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Mayberry LS, Nelson LA, Bergner EM, Raymond JK, Tanenbaum ML, Jaser SS, Wiebe DJ, Allen N, Berg CA, Naranjo D, Litchman M, Ollinger L, Hood K. Time for a Reframe: Shifting Focus From Continuous Glucose Monitor Uptake to Sustainable Use to Optimize Outcomes. J Diabetes Sci Technol 2024:19322968241268560. [PMID: 39143688 DOI: 10.1177/19322968241268560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
Continuous glucose monitors (CGMs) improve glycemic outcomes and quality of life for many people with diabetes. Research and clinical practice efforts have focused on CGM initiation and uptake. There is limited understanding of how to sustain CGM use to realize these benefits and limited consideration for different reasons/goals for CGM use. Therefore, we apply the Information-Motivation-Behavioral Skills (IMB) model as an organizing framework to advance understanding of CGM use as a complex, ongoing self-management behavior. We present a person-centered, dynamic perspective with the central thesis that IMB predictors of optimal CGM use vary based on the CGM use goal of the person with diabetes. This reframe emphasizes the importance of identifying and articulating each person's goal for CGM use to inform education and support.
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Affiliation(s)
- Lindsay S Mayberry
- Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Center for Health Behavior and Health Education, Vanderbilt Institute of Medicine and Public Health, Nashville, TN, USA
| | - Lyndsay A Nelson
- Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Center for Health Behavior and Health Education, Vanderbilt Institute of Medicine and Public Health, Nashville, TN, USA
| | - Erin M Bergner
- Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Center for Health Behavior and Health Education, Vanderbilt Institute of Medicine and Public Health, Nashville, TN, USA
| | - Jennifer K Raymond
- Keck School of Medicine, University of Southern California, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Molly L Tanenbaum
- Division of Endocrinology, Gerontology, and Metabolism, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Stanford Diabetes Research Center, Stanford, CA, USA
| | - Sarah S Jaser
- Center for Health Behavior and Health Education, Vanderbilt Institute of Medicine and Public Health, Nashville, TN, USA
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Deborah J Wiebe
- Psychological Sciences and the Health Sciences Research Institute, University of California, Merced, Merced, CA, USA
| | - Nancy Allen
- College of Nursing, The University of Utah, Salt Lake City, UT, USA
| | - Cynthia A Berg
- Department of Psychology, The University of Utah, Salt Lake City, UT, USA
| | - Diana Naranjo
- Stanford Diabetes Research Center, Stanford, CA, USA
- Division of Endocrinology and Diabetes, Department of Pediatrics and Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Logan Ollinger
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Korey Hood
- Stanford Diabetes Research Center, Stanford, CA, USA
- Division of Endocrinology and Diabetes, Department of Pediatrics and Medicine, Stanford University School of Medicine, Stanford, CA, USA
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Ghasemi M, Savabi-Esfahani M, Noroozi M, Satari M. Prediction of cervical cancer screening: application of the information-motivation-behavioral skills model. BMC Cancer 2024; 24:351. [PMID: 38504202 PMCID: PMC10949627 DOI: 10.1186/s12885-024-12098-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 03/07/2024] [Indexed: 03/21/2024] Open
Abstract
INTRODUCTION Screening is an effective method for preventing cervical cancer. The present study aimed to determine the predictability of cervical cancer screening using the information-motivation-behavioral skills (IMB) model, as this model can help understand the factors that influence health-related behaviors. METHOD The present cross-sectional study examined 310 women aged 20 to 60 in Isfahan, Iran, between 2020 and 2021. To this end, comprehensive health centers and gynecology clinics of hospitals were randomly selected by lot. Women who met the study's inclusion criteria were selected via convenience sampling. An IMB skills questionnaire developed by researchers comprised the data collection tool. The data were analyzed using SPSS 22 software, descriptive and regression tests, and AMOS 24.0 software. FINDINGS Approximately 18.1% of the participants had never undergone routine cervical cancer screening. The regression model results indicated that the model components accurately predicted regular cervical cancer screening (P < 0.00). Path analysis revealed that information (β = 0.05, P = 0.002), motivation (β = 0.187, P = 0.026), and behavioral skills (β = 0.95, P < 0.001) were directly associated with regular cervical cancer screening. Furthermore, behavioral skills had the greatest direct effect on regular cervical cancer screening. DISCUSSION AND CONCLUSION The results demonstrated that the IMB model accurately predicted cervical cancer screening. Therefore, it is possible to improve cervical cancer screening in women by designing and implementing interventions based on this model's components, particularly those that improve behavioral skills.
