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| PAM-1 | PAM-2 | PAM-3 | PAM-4 |
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Characteristics | Overwhelmed, disengaged, passive, lack of knowledge, and confidence “My doctor is in charge of my health” | Have some knowledge and low confidence but struggling “I could be doing more” | Good knowledge and confidence Taking action and building self-management skills “I am part of my health care team” | Very good knowledge, confident, adopted and maintained new behavior, but may struggle under stress “I am my own advocate” |
Goals | Provide basic knowledge Build confidence through small steps | Increase knowledge Develop self-management skill | Adopt and maintain self-management behaviors | Maintain self-management behaviors and prevent relapse |
Activities | | | | |
Condition and symptoms | Provide basic information about diabetes, risk factors, red flags, and important diabetes numbers | Build more knowledge about diabetes symptoms Learn self-monitoring skills Increase confidence by taking small step to reduce symptoms | Build and maintain diabetes self-monitoring skills Identify the challenges in managing diabetes Self-reward for healthy change | Maintain diabetes self-management behaviors at or near guideline levels Learn skills to get back on track Troubleshoot the difficult situations in self-management |
Medication | Provide basic information about diabetes medication and its side effects Take small step in medication adherence | Build more knowledge about medication and the risk of not being taken as prescribed Take small step to increase medication adherence | Strive for full adherence to medication Provide emotional support to overcome the challenges in medication adherence | Maintain optimal medication adherence Anticipate the difficult situation and learn skills to get back on track |
Diet | Provide basic information about healthy diet, carbohydrate, and the link between diet and health Take small step change in diet | Build more knowledge about the recommended diabetes diet Learn weight control skills Take more small step change in diet | Try to follow diet guidelines Learn glycemic index and calorie tools Address problem areas and learn problem-solving skills | Maintain a healthy diet Learn skills to get back on track Set some dietary goals |
Physical activity | Provide basic information about physical activity and its benefits Address current physical activity level and take small step to change | Learn skills that help to be active Discuss personal barriers and facilitators of being active Take small step to increase physical activity level | Discuss the elements of a well-rounded fitness plan Try to follow guidelines for physical activity Address the challenges and barriers | Maintain physical activity Anticipate the difficult situation and learn skills to get back on track Set some physical activity goals |
Stress management | Provide basic information about what stress is Know stress triggers and levels Take small step to reduce stress | Address personal stress triggers Learn stress coping skills Take small step change in stress management | Full understanding of stress effects Anticipate and avoid stress triggers Master stress coping skills | Follow a healthy lifestyle Track overall health, fitness, emotions, and stress levels Set some stress management goals |
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