, C. Diabetes WA
Skinner TC. Charles Darwin University
Stribling B DESMOND UK
Davies MJ DESMOND UK
Khunit K DESMOND UK

Background: DESMOND (Diabetes Education and Self Management for Ongoing and Newly Diagnosed) are theoretically driven, client centered programs for people with type 2 diabetes; with trained facilitators peer assessed and guided on a quality development journey.
Aim: To determine whether implementation of the DESMOND program in Western Australia (WA), is an effective intervention for people diagnosed with type 2 diabetes.
Methods: From June 2011, 468 individuals from 6 locations in WA (including 2 rural locations) participated in either Newly Diagnosed or Foundation DESMOND programs and completed questionnaires assessing their beliefs about diabetes, Diabetes Specific Distress, diet and physical activity pre- program, 1 month and 6 months post program. Participants also self-reported their blood pressure, weight, waist, HbA1c and total cholesterol levels.
Results: 113 individuals completed both baseline and 1 month post assessments and 85 completed the 6 month assessment. An increase in perceived understanding of diabetes was noted at 6 months (t=6.72; p<0.001) and a significant reduction in diabetes distress (t=3.05; p<0.004). Active leisure time increased significantly (Z=2.22; p<0.026) as did overall daily activity (Z=2.41; p<0.016). Metabolic outcomes showed significant reductions in systolic blood pressure (pre=133mmHg; 6 months=129mmHg; t=2.10; p<0.042) with a trend towards HbA1c reduction (pre=6.8%; 6 month=6.6%; t=1.97; p=0.056).
Conclusion: The DESMOND program, with its emphasis on empowering participants through quality assessed educator behaviour, was shown to be effective at 6 months post program in improving participant’s illness beliefs, physical activity levels, and diabetes distress and found a significant reduction to systolic BP and a trend towards lower HbA1c.