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Affiliation(s)
- Marzieh Ghasemi
- Department of Midwifery, Faculty of Medical Sciences, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran
- Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mitra Savabi-Esfahani
- Department of Midwifery and Reproductive Health, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Mahnaz Noroozi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Satari
- Department Health Information Technology, Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Sperl-Hillen JM, Haapala JL, Dehmer SP, Chumba LN, Ekstrom HL, Truitt AR, Asche SE, Werner AM, Rehrauer DJ, Pankonin MA, Pawloski PA, O'Connor PJ. Protocol of a patient randomized clinical trial to improve medication adherence in primary care. Contemp Clin Trials 2024; 136:107385. [PMID: 37956792 PMCID: PMC10922408 DOI: 10.1016/j.cct.2023.107385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 09/25/2023] [Accepted: 11/03/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Enhanced awareness of poor medication adherence could improve patient care. This article describes the original and adapted protocols of a randomized trial to improve medication adherence for cardiometabolic conditions. METHODS The original protocol entailed a cluster randomized trial of 28 primary care clinics allocated to either (i) medication adherence enhanced chronic disease care clinical decision support (eCDC-CDS) integrated within the electronic health record (EHR) or (ii) usual care (non-enhanced CDC-CDS). Enhancements comprised (a) electronic interfaces printed for patients and clinicians at primary care encounters that encouraged discussion about specific medication adherence issues that were identified, and (b) pharmacist phone outreach. Study subjects were individuals who at an index visit were aged 18-74 years and not at evidence-based care goals for hypertension (HTN), diabetes mellitus (DM), or lipid management, along with low medication adherence (proportion of days covered [PDC] <80%) for a corresponding medication. The primary study outcomes were improved medication adherence and clinical outcomes (BP and A1C) at 12 months. Protocol adaptation became imperative in response to major implementation challenges: (a) the availability of EHR system-wide PDC calculations that superseded our ability to limit PDC adherence information solely to intervention clinics; (b) the unforeseen closure of pharmacies committed to conducting the pharmacist outreach; and (c) disruptions and clinic closures due to the Covid-19 pandemic. CONCLUSION This manuscript details the protocol of a study to assess whether enhanced awareness of medication adherence issues in primary care settings could improve patient outcomes. The need for protocol adaptation arose in response to multiple implementation challenges.
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Affiliation(s)
| | | | | | | | | | | | | | - Ann M Werner
- HealthPartners Institute, Bloomington, MN, United States
| | - Dan J Rehrauer
- HealthPartners Health Plan, Bloomington, MN, United States; HealthPartners Medical Group, Bloomington, MN, United States
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Lin M, Chen T, Fan G. Current status and influential factors associated with adherence to self-monitoring of blood glucose with type 2 diabetes mellitus patients in grassroots communities: a cross-sectional survey based on information-motivation-behavior skills model in China. Front Endocrinol (Lausanne) 2023; 14:1111565. [PMID: 37441499 PMCID: PMC10335788 DOI: 10.3389/fendo.2023.1111565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 05/16/2023] [Indexed: 07/15/2023] Open
Abstract
Objective Self-monitoring of blood glucose (SMBG) plays a vital role in the maintenance of blood glucose with type 2 diabetes mellitus(T2DM) and pre-diabetes patients. The study was intended to describe the current status of SMBG with T2DM and pre-diabetes patients in grassroots communities, explore the relationship between SMBG frequency and blood glucose level and apply information-motivation-behavior(IMB) model to analyze the potential influencing factors of SMBG compliance based on electronic questionnaires. Methods A cross-sectional study was conducted with 1388 T2DM and pre-diabetes patients who completed electronic questionnaires composed of demographics and IMB model content. Chi-square test, Mann-Whitney U test and multivariable logistic regression model analysis were utilized to explore deeply causes of SMBG compliance. Results The results of this study showed that among 1388 T2DM patients, only 26.2% (363/1388) patients reached SMBG standard, indicating low compliance with SMBG. Given that SMBG is one of the individual predictors of type 2 risk in prediabetes patients, this result suggests that the SMBG compliance rate needs to be improved. Patients with fixed occupation (OR=1.989, P=0.035), BMI in normal range (OR=1.336, P=0.049), smoking habit(OR=1.492, P=0.019), understanding SMBG frequency (OR=1.825, P<0.001), understanding control goal of blood glucose (OR=1.414, P<0.001), knowing all the functions of the blood glucose meter (OR=1.923, P<0.001), buying a blood glucose meter/test paper conveniently(OR=2.329, P=0.047), taking supplementary measurement when forgetting blood glucose test(OR=2.044, P=0.005), rotating all the fingers when measuring blood glucose (OR=1.616, P<0.001) and less pain at the needling site(OR=2.114, P<0.001)were independently promoting factors of adherence to SMBG. However, the lack of accessibility and convenience of blood glucose meter or heavy financial burden were blocking factors of adherence to SMBG. Moreover, there were still bottlenecks such as lack of health care knowledge and needle pricking pain. Conclusion This study verified the practicability of applying IMB model to SMBG with T2DM and pre-diabetes patients. Adherence to SMBG still remained to improved, and putting more emphasis in improvement of individual information, motivation and behavioral skills with patients might be beneficial to maintain better adherence to SMBG in long-term routine of diabetes self-management.
