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Carvalho M, Dunne P, Kwasnicka D, Byrne M, McSharry J. Barriers and enablers to maintaining self-management behaviours after attending a self-management support intervention for type 2 diabetes: a systematic review and qualitative evidence synthesis. Health Psychol Rev 2024; 18:478-507. [PMID: 37807622 DOI: 10.1080/17437199.2023.2268731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 10/04/2023] [Indexed: 10/10/2023]
Abstract
Attendance at type 2 diabetes self-management interventions is associated with improved outcomes. However, difficulties maintaining self-management behaviours attenuate long-term impact. This review aimed to identify and synthesise qualitative research on barriers and enablers to maintaining type 2 diabetes self-management behaviours after attending a self-management intervention. Eight electronic databases were searched to identify relevant peer-reviewed and grey literature studies. Data were synthesised using the best-fit framework synthesis approach guided by the themes and constructs identified by Kwasnicka et al. (2016) on their review of theoretical explanations for behaviour change maintenance. Study methodological limitations and confidence in findings were assessed using an adapted version of the Critical Appraisal Skills Programme (CASP) tool and the GRADE-CERQual approach respectively. Eleven articles reporting on 10 studies were included. Twenty-eight barriers and enablers were coded to the a priori themes. Barriers were commonly coded to the themes self-regulation, resources, and environmental and social influences. Enablers were commonly coded to the themes habits and maintenance motives. Methodological limitations of included studies varied, leading to moderate or low confidence in most findings. Interventions may improve behavioural maintenance by providing post-intervention support, promoting positive behaviour change motives, self-regulation, habit formation, and facilitating access to resources and support.
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Affiliation(s)
- Márcia Carvalho
- Health Behaviour Change Research Group, School of Psychology, University of Galway, Galway, Republic of Ireland
| | - Pauline Dunne
- School of Agriculture and Food Science, University College Dublin, Dublin, Republic of Ireland
| | - Dominika Kwasnicka
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wrocław, Poland
- NHMRC CRE in Digital Technology to Transform Chronic Disease Outcomes, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Molly Byrne
- Health Behaviour Change Research Group, School of Psychology, University of Galway, Galway, Republic of Ireland
| | - Jenny McSharry
- Health Behaviour Change Research Group, School of Psychology, University of Galway, Galway, Republic of Ireland
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Rippon D, Shepherd J, Wakefield S, Lee A, Pollet TV. The role of self-efficacy and self-esteem in mediating positive associations between functional social support and psychological wellbeing in people with a mental health diagnosis. J Ment Health 2022:1-10. [PMID: 35510768 DOI: 10.1080/09638237.2022.2069695] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 03/11/2022] [Accepted: 03/22/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Previous research has observed positive associations between perceived quality of social support and mental well-being. Having access to functional social support that provides sources of care, compassion and helpful information have shown to be beneficial for mental health. However, there is a need to identify the psychological processes through which functional social support can elicit therapeutic outcomes on mental well-being. AIMS The present cross-sectional study aimed to examine the extent to which self-efficacy and self-esteem mediated the association between functional social support and mental well-being. METHOD Seventy-three people with a mental health diagnosis, who attended group-based activities as facilitated by a third sector community mental health organisation, took part in the present study. Participants were required to complete measures that assessed perceived quality of functional social support, self-efficacy, self-esteem, and subjective mental well-being. RESULTS A multiple mediation analysis revealed that self-efficacy and self-esteem fully mediated the positive association between perceived functional social support and mental well-being. CONCLUSIONS The implications of these results are that social interventions, which aim to facilitate the delivery of functional social support, could enhance mental well-being via their positive effects on self-efficacy and self-esteem.
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Affiliation(s)
| | | | | | - Ali Lee
- Waddington Street Centre, Durham, UK
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Thorsen IK, Kayser L, Teglgaard Lyk-Jensen H, Rossen S, Ried-Larsen M, Midtgaard J. " I Tried Forcing Myself to do It, but Then It Becomes a Boring Chore": Understanding (dis)engagement in Physical Activity Among Individuals With Type 2 Diabetes Using a Practice Theory Approach. QUALITATIVE HEALTH RESEARCH 2022; 32:520-530. [PMID: 34964675 DOI: 10.1177/10497323211064598] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Lack of physical activity (PA) is common among individuals with type 2 diabetes (T2D). We apply a practice theory approach to investigate PA engagement in the context of T2D. Data were collected through semi-structured individual interviews (n = 23) and focus groups (n = 3x6) and analyzed by deductive-inductive reflexive thematic analysis using a practice theory framework. Forty-one purposefully selected individuals with T2D (29 men) between the ages of 54 and 77 years were included. The analysis resulted in three main themes informed by five subthemes, reflecting the key elements of practice theory (i.e., meanings, materialities, and competencies). One overarching theme identified PA engagement as an unsustainable and insurmountable project in constant and unequal competition with the practice of physical inactivity. To increase PA among individuals with T2D, future PA interventions and strategies should aim to establish a stronger link between PA and everyday life practices.
