Development of collaborative diabetes management in communities

Abstract

Diabetes is on constant rise worldwide as regards both its prevalence rate and related complications: persons affected with diabetes suffer from physiological, psychosocial, and economic consequences. This study aimed to increase community collaboration among diabetics to deal with the problem of diabetes and to develop and measure the effective diabetes management via mutual-collaborative action research. The core working group represented 60 participants from local community leaders, persons with diabetes, family caregivers, village health volunteers, healthcare providers, and other interested community residents. The five-step development procedure was composed of community preparation; community needs assessment; collaborative planning; implementation; and continuous monitoring and evaluation. The qualitative methods of data collection consisted of focus group discussions, in-depth interviews, and participatory observation. The content analysis utilized all the data assembly. The Collaborative Diabetes Management [CDM] method composed of six components, including 1) local capacity building, 2) municipality government policy, 3) diabetic management curriculum and community advocacy, 4) maximized used of community social capital, 5) community care and support, and 6) lessons learned sharing. The processes and the outcome measurement were to increase all the community capabilities and the impacts of all collaborative diabetes management components. Moreover, the number of participants whose HbA1C could be controlled after participating in the CDM program was significantly different from the number of participants whose HbA1C could be controlled before participating in the CDM program (Χ2= 10.971, p < 0.05). The percentage of persons who can control the blood sugar level different in 25% (3 persons) increased to 92% (11 persons) after participated in CDM program. Consequently, the CDM encouraged all the local community organizations and the community members to utilize the collaborative diabetic management by community participation as a significant method with individuals and group participants by effectively engaging stakeholders based on their community context, thereby triggering a movement in the direction of community practice, nursing education, local health policy, and future research. It still requires continued community collaborative management by including community members, local organizations, and healthcare providers.