Evaluation of the Behavioral Strategies in Diabetes Mellitus Type 2: Education in Group and Telephone Intervention

INTRODUCTION: Type 2 diabetes mellitus (T2DM) is a chronic health condition of high incidence and worldwide prevalence that is related to poor behaviors such as inadequate diet and sedentary lifestyle. Faced with this scenario, strategies such as group education and telephone intervention with the use of the empowerment approach have favored adherence to the self-care practices of the person with diabetes to improve glycemic control. OBJECTIVE: To evaluate the behavioral strategies of group education and telephone intervention in relation to the variables empowerment, self-care and glycemic control of the person with diabetes. METHOD: This study used the research database titled "Evaluation of the Diabetes Empowerment Program in Primary Health Care," which was a randomized cluster clinical trial involving 208 people with type 2 diabetes enrolled in the empowerment program. The study participants were divided into an experimental group composed of 4 Basic Health Units (BHU) (n=119 people with T2DM) and the control group for 4 BHU (n=89 people with T2DM). The experimental group was subdivided so that two UBS (n=57 people with T2DM) received group education and two UBS (n=62 people with T2DM) received education through telephone intervention. In order to verify the effect of the educational strategies, the instruments Scale of self-efficacy in diabetes mellitus (EAD-VC) and the self-care questionnaire in diabetes (ESM) were used. In order to evaluate the glycemic level, the glycated hemoglobin test was used as a clinical indicator. In addition, a sociodemographic questionnaire was used. The instruments were applied and the glycated hemoglobin were dosed at the initial and final time by the major project "Evaluation of the Diabetes Empowerment Program in Primary Health Care." The data were organized in an Excel worksheet Microsoft Windows 2013 and analyzed with the support of the statistical programming environment R (R Core Team, 2015). The descriptive analysis was performed by means of frequency calculations for categorical variables and measures of central tendency (mean and median) and dispersion (SD: standard deviation) for the quantitative variables. To evaluate the effect of the strategies, the t-Student and Wilcoxon t tests were used to compare the means and medians, respectively. The comparisons between the strategies were made through the Kruskal-Wallis and Dunn tests (for multiple comparisons). Normality was assumed by the Shapiro-Wilk test, and for all analyzes a significance level of 5% was considered. RESULTS: Of the total number of participants, 124 (59.6%) were female and 84 (40.4%) were male. The mean age was 63.5 years. Regarding marital status, 131 (63.0%) of them reported that they had a partner. Regarding the occupation, 157 (75.5%) stated that they did not have an employment relationship. There was an improvement in the aspects related to empowerment, self-care practices and glycated hemoglobin in the telephone intervention. However, in group education improvement was observed only in the variable glycated hemoglobin, the other variables analyzed did not demonstrate a statistically significant change. CONCLUSION: The strategies group education and telephone intervention presented significant results to the treatment of the person with T2DM, however, in this study telephone intervention presented better results when compared to group education.