Occupational therapy may significantly improve the health and quality of life of diabetic young people, according to a new study led by researchers at the University of Southern California (USC).
The researchers hypothesize that occupational therapy is able to help diabetes patients improve their quality of life through its central focus of building healthier habits and routines.
For the study, both English- and Spanish-speaking young adults (aged 18-30) with type I or II diabetes participated in the Resilient, Empowered, Active Living (REAL) with Diabetes program, an occupational therapy intervention focusing on the lifestyle-related activities, habits and goals of young adults who are managing their diabetes.
The intervention is specifically designed to address the needs of young adults from low socioeconomic status or racial/ethnic minority backgrounds. All of the participants in the study were of low-socioeconomic status living in Los Angeles County.
The findings show that those who completed the program significantly improved their average blood glucose levels, diabetes-related quality of life and habits for checking blood glucose.
The findings of the randomized controlled trial are published in the journal Diabetes Care. The study is the first occupational therapy clinical trial to appear in any diabetes-focused literature or journal.
Principal Investigator and REAL intervention developer Dr. Elizabeth Pyatak, an assistant professor at the USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, and her colleagues aimed to rigorously test the effectiveness of the REAL Diabetes program.
The intervention has real-world implications as young adulthood poses distinct challenges related to health care access and the successful management of chronic diseases. These challenges are made even worse by limited finances, greater stress and more barriers to quality care, all of which are more common among individuals with low-socioeconomic status or from underrepresented minority backgrounds.
The manual for REAL Diabetes guides the occupational therapist and participants through seven modules that include suggested goals, activities supporting those goals and relevant educational materials and resources. The module topics are: assessment and goal-setting; living with diabetes; access and advocacy; activity and health; social support; emotions and well-being; and long-term health.
During the study, the young adults were randomly assigned to one of two groups: 41 participants were assigned to receive the REAL Diabetes intervention with a licensed occupational therapist for a minimum of 10 hours over the course of six months, while 40 participants were assigned to a control group that consisted of an initial home visit at which they received a packet of educational materials, and 11 follow-up telephone conversations guided by a script.
Participants who finished the REAL Diabetes program showed significant improvements in their hemoglobin A1c levels, improvements in their diabetes-related quality of life, and increases in the strength of their habits for self-monitoring blood glucose.
Although the study was not large enough to statistically determine the underlying mechanisms which make the intervention effective, the researchers hypothesize that by building healthier habits and routines — a central focus of occupational therapy in chronic disease management — participants can improve and sustain their health and quality of life.
“Occupational therapists are the experts of choice when it comes to the intersection of everyday activities, lifestyle and better management of chronic diseases,” said Pyatak, who is both a researcher and occupational therapist.
“The REAL Diabetes study validates our distinct contributions on every diabetes care team and shows the real differences that occupational therapy can make in the lives of the 30 million Americans who have diabetes.”