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Affiliation(s)
- Manxin Lin
- School of Public Health, Shantou University, Shantou, China
- Shantou University Medical College, Shantou, China
| | - Tingting Chen
- School of Public Health, Shantou University, Shantou, China
- Shantou University Medical College, Shantou, China
| | - Guanhua Fan
- Shantou University Medical College, Shantou, China
- Health Management Center of Outpatient Department, Cancer hospital of Shantou University Medical College, Shantou, China
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Motahari-Tabari NS, Nasiri-Amiri F, Faramarzi M, Shirvani MA, Bakhtiari A, Omidvar S. The Effectiveness of Information-Motivation-Behavioral Skills Model on Self-Care Practices in Early Pregnancy to Prevent Gestational Diabetes Mellitus in Iranian Overweight and Obese Women: A Randomized Controlled Trial. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2023; 43:257-264. [PMID: 34056987 DOI: 10.1177/0272684x211020300] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is one of the most common metabolic dysfunction in pregnancy and as overweight and obesity are of the major risk factors. The aim of this study was to determine the effect of Information-Motivation and Behavioral skills (IMB) model-based counseling on preventing GDM in overweight and obese pregnant women. METHODS This randomized controlled trial study was conducted on 137 pregnant women in two groups; education and counseling IMB model-based for four sessions (n = 70), and antenatal usual care (AUC) (n = 67). This study was conducted on overweight and obese pregnant women, at the 12 to 16 weeks' gestation and recruited from the Prenatal Clinic of Rohani Hospital in north of Iran. Blood glucose was measured before and 8 weeks after the intervention. Descriptive and inferential statistics including mean, frequency, t-test, chi-square and ANCOVA were used. RESULTS The prevalence of GDM was lower in the intervention group than the control group (10% and 29.9%, respectively, RR = 0.33, CI 95% (0.15- 0.74) p = .004) as well as mean fasting blood glucose (Cohen's d = 0.28, p = .07), and glucose tolerance test at the first and second hour (d = 0.41 and Cohen's d = 0.73, respectively, p < .01). CONCLUSIONS A lifestyle intervention in early pregnancy by IMB counseling in overweight and obese pregnant women can be effective in decrease GDM.
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Affiliation(s)
| | - F Nasiri-Amiri
- Department of Midwifery and Reproductive Health, Faculty of Nursing & Midwifery, Babol University of Medical Sciences, Babol, I.R Iran
| | - Mahbobeh Faramarzi
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Marjan Ahmad Shirvani
- Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Afsaneh Bakhtiari
- Mobility Impairment Research Babol, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Shabnam Omidvar
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.,Department of Reproductive Health, School of Nursing & Midwifery, Babol University of Medical Sciences, Babol, Iran
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Dai Z, Jing S, Liu X, Zhang H, Wu Y, Wang H, Xiao W, Huang Y, Fu J, Chen X, Gao L, Su X. Development and validation of the diabetic self-management scale based on information-motivation-behavioral skills theory. Front Public Health 2023; 11:1109158. [PMID: 36908406 PMCID: PMC9998917 DOI: 10.3389/fpubh.2023.1109158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 02/07/2023] [Indexed: 03/14/2023] Open
Abstract
Background Self-management is important for the blood sugar control of middle-aged and elderly Type 2 diabetes mellitus (T2DM) patients, of which diet, exercise, and drug compliance are the most common components. The Information-Motivation-Behavioral Skills Model (IMB) has been widely used in health behavior management and intervention. Objective The purpose of this study is to develop and validate the Diabetic Self-Management Scale (DSMS) based on the IMB model. Methods Self-report survey data was collected from middle-aged and elderly T2DM patients in Zhongmu City, Henan Province, China in November 2021 using convenience sampling. The original DSMS was developed through a literature review and summary of previous similar scales using an inductive approach. Item modification was finished by a panel of specialists. Exploratory factor analysis and confirmatory factor analysis were used to evaluate the reliability, convergent validity, discriminant validity, and criterion validity of DSMS. Results Four hundred and sixty nine T2DM patients completed the questionnaire survey. The final DSMS consists of 22 items with three dimensions, including information (five items), motivation (eight items), and behavior skills (nine items). The results of simple factor analysis showed that the KMO value was 0.839, Bartlett spherical test 2 = 3254.872, P < 0.001. The results of confirmatory factor analysis showed that 2/df = 2.261, RMSEA = 0.073, CFI = 0.937, TLI = 0.930, and SRMR = 0.096. The standardized factor loadings of 22 DSMS items were all above 0.6, and the CR values of 3 dimensions were all higher than 0.9. In addition, DSMS also showed good discriminant and criterion validity. Conclusion The 22-item DSMS has good reliability and validity, and can be used to make diabetic self-management assessment regarding diet, physical activity, and medication among middle-aged and elderly Chinese T2DM patients. DSMS is of moderate length and easy to understand. It can be promoted in China in the future to understand the self-management status of middle-aged and elderly T2DM patients in China.
