Building Competency in Diabetes Education THE ESSENTIALS

SELF-MANAGEMENT EDUCATION & SUPPORT: PROGRAM DEVELOPMENT| 11-21

psychomotor task of the injection itself before discussing the type and action of the insulin being injected.

The key lies in the assessment of each patient’s needs and the development of a variety of programs appropriate for differing individual concerns.

Writing objectives for behavior change: It is important to remember that informed adults have the right to make choices that may not match the health-care provider’s recommendations. The key phrase here is informed choice . Too often, it seems, neither the patient nor the health-care provider has correctly identified the problem, and an ineffective intervention has been used; in such situations, the person has really made an uninformed choice . Using motivational interviewing (MI) and the TTM framework (with integration of the empowerment philosophy) to guide the assessment and planning processes can help avoid this situation. A central hypothesis of MI and the TTM is that not all people are prepared to change their behaviour; indecision to change is normal. SME/SMS interventions need to be tailored for those in pre-contemplation and contemplation (and relapse) stages so that they can/will become ready to learn. Ambivalence about change is normal. On one hand, I want to … on the other hand, I don’t. In both a CCM and an individual context, this means the creation of outreach strategies to reach those who do not access or commonly use available education programs. There are many reasons why people do not access services. Barriers to care may include:

● Physical ● Emotional ● Psychological ● Social

Barriers to access for care

● Financial ● Spiritual ● Economic ● Cultural