PMID- 34274165 OWN - NLM STAT- MEDLINE DCOM- 20220419 LR - 20220510 IS - 1873-5134 (Electronic) IS - 0738-3991 (Linking) VI - 105 IP - 4 DP - 2022 Apr TI - Change is possible: How increased patient activation is associated with favorable changes in well-being, self-management and health outcomes among people with type 2 diabetes mellitus: A prospective longitudinal study. PG - 821-827 LID - S0738-3991(21)00473-0 [pii] LID - 10.1016/j.pec.2021.07.014 [doi] AB - OBJECTIVE: To examine the relationship between risk factors for low patient activation and change in patient activation, well-being, and health outcomes in people with type 2 diabetes mellitus (T2DM). METHOD: A longitudinal prospective study was conducted with measurements at baseline and 20-week follow-up among 603 people with T2DM participating in a group-based walking intervention. Patient activation and risk factors were assessed using online questionnaires. Health outcomes were assessed in participants' general practices. RESULTS: No association was found between risk factors for activation and change in patient activation. Patient activation significantly increased (t(602) = 2.53, p = 0.012) and was associated with an increase in emotional well-being (beta = 0.22), exercise behavior (beta = 0.17), general diet behavior (beta = 0.20), and a reduction in BMI (beta = -0.28), weight (beta = -0.29), and HbA1c (beta = -0.27). CONCLUSION: Favorable changes in patient activation, self-management, well-being, and health outcomes occurred during a walking intervention, despite highly prevalent risk factors for low activation and less engagement in self-management. PRACTICE IMPLICATIONS: Group-based walking interventions might empower people with T2DM to begin taking a larger role in their self-care and improve (mental) health outcomes. Vulnerable groups of patients (with multiple risk factors for low activation) can change and presumably need this kind of interventions to be able to change. CI - Copyright (c) 2021 The Authors. Published by Elsevier B.V. All rights reserved. FAU - Regeer, Hannah AU - Regeer H AD - Department of Internal Medicine, Leiden University Medical Centre, Leiden, The Netherlands; Bas Van De Goor Foundation, Arnhem, The Netherlands. Electronic address: H.Regeer@lumc.nl. FAU - van Empelen, Pepijn AU - van Empelen P AD - Research Group Child Health, TNO, Leiden, The Netherlands. Electronic address: pepijn.vanempelen@tno.nl. FAU - Bilo, Henk J G AU - Bilo HJG AD - Diabetes Knowledge Centre, Isala, Zwolle, The Netherlands. Electronic address: H.J.G.Bilo@isala.nl. FAU - de Koning, Eelco J P AU - de Koning EJP AD - Department of Internal Medicine, Leiden University Medical Centre, Leiden, The Netherlands. Electronic address: E.J.P.de_Koning@lumc.nl. FAU - Huisman, Sasja D AU - Huisman SD AD - Department of Internal Medicine, Leiden University Medical Centre, Leiden, The Netherlands. Electronic address: S.D.Huisman@lumc.nl. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20210711 PL - Ireland TA - Patient Educ Couns JT - Patient education and counseling JID - 8406280 MH - *Diabetes Mellitus, Type 2/psychology/therapy MH - Humans MH - Longitudinal Studies MH - Outcome Assessment, Health Care MH - Patient Participation MH - Prospective Studies MH - *Self-Management OTO - NOTNLM OT - Change in patient activation OT - Health outcomes OT - Self-management OT - Type 2 diabetes mellitus OT - Well-being EDAT- 2021/07/19 06:00 MHDA- 2022/04/20 06:00 CRDT- 2021/07/18 20:28 PHST- 2021/01/22 00:00 [received] PHST- 2021/06/21 00:00 [revised] PHST- 2021/07/08 00:00 [accepted] PHST- 2021/07/19 06:00 [pubmed] PHST- 2022/04/20 06:00 [medline] PHST- 2021/07/18 20:28 [entrez] AID - S0738-3991(21)00473-0 [pii] AID - 10.1016/j.pec.2021.07.014 [doi] PST - ppublish SO - Patient Educ Couns. 2022 Apr;105(4):821-827. doi: 10.1016/j.pec.2021.07.014. Epub 2021 Jul 11.