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Affiliation(s)
- Zhenwei Dai
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shu Jing
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaoyang Liu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Haoran Zhang
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, and Center for Tuberculosis Research, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yijin Wu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hao Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Weijun Xiao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yiman Huang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiaqi Fu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xu Chen
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lei Gao
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, and Center for Tuberculosis Research, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xiaoyou Su
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Jiang R, Ta X, Xu M, Luo Z, Du Y, Zhong X, Pan T, Cao X. Mediating Role of Depression Between Diabetes Management Self-Efficacy and Diabetes Self-Care Behavior Among Elderly Type 2 Diabetes Mellitus Patients in China. Psychol Res Behav Manag 2023; 16:1545-1555. [PMID: 37143902 PMCID: PMC10153400 DOI: 10.2147/prbm.s396916] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 04/05/2023] [Indexed: 05/06/2023] Open
Abstract
Objective To investigate the current status of diabetes self-care behavior and the association between depression, self-efficacy and self-care in a sample of Chinese elderly type 2 diabetes mellitus (T2DM) patients. Methods A cross-sectional study with a convenient sample including 240 elderly T2DM patients collected the data of demographic characteristics, diabetes self-care behavior, self-efficacy and depression status. The difference of self-care behavior in different sample characteristics was compared by independent t-test. The Personal correlation analysis was employed to examine the correlation of study variables. The method of bootstrap was used to analyze mediating role of depression. Results Only 22.5% of patients reported better diabetes self-care behavior and depression partly mediated the association between self-efficacy and self-care behavior. The significant coefficient of path a (B = -0.052, p < 0.001) and path b (B = -0.423, p < 0.05) indicated negative associations of self-efficacy on depression, and depression on self-care behavior. The indirect effect (Path a × b) between self-efficacy and self-care behavior through depression was significant (B = 0.022, p < 0.05), the 95% bias-corrected bootstrap confidence interval was 0.004 to 0.006. Meanwhile, the mediating role of depression was not found significant among the participants reported 60-74 years old (B = 0.104, p < 0.001). But depression completely mediated this association among the participants reported 75-89 years old (B = 0.034, p > 0.05). Conclusion The level of diabetes self-care behavior among the elderly T2DM patients in Dahu community of Anqing city was hardly optimistic. The self-efficacy focused intervention could be encouraged for community and clinicians to improve diabetes self-care behavior. Moreover, the prevalence of depression and T2DM is increasing in younger population. More work is needed to confirm these findings, especially conducting cohort studies on different populations.
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Affiliation(s)
- Ruobing Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China
| | - Xin Ta
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China
| | - Min Xu
- Department of Endocrinology, First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, People’s Republic of China
| | - Zhihua Luo
- Department of Pediatrics, First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, People’s Republic of China
| | - Yijun Du
- Department of Endocrinology, Second Affiliated Hospital, Anhui Medical University, Hefei, Anhui, People’s Republic of China
| | - Xing Zhong
- Department of Endocrinology, Second Affiliated Hospital, Anhui Medical University, Hefei, Anhui, People’s Republic of China
| | - Tianrong Pan
- Department of Endocrinology, Second Affiliated Hospital, Anhui Medical University, Hefei, Anhui, People’s Republic of China
- Tianrong Pan, Department of Endocrinology, Second Affiliated Hospital, Anhui Medical University, Hefei, Anhui, People’s Republic of China, Email
| | - Xiujing Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China
- Correspondence: Xiujing Cao, Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China, Email
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Benton M, Iman I, Goldsmith K, Forbes A, Ching SM, Papachristou Nadal I, Guess N, Murphy HR, Mohd Yusof BN, Baharom A, Mahamad Sobri NH, Basri NI, Salim MS, Ismail IZ, Hassan F, Ismail K, Chew BH. A Mobile Phone App for the Prevention of Type 2 Diabetes in Malaysian Women With Gestational Diabetes Mellitus: Protocol for a Feasibility Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e37288. [PMID: 36074545 PMCID: PMC9501684 DOI: 10.2196/37288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/20/2022] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Over 50% of women with a history of gestational diabetes mellitus (GDM) will develop type 2 diabetes (T2D) in later life. Asian women experience a disproportionate risk of both GDM and T2D compared to women from other ethnic backgrounds. Lifestyle interventions and behavior change can delay or even prevent the onset of T2D. We have developed a digitalized diabetes prevention intervention for the prevention of T2D in Malaysian women with GDM. OBJECTIVE The protocol describes a randomized controlled trial (RCT) to test the feasibility of undertaking a definitive trial of a diabetes prevention intervention, including a smartphone app and group support. Secondary aims are to summarize anthropometric, biomedical, psychological, and lifestyle outcomes overall and by allocation group, and to undertake a process evaluation. METHODS This is a two-arm parallel feasibility RCT. A total of 60 Malaysian women with GDM will be randomized in the antenatal period to receive the intervention or standard care until 12 months post partum. The intervention is a diabetes prevention intervention delivered via a smartphone app developed based on the Information-Motivation-Behavioral Skills model of behavior change and group support using motivational interviewing. The intervention provides women with tailored information and support to encourage weight loss through adapted dietary intake and physical activity. Women in the control arm will receive standard care. The Malaysian Ministry of Health's Medical Research and Ethics Committee has approved the trial (NMRR-21-1667-60212). RESULTS Recruitment and enrollment began in February 2022. Future outcomes will be published in peer-reviewed health-related research journals and presented at national, regional, or state professional meetings and conferences. This publication is based on protocol version 2, January 19, 2022. CONCLUSIONS To our knowledge, this will be the first study in Malaysia that aims to determine the feasibility of a digital intervention in T2D prevention among women with GDM. Findings from this feasibility study will inform the design of a full-scale RCT in the future. TRIAL REGISTRATION ClinicalTrials.gov NCT05204706; https://clinicaltrials.gov/ct2/show/NCT05204706. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/37288.
