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Improving patients' self-care in diabetes: the role of the Family Strategy Team with emphasis on community health workers in the Western region of São Paulo

Grant number: 13/10313-6
Support Opportunities:Regular Research Grants
Duration: April 01, 2014 - March 31, 2015
Field of knowledge:Health Sciences - Medicine - Medical Clinics
Principal Investigator:Márcia Nery
Grantee:Márcia Nery
Host Institution: Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil
Associated researchers: Ken Resnicow ; Mary Ellen Michele Heisler ; Thais Moura Ribeiro Do Valle Nascimento


Diabetes is a chronic disease that requires a large number of demanding and sustained self-care procedures: taking medications regularly; following a healthy diet; engaging in physical activity; self-monitoring. Lack of adherence to recommended practices can result in chronic complications. The strategy of Motivational Interviewing is a counseling approach that aims to help people explore how adopting healthier practices links into their important values and then set and take steps to achieve their behavioral goals and build motivation and confidence. Multiple randomized controlled trials in other settings have found MI approaches to improve medication adherence and healthy behaviors. To date, few primary care programs in Brazil have evaluated the effectiveness of these approaches. To address this need, this study aims to: 1) analyze the feasibility and acceptance by the Family Health Strategy, in particular the community agents, of a self-care program for diabetes that uses the technique of motivational interviewing; and 2) evaluate the impact of the intervention on clinical parameters and self-care in diabetes. The study has three principal components: training in diabetes self-care and motivational interviewing for health professionals and community agents. 6 months of community agents using MI-based approaches to help patients set and follow up on diabetes action plans during their monthly home visits did to patients with diabetes; and clinical and laboratory parameters as well as self-reported patient-centered outcomes will be checked in 100 patients with diabetes participating in the pilot program at baseline and after 6 months of intervention. (AU)

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Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
RIBEIRO DO VALLE NASCIMENTO, THAIS MOURA; RESNICOW, KEN; NERY, MARCIA; BRENTANI, ALEXANDRA; KASELITZ, ELIZABETH; AGRAWAL, POOJA; MAND, SIMANJIT; HEISLER, MICHELE. A pilot study of a Community Health Agent-led type 2 diabetes self-management program using Motivational Interviewing-based approaches in a public primary care center in Sao Paulo, Brazil. BMC HEALTH SERVICES RESEARCH, v. 17, . (13/10313-6)

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