Translating extensive research as evidence for practice: Meta-analysis of interventions to improve metabolic control among adults with type 2 diabetes

2.50
Hdl Handle:
http://hdl.handle.net/10755/153362
Type:
Presentation
Title:
Translating extensive research as evidence for practice: Meta-analysis of interventions to improve metabolic control among adults with type 2 diabetes
Abstract:
Translating extensive research as evidence for practice: Meta-analysis of interventions to improve metabolic control among adults with type 2 diabetes
Conference Sponsor:Sigma Theta Tau International
Conference Year:2007
Author:Conn, Vicki, PhD, RN, FAAN
P.I. Institution Name:University of Missouri
Title:Associate Dean
[Research Presentation] Background: Evidence-based practice requires systematic evaluation of diverse and sometimes large bodies of existing research and program evaluations to determine which interventions should be incorporated in practice. Meta-analysis can quantitatively synthesize research to determine interventions that merit evidence-based practice implementation.á Aims: This meta-analysis integrates ambulatory care program evaluations and research testing the metabolic effects of interventions to improve diabetes self-management among adults with type 2 diabetes. Methods: Comprehensive searching strategies located diverse international (Europe, Asia, North America) published and unpublished intervention reports that measured glycated hemoglobin (HbA1c) outcomes. Statistical results and study characteristics were coded. Fixed- and random-effects meta-analytic procedures were used to analyze weighted main effects and moderator influence. Results: Data were synthesized from 103 research reports which included 10,455 subjects. Common intervention strategies included self-monitoring, goal setting, behavior modification, cognitive modification, social modeling, feedback, problem solving, social support, barriers management, contracting, stimulus control/cueing, and motivational interviewing. The overall mean weighted effect size (0.29 to 0.34) documents that intervention subjects experienced improvements in metabolic control. This effect size translates to a 7.38% HbA1c for treatment subjects versus a 7.83% HbA1c for control subjects. Interventions that focused only on exercise behaviors (0.45) were more effective than interventions which targeted multiple health behaviors (0.22). Studies with more male subjects reported higher effect sizes. Metabolic outcomes were unrelated to baseline HbA1c or body mass index. Too few studies documented cost factors related to interventions or outcomes to quantitatively synthesize the information. Conclusions: These findings document significant metabolic control improvements from diabetes self-management interventions. Interventions that focus exclusively on exercise behavior may produce larger improvements. Interventions designed specifically for women need to be tested to ensure women attain improved metabolic outcomes. These findings document the importance of meta-analysis as a research methodology for translational research as a foundation for evidence-based practice.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleTranslating extensive research as evidence for practice: Meta-analysis of interventions to improve metabolic control among adults with type 2 diabetesen_GB
dc.identifier.urihttp://hdl.handle.net/10755/153362-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Translating extensive research as evidence for practice: Meta-analysis of interventions to improve metabolic control among adults with type 2 diabetes</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2007</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Conn, Vicki, PhD, RN, FAAN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Missouri</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Associate Dean</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">conn@missouri.edu</td></tr><tr><td colspan="2" class="item-abstract">[Research Presentation] Background: Evidence-based practice requires systematic evaluation of diverse and sometimes large bodies of existing research and program evaluations to determine which interventions should be incorporated in practice. Meta-analysis can quantitatively synthesize research to determine interventions that merit evidence-based practice implementation.&aacute; Aims: This meta-analysis integrates ambulatory care program evaluations and research testing the metabolic effects of interventions to improve diabetes self-management among adults with type 2 diabetes. Methods: Comprehensive searching strategies located diverse international (Europe, Asia, North America) published and unpublished intervention reports that measured glycated hemoglobin (HbA1c) outcomes. Statistical results and study characteristics were coded. Fixed- and random-effects meta-analytic procedures were used to analyze weighted main effects and moderator influence. Results: Data were synthesized from 103 research reports which included 10,455 subjects. Common intervention strategies included self-monitoring, goal setting, behavior modification, cognitive modification, social modeling, feedback, problem solving, social support, barriers management, contracting, stimulus control/cueing, and motivational interviewing. The overall mean weighted effect size (0.29 to 0.34) documents that intervention subjects experienced improvements in metabolic control. This effect size translates to a 7.38% HbA1c for treatment subjects versus a 7.83% HbA1c for control subjects. Interventions that focused only on exercise behaviors (0.45) were more effective than interventions which targeted multiple health behaviors (0.22). Studies with more male subjects reported higher effect sizes. Metabolic outcomes were unrelated to baseline HbA1c or body mass index. Too few studies documented cost factors related to interventions or outcomes to quantitatively synthesize the information. Conclusions: These findings document significant metabolic control improvements from diabetes self-management interventions. Interventions that focus exclusively on exercise behavior may produce larger improvements. Interventions designed specifically for women need to be tested to ensure women attain improved metabolic outcomes. These findings document the importance of meta-analysis as a research methodology for translational research as a foundation for evidence-based practice.</td></tr></table>en_GB
dc.date.available2011-10-26T12:13:19Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T12:13:19Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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