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Affiliation(s)
- Madeleine Benton
- Department of Psychological Medicine, King's College London, London, United Kingdom
| | - Iklil Iman
- Department of Family Medicine, Universiti Putra Malaysia, Selangor, Malaysia
| | - Kimberley Goldsmith
- Department of Biostatistics & Health Informatics, King's College London, London, United Kingdom
| | - Angus Forbes
- Division of Care in Long-term Conditions, King's College London, London, United Kingdom
| | - Siew Mooi Ching
- Department of Family Medicine, Universiti Putra Malaysia, Selangor, Malaysia
| | | | - Nicola Guess
- Research Centre for Optimal Health, University of Westminster, London, United Kingdom
| | - Helen R Murphy
- Department of Medicine, University of East Anglia, Norfolk, United Kingdom
| | | | - Anisah Baharom
- Department of Community Health, Universiti Putra Malaysia, Selangor, Malaysia
| | | | - Nurul Iftida Basri
- Department of Obstetrics and Gynaecology, Universiti Putra Malaysia, Selangor, Malaysia
| | | | - Irmi Zarina Ismail
- Department of Family Medicine, Universiti Putra Malaysia, Selangor, Malaysia
| | - Faezah Hassan
- Department of Family Medicine, Universiti Putra Malaysia, Selangor, Malaysia
| | - Khalida Ismail
- Department of Psychological Medicine, King's College London, London, United Kingdom
| | - Boon How Chew
- Department of Family Medicine, Universiti Putra Malaysia, Selangor, Malaysia
- Clinical Research Unit, Hospital Pengajar Universiti Putra Malaysia, Serdang, Malaysia
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Abbott L, Graven L, Schluck G, Lemacks J. A Structural Equation Modeling Analysis to Explore Diabetes Self-Care Factors in a Rural Sample. Healthcare (Basel) 2022; 10:1536. [PMID: 36011193 PMCID: PMC9407851 DOI: 10.3390/healthcare10081536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/07/2022] [Accepted: 08/09/2022] [Indexed: 11/16/2022] Open
Abstract
Diabetes is a public health problem that requires management to avoid health sequelae. Little is known about the determinants that influence diabetes self-care activities among rural populations. The purpose of this analysis was to explore the relationships among diabetes self-care activities, diabetes knowledge, perceived diabetes self-management, diabetes fatalism, and social support among an underserved rural group in the southern United States. A diabetes health promotion program was tested during a cluster randomized trial that tested a disease risk reduction program among adults living with prediabetes and diabetes. A structural equation model was fit to test psychosocial factors that influence diabetes self-care activities using the Information-Motivation-Behavioral Skills Model of Diabetes Self-Care (IMB-DSC) to guide the study. Perceived diabetes self-management significantly predicted self-care behaviors, and there was also a correlation between perceived diabetes self-management and diabetes fatalism. Perceived diabetes self-management influenced diabetes self-care activities in this rural sample and had an association with diabetes fatalism. The findings of this study can facilitate clinical care and community programs targeting diabetes and advance health equity among underserved rural groups.
