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Use of Behavioral Therapies for Treatment of Medical Disorders

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Part 1. Impact on Management of Patients with Diabetes Mellitus (continued)


Appendix C

Key to Figures Illustrating Effect Size

Rec # Study Metabolic Control Intervention Intervention Category Size Intensity Control N (total) Subjects Treatment Length (weeks) Number of Sessions Sessions/ Week
5220 Agurs-Collins, 1997 HbA1c Group and individual diet and exercise counseling D/E Large High Usual Care 64 24 18 0.750
460 Aikens, 1997 GHb Theory, guidelines and in-session therapist-guided instruction on relaxation Relaxation Small Low Usual Care 22 8 6 0.750
2920 Anderson, 1995 GHb Patient empowerment: goal-setting, problem-solving, coping strategies CBT Large Low Wait list 64 6 6 1.000
840 Boehm, 1993 GHb Compliance—behaviors related to regimen CBT Large NR Usual care 73 NS NS NS
840 Boehm, 1993 (2) GHb Behavioral strategies—analysis sessions with nurse, focused on one strategy CBT Large NR Usual care 83 NS NS NS
840 Boehm, 1993 (3) GHb Behavioral strategies with instruction—patient received instruction on strategies CBT Large NR Usual care 82 NS NS NS
3830 Brown, 2002 HbA1c Bilingual health behavior—focused on realistic health recommendations CBT Large High Usual care/ Wait list 252 28 26 0.929
1440 Cabrera-Pivaral, 2000 Glucose means Behavior modification—changing thoughts, behaviors and feelings through participation techniques CBT Small High Standard education 49 36 36 1.000
3400 Campbell, 1990 FBG Intensive group education including visualization CBT Large Low Conventional education program 62 11NS NS
620 Campbell, 1996 HbA1c Individual sessions plus 3 day small group course focused on diet, exercise, diabetes education CBT Large NR Minimal intervention 116 NS NS NS
620 Campbell, 1996 (2) HbA1c Group sessions with information on diet, exercise, diabetes education CBT Large NR Minimal intervention 125 NS NS NS
620 Campbell, 1996 (3) HbA1c CBT strategies taught by nurse, focused on eating, exercise and smoking—individual CBT Large NR Minimal intervention 115 NS NS NS
6360Cox, 1991 HbA1c BGAT (standard)—classes with readings and homework and daily recordings of BG cues BGAT Small Low Control—attended meetings and kept diaries 27 7 7 1.000
6360Cox, 1991 (2) HbA1c BGAT (intensive)—immediate feedback during hospitalization BGAT Small Low Control—attended meetings and kept diaries 16 7 7 1.000
6250D'Eramo-Melkus, 1991 HbA1c Group behavioral intervention—lecture sessions on general skills and nutrition, goal-setting CBT Large Low Minimal skills intervention 56 11 11 1.000
6250D'Eramo-Melkus, 1992 (2) HbA1c Group behavioral intervention plus individual followup sessions CBT Large Low Minimal skills intervention 54 18 13 .7220
20Didjurgeit, 2002 HbA1c Psycho-therapeutic intervention by one therapist CBT Small High Wait list 44 14 14 1.000
510Fosbury, 1997HbA1Cognitive Analytic Therapy (CAT) CBT Small High Diabetes specialist nurse education 32 16 16 1.000
330Gaede, 1999 HbA1c Intensified treatment—standard treatment plus behavior modification and introduction to pharmacological therapy CBT Large High Standard information 160 208 16 0.077
210Gaede, 2001 HbA1c Intensive multifactorial intervention—goal-setting and information on diet, exercise, smoking cessation, self-monitoring CBT Large Low Standard information 149 24 NS NS
6180Glasgow, 1992 GHb Focused education on dietary and self-care behaviors, problem-solving and coping strategies CBT Large Low Delayed intervention 102 12 10 0.833
240Glasgow, 2000 HbA1 Basic intervention plus telephone follow-up to provide support and reinforcement, personalized problem-solving training CBT Large NR Basic intervention—interactive multimedia touch-screen assessment 160 NS NS NS
240Glasgow, 2000 (2) HbA1 Basic intervention plus community resources—newsletters, goal feedback, food-frequency questionnaire CBT Large NR Basic intervention—interactive multimedia touch-screen assessment 160 NS NS NS
240Glasgow, 2000 (3) HbA1 Combined condition—combination of basic, telephone and community resource followup CBT Large NR Basic intervention—interactive multimedia touch-screen assessment 160 NS NS NS
3440Goldhaber-Fiebert, 2003 GHb Lifestyle intervention (in Spanish) focusing on nutrition D/E Large Low Standard diabetes lecture 75 12 11 0.917
3220Hanefeld, 1991 FBG IHE + placebo—patients seen at 3-month intervals D/E Large High Regular clinical checkups 760 260 20 0.077
3220Hanefeld, 1991 (2) FBG IHE + calofibric acid—patients seen at 3-month intervals D/E Large High Regular clinical checkups757260200.077
4650Kinsley, 1999 HbA1c BGAT—group training sessions BGAT Small Low Cholesterol awareness471680.500
6110Laitinen, 1993 GHb In-clinic education and goal-setting focusing on nutrition CBT Large Low Usual care865260.115
2050Lane, 1993 GHb Intensive diabetes education plus weekly biofeedback-assisted relaxation training Relaxation Small High Intensive diabetes education 3848521.083
3180Maxwell, 1992 GHb 5-day training program plus behavioral group therapy—0-3 group meetings CBT Large Low 5-day small group training program 180881.000
3180Maxwell, 1992 (2) GHb 5-day training program plus behavioral group therapy—4-8 group meetings CBT Large Low 5-day small group training program117881.000
2970McGrady, 1991 Blood glucose means Biofeedback-assisted relaxation Relax Small Low Group counseling1810101.000
350McGrady, 1999 GHb 45-minute sessions of biofeedback assisted relaxation Relaxation Small High Usual care/ glucose monitoring18 8 to 1512 NS
2370Oh, 2003 HbA1c Telephone intervention—continuous education reinforcement D/E Small High Usual care3812161.333
2910Perry, 1997 HbA1c Monthly meetings, individualized diet and exercise prescriptions, fitness appraisal D/E Large Low Standard care once every 3 months 61 NS NS NS
3200Rost, 1991 GHb Patient activation intervention—focusing on decisionmaking and information seeking CBT Large Low Standard evaluation and education610.14 2 14.286
550Smith, 1997 GHb Behavioral weight control (group) plus three individualized motivational interviews CBT Small High Behavioral weight control (group)16 16 16 1.000
2360Trento, 2002 HbA1c Group education sessions focusing on multiple factors CBT Large High Individual diabetes education112208160.077
6240Vanninen, 1992 (men) HbA1c Physician distributed information on exercise D/E Small Low Basic information sessions4552 60.115
6240Vanninen, 1992 (women) HbA1c Physician distributed information on exercise D/E Small Low Basic information sessions325260.115

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