LONG-TERM EFFECTS AND COSTS OF BRIEF BEHAVIORAL DIETARY INTERVENTION FOR PATIENTS WITH DIABETES DELIVERED FROM THE MEDICAL OFFICE

This study evaluated the 12-month follow-up results and costs of a per sonalized, medical office-based intervention focused on behavioral iss ues related to dietary self-management. Two hundred and six adults hav ing diabetes attending an internal medicine outpatient clinic visit we re randomized to either Usual Care or to Brief Intervention. The singl e session intervention involved touchscreen computer-assisted assessme nt that provided immediate feedback on key barriers to dietary self-ma nagement, goal setting and problem-solving counselling. Follow-up comp onents included phone calls and videotape intervention relevant to eac h participant. Brief Intervention produced significantly greater impro vement than Usual Care on multiple measures of change in dietary behav iour (e.g., covariate adjusted difference of 2.2% of calories from fat ; p = 0.023) and on serum cholesterol levels (covariate adjusted diffe rence of 15 mg/dl; p = 0.002) at 12-month follow-up. There were also s ignificant differences favouring intervention on patient satisfaction (p < 0.02) but not on HbA(1c) levels. The costs of intervention ($137 per patient) were modest relative to many commonly used practices. (C) 1997 Elsevier Science Ireland Ltd.