Determining the Impact of an Intervention to Increase Problem-Solving Skills in Diabetes Self-Management: The Diabetes Problem-Solving Passport Pilot Study

ObjectiveThe purpose of this pilot study is to determine the feasibility of a clinic-based problem-solving passport and educative dialogue designed to improve diabetes self-management behaviours, self-efficacy, and blood-glucose levels. Although limited studies have used problem-solving as an approach to improve self-efficacy and self-management abilities, current research suggests its effectiveness.MethodsA randomized controlled pilot trial was completed in 2 tertiary care outpatient diabetes clinics. Participants (n=60) with type 1 or 2 diabetes mellitus were randomized to either usual care or the intervention group; which included a short educative dialogue and problem-solving tool to complete on their own (passport). Outcomes measured included: 1) self-efficacy, 2) problem resolution and 3) glycated hemoglobin (A1C).ResultsBoth groups were assessed at baseline and at their subsequent visit (2.42 months, standard deviation 1.26). Baseline characteristics were similar between groups, except for mean diabetes duration (control 20.17 years vs. intervention 13.17 years; p=0.02). At the follow-up visit, 18 (60%) intervention and 15 (50%) control participants were assessed. No statistically significant differences were noted for self-efficacy and A1C within and between groups at follow-up. Overall, the intervention group reported slightly higher problem resolution percentages and self-efficacy scores compared to the control group. The findings are limited due to the number of participants lost to follow-up.ConclusionThis pilot study showed some promising findings that an intervention directed to promoting problem-solving capabilities may enhance diabetes self-management behaviours, specifically self-efficacy. However, with low participant retention, strategies need to be identified to improve feasibility.