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Affiliation(s)
- Ida K Thorsen
- The Centre for Physical Activity Research, Rigshospitalet, 4321University of Copenhagen, Copenhagen, Denmark
| | - Lars Kayser
- Department of Public Health, 4321University of Copenhagen, Copenhagen, Denmark
| | | | - Sine Rossen
- Copenhagen Centre for Cancer and Health, Municipality of Copenhagen, Copenhagen, Denmark
| | - Mathias Ried-Larsen
- The Centre for Physical Activity Research, Rigshospitalet, 4321University of Copenhagen, Copenhagen, Denmark
| | - Julie Midtgaard
- Centre for Applied Research in Mental Health Care (CARMEN), Mental Health Centre Glostrup, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, 4321University of Copenhagen, Copenhagen, Denmark
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Hamidi S, Gholamnezhad Z, Kasraie N, Sahebkar A. The Effects of Self-Efficacy and Physical Activity Improving Methods on the Quality of Life in Patients with Diabetes: A Systematic Review. J Diabetes Res 2022; 2022:2884933. [PMID: 35936392 PMCID: PMC9348907 DOI: 10.1155/2022/2884933] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 05/15/2022] [Accepted: 07/15/2022] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE The purpose of this systematic review is to study the impact of self-efficacy-improving strategies on physical activity-related glycemic control of diabetes. METHOD This systematic review was conducted based on the PRISMA statement. ("Diabetes" OR "glycemic control") AND ("exercise" OR "physical activity") AND "self-efficacy" were searched as keywords in databases including PubMed, Google Scholar, Science Direct, Embase, Cochrane, Web of Science, and Scopus between 2000 and 2019 for relesvant articles. RESULTS Two reviewers independently screened articles (n = 400), and those meeting eligibility criteria (n = 47) were selected for data extraction using a predesigned Excel form and critical appraisal using the "Tool for Quantitative Studies." Different strategies and health promotion programs such as individual or group face-to-face education and multimedia (video conference, video, phone calls, short message service, and Internet-based education) were used in diabetes self-management education programs. The results of different interventions including motivational interviewing (7 studies), exercise (5 studies), multidimensional self-management programs (25 studies), and electronic education (11 studies) had been evaluated. Interventions with more social support, longer duration, combined educative theory-based, and individual education had better outcomes both in postintervention and in follow-up evaluation. CONCLUSION A combination of traditional and virtual long-lasting self-care promoting (motivating) programs is needed to improve patients' self-efficacy for healthy habits like active lifestyle.
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Affiliation(s)
- Sajjad Hamidi
- Department of Psychiatric Nursing, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Gholamnezhad
- Department of Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Narges Kasraie
- Rosenberg School of Optometry, University of the Incarnate Word, San Antonio, Texas, USA
| | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Biotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
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Abstract
The article provides an overview of sulfonylureas and meglitinides as second-line agents for treating type 2 diabetes mellitus (T2DM). Implications for occupational health clinicians who work with these individuals when they take either of these medications to achieve target glycemic indices are emphasized.
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Wozniak L, Soprovich A, Mundt C, Johnson JA, Johnson ST. Contextualizing the Proven Effectiveness of a Lifestyle Intervention for Type 2 Diabetes in Primary Care: A Qualitative Assessment Based on the RE-AIM Framework. Can J Diabetes 2015; 39 Suppl 3:S92-9. [PMID: 26277222 DOI: 10.1016/j.jcjd.2015.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 04/20/2015] [Accepted: 05/01/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The Healthy Eating and Active Living for Diabetes in Primary Care Networks (HEALD) intervention proved effective in increasing daily physical activity among people with type 2 diabetes in 4 community-based primary care networks (PCNs) in Alberta. Here, we contextualize its effectiveness by describing implementation fidelity and PCN staff's perceptions of its success in improving diabetes management. METHODS We used the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework to evaluate the HEALD intervention. Qualitative methods used to collect data related to the RE-AIM dimensions of implementation and effectiveness included interviews with PCN staff (n=24), research team reflections (n=4) and systematic documentation. We used content analysis, and data were imported into and managed using Nvivo 10. RESULTS HEALD was implemented as intended with adequate fidelity across all 4 PCNs. Identified implementation facilitators included appropriate human resources, the training provided, ongoing support, the provision of space and the simplicity of the intervention. However, PCN staff reported varying opinions regarding its potential for improving diabetes management among patients. Rationales for their views included intervention "dose" inadequacy; that the quality of usual care for people with diabetes was already good; patients were already managing their diabetes well; and the potential for cointervention. Recommended improvements to HEALD included increasing the dose of the intervention, expanding it to other modes of exercise and incorporating a medical clearance process. CONCLUSIONS Based on the high degree of fidelity, the demonstrated effectiveness of HEALD in improving physical activity among patients was a result of sound implementation of an efficacious intervention. Increasing the dose of HEALD could result in additional improvements for patients.
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Key Words
- RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance)
- RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance, soit la portée, l’efficacité, l’adoption, la mise en œuvre et le maintien)
- activité physique
- diabète de type 2
- health program evaluation
- physical activity
- primary care
- soins primaires
- type 2 diabetes
- évaluation des programmes sanitaires
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Affiliation(s)
- Lisa Wozniak
- Alliance of Canadian Health Outcomes Research in Diabetes, University of Alberta, Edmonton, Alberta, Canada
| | - Allison Soprovich
- Alliance of Canadian Health Outcomes Research in Diabetes, University of Alberta, Edmonton, Alberta, Canada
| | - Clark Mundt
- Alliance of Canadian Health Outcomes Research in Diabetes, University of Alberta, Edmonton, Alberta, Canada
| | - Jeffrey A Johnson
- Alliance of Canadian Health Outcomes Research in Diabetes, University of Alberta, Edmonton, Alberta, Canada; Department of Public Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Steven T Johnson
- Alliance of Canadian Health Outcomes Research in Diabetes, University of Alberta, Edmonton, Alberta, Canada; Faculty of Health Disciplines, Athabasca University, Athabasca, Alberta, Canada.
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