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Affiliation(s)
- Laurie Abbott
- College of Nursing, Florida State University, Tallahassee, FL 32306, USA
| | - Lucinda Graven
- College of Nursing, Florida State University, Tallahassee, FL 32306, USA
| | - Glenna Schluck
- College of Nursing, Florida State University, Tallahassee, FL 32306, USA
| | - Jennifer Lemacks
- College of Nursing and Health Professions, University of Southern Mississippi, Hattiesburg, MS 39406, USA
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Kuang J, Li Y, Deng S, Su J, Gong S, Wang Y. Effect of information -motivation -behavior skills on adherence of continuous positive airway pressure therapy in patients with obstructive sleep apnea hypopnea syndrome. ZHONG NAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF CENTRAL SOUTH UNIVERSITY. MEDICAL SCIENCES 2022; 47:479-487. [PMID: 35545343 PMCID: PMC10930157 DOI: 10.11817/j.issn.1672-7347.2022.210590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Indexed: 06/15/2023]
Abstract
OBJECTIVES Obstructive sleep apnea hypopnea syndrome (OSAHS) is a common disease that seriously affects health. Continuous positive airway pressure (CPAP) therapy is the preferred treatment for moderate-to-severe OSAHS patients. However, poor adherence to CPAP is a major obstacle in the treatment of OSAHS. Information-motivation-behavioral (IMB) skills, as a kind of mature technology to change the behavior, has been used in various health areas to improve treatment adherence. This study aims to explore the effects of the IMB skills intervention on CPAP adherence in OSAHS patients. METHODS Patients who were primary diagnosed with moderate-to-severe OSAHS were randomly divided into the IMB group (n=62) and the control group (n=58). The patients in the IMB group received CPAP therapy and the IMB skills intervention for 4 weeks. The patients in the control group received CPAP therapy and a usual health care provided by a registered nurse. We collected the baseline data of the general information, including age, sex, body mass index (BMI), the Epworth Sleepiness Scale (ESS) score, the Hospital Anxiety and Depression Scale (HADS) score, and indicators about disease severity [apnea-hypopnea index (AHI), percentage of time with arterial oxygen saturation SaO2<90% (T90), average SaO2, lowest SaO2, arousal index]. After CPAP titration, we collected CPAP therapy-relevant parameters (optimal pressure, maximum leakage, average leakage, 95% leakage, and residual AHI), score of satisfaction and acceptance of CPAP therapy, and score of willingness to continue CPAP therapy. After 4 weeks treatment, we collected the ESS score, HADS score, CPAP therapy-relevant parameters, effective CPAP therapy time per night, CPAP therapy days within 4 weeks, CPAP adherence rate, score of satisfaction and acceptance of CPAP therapy, and score of willingness to continue CPAP therapy. Visual analog scale (VAS) of 0-5 was used to evaluate the satisfaction and acceptance of IMB intervention measures in the IMB group. RESULTS There were no significant differences in the baseline level of demographic parameters, ESS score, HADS score, disease severity, and CPAP therapy related parameters between the IMB group and the control group (all P>0.05). There were no significant differences in score of willingness to continue CPAP therapy, as well as score of satisfaction and acceptance of CPAP therapy after CPAP titration between the IMB group and the control group (both P>0.05). After 4 weeks treatment, the ESS score, HADS score, maximum leakage, average leakage, and 95% leakage of the IMB group were significantly decreased, while the score of satisfaction and acceptance of CPAP therapy and willingness to continue CPAP therapy of the IMB group were significantly increased (all P<0.05); while the above indexes in the control group were not different before and after 4 weeks treatment (all P<0.05). Compared with the control group, the ESS score, HADS score, maximum leakage, average leakage, and 95% leakage of the IMB group after 4 weeks treatment were significantly lower (all P<0.05); the effective CPAP therapy time, CPAP therapy days within 4 weeks, score of satisfaction and acceptance of CPAP therapy, score of willingness to continue CPAP therapy of the IMB group were significantly higher (all P<0.05). The rate of CPAP therapy adherence in 4 weeks of the IMB group was significantly higher than that of the control group (90.3% vs 62.1%, P<0.05). The VAS of overall satisfaction with IMB skills intervention measures was 4.46±0.35. CONCLUSIONS IMB skills intervention measures can effectively improve the adherence of CPAP therapy in OSAHS patients, and is suitable for clinical promotion.
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Affiliation(s)
- Jingjie Kuang
- Department of Geriatrics, Second Xiangya Hospital, Central South University, Changsha 410011.
| | - Yayong Li
- Department of Emergency, Third Xiangya Hospital, Central South University, Changsha 410013, China
| | - Silei Deng
- Department of Geriatrics, Second Xiangya Hospital, Central South University, Changsha 410011
| | - Jing Su
- Department of Geriatrics, Second Xiangya Hospital, Central South University, Changsha 410011
| | - Subo Gong
- Department of Geriatrics, Second Xiangya Hospital, Central South University, Changsha 410011
| | - Yina Wang
- Department of Geriatrics, Second Xiangya Hospital, Central South University, Changsha 410011.
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Sayin Kasar K, Duru Asiret G, Kutmec Yilmaz C, Canlar Ş. The effect of model-based telephone counseling on HbA1c and self-management for individuals with type 2 diabetes: A randomized controlled trial. Prim Care Diabetes 2022; 16:41-48. [PMID: 34518109 DOI: 10.1016/j.pcd.2021.09.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/26/2021] [Accepted: 09/06/2021] [Indexed: 11/18/2022]
Abstract
AIMS This study was conducted to examine the effect of telephone counseling based on the Information, Motivation, Behavioral Skills (IMB) Model on HbA1c and self-management in patients with type 2 diabetes mellitus (T2DM). METHODS This study was conducted between January 2019 and September 2019 with a total of 63 (31 interventions, 32 controls) T2DM patients. The intervention group was followed-up for a total of 12 weeks, after 45-60 min of patient training based on IMB, a weekly reminder message and a phone call every two weeks. No intervention was made to the control group. Data were collected at the beginning of the study and at the end of the 12th week. The data were obtained using a Patient Information Form, the Type 2 Diabetes Self-Efficacy Scale, the Diabetes Self-Management Questionnaire (DSMQ), the Perceived Diabetes Self Management Scale (PDSMS) and glycemic control (HbA1c). RESULTS Participants were on average 54 years old and the majority were female (58.1%). According to the results of the covariance analysis (ANCOVA), there was a statistically significant difference between the pre-post-test HbA1c (F:13.589; p < 0.001), weight (F:32.176; p < 0.001) and systolic blood pressure (F:7.109; p = 0.01). However, there was no significant difference in diastolic blood pressure between the intervention and control groups (F:2.686; p = 0.106). Also, after three months of follow-up, self-efficacy (F:26.632; p < 0.001), self-management (F:44.487; p < 0.001) and self-management perceptions (F:71.132; p < 0.001) were significantly higher in the intervention group. CONCLUSION The researchers concluded that telephone counseling based on the IMB model could be a suitable method to improve glycemic control and self-care behaviors in patients with type 2 diabetes.
