# Improving Patient Self-Advocacy and Communication with Providers through Diabetes Self-Management Education: A Randomized Controlled Trial

> **NIH NIH F31** · WEST VIRGINIA UNIVERSITY · 2022 · $46,752

## Abstract

PROJECT SUMMARY
West Virginia (WV) is a rural state in Appalachia, a region known for unique cultural traits, but also a history of
disempowerment, disadvantage, and poor social determinants that impact effective self-management of type 2
diabetes mellitus (T2DM). WV experiences a high burden of chronic disease as the state has the highest rate
of T2DM (16.2%) in the US. Communication in the patient-provider relationship is a key component of chronic
disease management and supports the prevention of devastating long-term complications. However, patients
living with T2DM are often reluctant to openly share their concerns regarding self-care with their provider. This
study aims to test the effectiveness of the Diabetes and Hypertension Self-Management Program (DHSMP), a
12-week group lifestyle intervention implemented in two Patient Centered Medical Homes in WV on improving
patients' self-advocacy and communication in the patient-provider relationship regarding their concerns and
preferences in management and treatment of their T2DM. The program's impact on relevant clinical (HbA1c,
fasting blood glucose, lipids), behavioral (self-care) and psychosocial (diabetes distress) variables will also be
assessed and relationships between these variables and patient self-advocacy and patient-provider
communication will be explored. The DHSMP utilizes health coaches to deliver group educational sessions and
support participants in improving self-care behaviors, including encouraging and empowering participants to
self-advocate/communicate their needs to their providers. Using a randomized controlled trial (RCT) design
and an integrated and explanatory sequential mixed-method approach, the objectives of this study are: to
assess the DHSMP's impact on improving patient self-advocacy and communication with providers regarding
diabetes compared to an active control group (Aim 1), to understand participants' experiences and perceptions
of the DHSMP and patient-provider communication regarding diabetes self-management via focus groups and
interviews (Aim 2a), and to assess differences in experiences/perceptions of self-advocacy and patient-
provider communication based on various participant characteristics (Aim 2b). This study is innovative in that it
is the first RCT to test the impact of a lifestyle intervention on patient self-advocacy and patient-provider
communication regarding diabetes care, management, and related distress. Furthermore, this study will
advance understanding of patient-provider relationships and fill an important gap by informing strategies to
address patient-provider communication regarding self-management of diabetes among rural Appalachian
adults. This fellowship will also equip Ms. Brenna Kirk (PI) with skills and experience in managing a multi-site
intervention, conducting mixed-methods research, disseminating results via publications/presentations, and will
enhance her understanding of rural clinical management of chronic diseases and...

## Key facts

- **NIH application ID:** 10536514
- **Project number:** 1F31DK132917-01A1
- **Recipient organization:** WEST VIRGINIA UNIVERSITY
- **Principal Investigator:** Brenna Owens Kirk
- **Activity code:** F31 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $46,752
- **Award type:** 1
- **Project period:** 2022-07-01 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10536514

## Citation

> US National Institutes of Health, RePORTER application 10536514, Improving Patient Self-Advocacy and Communication with Providers through Diabetes Self-Management Education: A Randomized Controlled Trial (1F31DK132917-01A1). Retrieved via AI Analytics 2026-06-02 from https://api.ai-analytics.org/grant/nih/10536514. Licensed CC0.

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