Publication Date


Advisor(s) - Committee Chair

Nicholas Brake, John Baker, Lester Archer, Merritt Bates-Thomas

Degree Program

Department of Educational Administration, Leadership, and Research

Degree Type

Doctor of Education


Background: Worldwide diabetes is estimated at 415 million, and that number is expected to increase to 642 million by 2040 (Roberts et al., 2017). Certified Diabetes Care and Educational Specialists (CDCES) and other health care providers strive to teach patients with diabetes skills that assist them in developing and maintaining self-efficacy. Current education methods are not always enough to help a patient navigate effects of their diabetes. Using the adaptive leadership principles can provide educators an interventional practice that facilitates patient self-management. This study explores the effectiveness of adaptive leadership when applied to the diabetes education delivery and confirms the leadership approach can result in patients gaining higher levels of self-efficacy through achieving their goals.

Methods: Utilizing an improvement science as an approach to research, this study focuses on identifying patient barriers to self-efficacy through root cause analysis tools that capture the essence of the diabetes patient experience with education and living with their diagnosis. Purposeful sampling was used to identify diabetes educators and patients in the Western Kentucky area for study inclusion. Participation was voluntary. Information collected during empathy interviews provided input for curriculum development to teach educators adaptive leadership principles and apply the method in their teaching patient’s standard diabetes self-management education and support (DSMES) standards. A post educator survey measured if the curriculum offered enough resources for the educator regarding the study purpose and application of adaptive leadership. Effectiveness of adaptive leadership application was measured with patients at first visit and follow up visit with the Diabetes Self-Efficacy Scale (DSES). The study had two iterations, and the period for each cycle is six weeks.

Results: This project focuses on offering educators a tool to teach diabetes patients selfefficacy skills. Each educator participating did not utilize a validated assessment tool prior to the study. The study offered a comprehensive approach to evaluating patients’ self-efficacy with use of the DSES. Patients with diabetes must overcome barriers to achieving self-efficacy that include depression, fatigue, and health issues. The introduction of adaptive leadership provides a method and approach for educators to instill self-management ownership with patients that results in them achieving their educational goals. The study showed some significance in an increase in patient self-efficacy confidence from first visit to follow-up encounter as measured by the scale.

Discussion: Diabetes patients must alter their lifestyle to effectively manage their disease. The constant monitoring diabetes requires can cause patients to experience self-doubt and unhappiness due to the disease effects. Patients need individualized attention and support that often goes beyond the limits of traditional education. Further investigation into the effectiveness of adaptive leadership could be measured with a larger patient population and longitudinal study. The continued evaluation of applying adaptive leadership as a viable method for patient intervention and empowerment is also justified. Finding solutions as intervention to the increasing numbers of people with diabetes is crucial to the healthcare field.


Life Sciences | Medicine and Health Sciences | Social and Behavioral Sciences

Available for download on Saturday, September 07, 2024