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Affiliation(s)
- Kadriye Sayin Kasar
- Department of Nursing, Faculty of Health Sciences, Aksaray University, Aksaray, Turkey.
| | - Guler Duru Asiret
- Department of Nursing, Faculty of Health Sciences, Aksaray University, Aksaray, Turkey.
| | - Cemile Kutmec Yilmaz
- Department of Nursing, Faculty of Health Sciences, Aksaray University, Aksaray, Turkey.
| | - Şule Canlar
- Department of Endocrinology and Metabolic Diseases, TOBB ETU Hospital, Ankara, Turkey.
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12
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Associated patient demographic characteristics and disease-related self-care behaviors with diabetes: a mediation model. J Diabetes Metab Disord 2021; 20:1301-1308. [PMID: 34900781 DOI: 10.1007/s40200-021-00856-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 07/10/2021] [Indexed: 10/20/2022]
Abstract
Objective The burden of diabetes is increasing rapidly in Turkey; however, there is insufficient information regarding the interrelated factors of diabetes. This study aims to fill this gap by investigating associated characteristics and self-care behaviors of patients with diabetes. Methods Path analysis was used to test interrelated factors of diabetes. Data were obtained from a cross-sectional, population-based study (Turkey Health Survey) from 2014. The determined sample size was 9,740 households, and 26,075 individuals were interviewed. There were 19,129 persons who reported having diabetes. Age and gender characteristics and disease-related self-care behaviors of individuals were collected through a self-reported questionnaire. Goodness-of-fit indices were used to assess model fit. Results The results demonstrated that patient characteristics, self-care behaviors, and diabetes are causally interrelated (p < 0.0001). Blood glucose monitoring mediated the interrelationships between patient demographic characteristics and diabetes. The model fit indices indicated a good fit of the path model to the data (goodness-of-fit index = 0.96; comparative fit index = 0.89; incremental fit index = 0.89; normed fit index = 0.89). The fight against the increasing prevalence of diabetes mandates enhancing self-care behaviors of individuals with diabetes, including regular blood glucose monitoring and the inculcation of healthy dietary habits. Conclusions The results can guide health policy makers to promote patient-centered management of diabetes in the age of the escalating burden of this disease.
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Kim Y, Lee H, Seo JM. Integrated Diabetes Self-Management Program Using Smartphone Application: A Randomized Controlled Trial. West J Nurs Res 2021; 44:383-394. [PMID: 33655794 DOI: 10.1177/0193945921994912] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study identified the effects of an integrated diabetes self-management program using smartphone application (app), based on the Information-Motivation-Behavioral skills (IMB) model. A randomized comparison, using a pre-and post-test design, was conducted with 32 participants in the experimental group and 36 in the control group. The integrated diabetes self-management program consisted of face-to-face educational sessions, a diabetes self-management smartphone app, and phone counseling. In the experimental group, diabetes self-management knowledge (Z=-2.70, p=.007), social motivation (Z=-1.97, p=.048), and behavior (t=3.22, p=.002) improved, with their hemoglobin A1c (Z=-4.83, p<.001) decreasing compared to the control group. At the post-test, the experimental group's fasting blood sugar level (t=2.79, p=.009), total calorie intake (t=3.94, p=.001), carbohydrate intake (t=5.69, p<.001), and fat intake (t=2.54, p=.021) decreased compared to the pre-test. An integrated diabetes self-management program using smartphone app, based on the IMB model, should be utilized as a nursing intervention.
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Affiliation(s)
- Yeojin Kim
- Pusan National University Hospital, Busan, South Korea
| | - Hyejin Lee
- College of Nursing, Pusan National University, Yangsan, South Korea
| | - Ji Min Seo
- College of Nursing, Pusan National University, Yangsan, South Korea
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14
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Chen Z, Chen Y, Geng J, Wang M, Yu H. Psychometric testing of the Chinese version of Self-Care of Coronary Heart Disease Inventory. Int J Nurs Pract 2020; 27:e12885. [PMID: 32914484 DOI: 10.1111/ijn.12885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 07/14/2019] [Accepted: 08/15/2020] [Indexed: 01/23/2023]
Abstract
AIM To psychometrically test the Chinese version of Self-Care of Coronary Heart Disease Inventory. BACKGROUND Self-care is a significant step to impede the progression of coronary heart disease and serves as the primary outcome in self-care interventions. In China, however, no instrument is available to measure self-care in patients with coronary heart disease. To address this gap, we introduce the Self-Care of Coronary Heart Disease Inventory into China. DESIGN A cross-sectional design. METHODS We translated the inventory into Chinese using standardized methods. Then, it was psychometrically tested on a convenience sample of 301 patients with coronary heart disease (October 2017 to May 2018). Construct validity was evaluated via exploratory factor analysis and testing hypotheses. Internal consistency reliability was measured with Cronbach's alpha or composite reliability. RESULTS Both self-care maintenance and management subscales showed a two-factor structure, whereas self-care confidence subscale showed a one-dimension structure. All subscales were significantly correlated with associated variables (disease-related knowledge and perceived control). The internal consistency reliability for all three subscales was acceptable. CONCLUSION The Chinese version showed acceptable psychometric properties when applied to the sample group of this study. It is recommended for use in self-care interventions targeting coronary heart disease.
