Behavior Change Measurement in Self-Management

Objective: Diabetes is the 7^th leading cause of death in the US, and its prevalence is rising.  Behavior change is essential to effective self-management of diabetes -- measurement is hampered by a lack of accepted and objective metrics/tools. The American Association of Diabetes Educators (AADE) aimed to develop a scoring process and tools for measuring behavior change due to diabetes self-management education (DSME). 

Methods: The Behavior Score Instrument (BSI), a questionnaire that captures patient reports of actions relating to each of the AADE7 self-care behaviors over a specific period of time, and Dashboard are designed to be administered upon the initial contact between the educator and patient and again at intervals over the course of the intervention. The patient and educator can then see the behavior changes and progress/regression over time. Data capture relating to the behavior score will be facilitated by the AADE7™ System, an on-line data base for DSME.

Results: To date, initial steps have been taken to assess the validity and internal reliability of the tools to determine if the instrument: 1) is understood and useable within the patient population that are seen by diabetes educators, 2) affects behavior change at a basic level,  3) meaningful to patients, and 4) able to capture behavior change in the short term (e.g. one-year or less). Focus groups and electronic reviews were used for cognitive testing, to assess appropriateness of literacy/numeracy.

Conclusion: Behavior scoring works in practice. Next steps, following completion of the field testing, is widespread use by diabetes educators with patients.