Diabetes self-management programs grounded in health behavior change theories have been shown to be more likely to change behavior when a patient is in the precontemplation, contemplation, or preparation stages of change (Riley, 2013). Clancy suggests that diabetic patients in underserved populations often lack continuity of care and an increase in a patient’s perception of locus of control may be the motivation for behavior and lifestyle change (Simmons & Kapustin, 2011). Finally, it is important to mention that there is abundant evidence that diabetes self-management education is crucial to glycemic control, reduce mortality, and improve quality of life (Jessee & Rutledge, …show more content…
The duration of treatment directly affects A1C values and patients who attend group visits for longer periods have better outcomes (Housden, 2013). According to Housden (2013), for every one year increase in the duration of treatment, there was a decrease in effect size of 0.25, which indicated a drop in A1C of one quarter of one percent. Small decreases have been shown to have substantial clinical impact. In fact, a one percent decrease in A1C may be associated with a 37-40% decrease in microvascular complications (Housden, 2013). Housden (2013) also determined the duration of treatment had a greater effect on A1C outcomes than the total number of appointments attended. This is crucial to consider for chronic disease management because of the long-term status of the disease and the importance of routine follow up for adequate disease management and comorbidity risk