Behavior change in diabetes education.

PURPOSE: The purpose of this paper is to explore how diabetes education produces change in self-care behavior.
METHODS: Published research on diabetes education relevant to behavior change was examined and a framework was formulated for the study of behavior change.
RESULTS: Research indicates that education improves patient self-management, which in turn improves glycemic control and health status. Yet, there is relatively little information on what types of education produce what particular benefits for which types of patients. Moreover, we do not know the benefits of various forms of education (for selected groups) relative to their costs. Empirical studies of how education produces behavior change are few, but much preliminary work has been done to identify potential behavioral determinants that can be targeted by interventions. Theoretical models of behavior change have been advanced (e.g., stages of change) but they have yet to be rigorously tested.
CONCLUSIONS: Initial answers to the research questions can be generated by conducting more sophisticated analyses of the type of data already being collected. However, obtaining complete answers to some of these questions will require more extensive data collection, including large-scale studies of multiple interventions in multiple patient groups.