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Affiliation(s)
- Zi Chen
- School of Health Sciences, Wuhan University, Wuhan, Hubei, China.,School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Yuan Chen
- Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Jing Geng
- Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Mian Wang
- Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Huidan Yu
- School of Health Sciences, Wuhan University, Wuhan, Hubei, China
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15
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Steinman L, Heang H, van Pelt M, Ide N, Cui H, Rao M, LoGerfo J, Fitzpatrick A. Facilitators and Barriers to Chronic Disease Self-Management and Mobile Health Interventions for People Living With Diabetes and Hypertension in Cambodia: Qualitative Study. JMIR Mhealth Uhealth 2020; 8:e13536. [PMID: 32329737 PMCID: PMC7210501 DOI: 10.2196/13536] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 07/04/2019] [Accepted: 09/24/2019] [Indexed: 12/15/2022] Open
Abstract
Background In many low- and middle-income countries (LMICs), heart disease and stroke are the leading causes of death as cardiovascular risk factors such as diabetes and hypertension rapidly increase. The Cambodian nongovernmental organization, MoPoTsyo, trains local residents with diabetes to be peer educators (PEs) to deliver chronic disease self-management training and medications to 14,000 people with hypertension and/or diabetes in Cambodia. We collaborated with MoPoTsyo to develop a mobile-based messaging intervention (mobile health; mHealth) to link MoPoTsyo’s database, PEs, pharmacies, clinics, and people living with diabetes and/or hypertension to improve adherence to evidence-based treatment guidelines. Objective This study aimed to understand the facilitators and barriers to chronic disease management and the acceptability, appropriateness, and feasibility of mHealth to support chronic disease management and strengthen community-clinical linkages to existing services. Methods We conducted an exploratory qualitative study using semistructured interviews and focus groups with PEs and people living with diabetes and/or hypertension. Interviews were recorded and conducted in Khmer script, transcribed and translated into the English language, and uploaded into Atlas.ti for analysis. We used a thematic analysis to identify key facilitators and barriers to disease management and opportunities for mHealth content and format. The information-motivation-behavioral model was used to guide data collection, analysis, and message development. Results We conducted six focus groups (N=59) and 11 interviews in one urban municipality and five rural operating districts from three provinces in October 2016. PE network participants desired mHealth to address barriers to chronic disease management through reminders about medications, laboratory tests and doctor’s consultations, education on how to incorporate self-management into their daily lives, and support for obstacles to disease management. Participants preferred mobile-based voice messages to arrive at dinnertime for improved phone access and family support. They desired voice messages over texts to communicate trust and increase accessibility for persons with limited literacy, vision, and smartphone access. PEs shared similar views and perceived mHealth as acceptable and feasible for supporting their work. We developed 34 educational, supportive, and reminder mHealth messages based on these findings. Conclusions These mHealth messages are currently being tested in a cluster randomized controlled trial (#1R21TW010160) to improve diabetes and hypertension control in Cambodia. This study has implications for practice and policies in Cambodia and other LMICs and low-resource US settings that are working to engage PEs and build community-clinical linkages to facilitate chronic disease management.
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Affiliation(s)
- Lesley Steinman
- Department of Health Services, University of Washington, Seattle, WA, United States
| | - Hen Heang
- MoPoTsyo Patient Information Centre, Phnom Penh, Cambodia
| | | | - Nicole Ide
- Division of General Internal Medicine, University of Washington, Seattle, WA, United States
| | - Haixia Cui
- MoPoTsyo Patient Information Centre, Phnom Penh, Cambodia
| | - Mayuree Rao
- Division of General Internal Medicine, University of Washington, Seattle, WA, United States.,General Medicine Service, VA Puget Sound Health Care System, Seattle, WA, United States
| | - James LoGerfo
- Department of Medicine, University of Washington, Seattle, WA, United States.,Department of Global Health, University of Washington, Seattle, WA, United States
| | - Annette Fitzpatrick
- Department of Global Health, University of Washington, Seattle, WA, United States.,Departments of Family Medicine, University of Washington, Seattle, WA, United States.,Department of Epidemiology, University of Washington, Seattle, WA, United States
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16
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Ferrari M, Speight J, Beath A, Browne JL, Mosely K. The information-motivation-behavioral skills model explains physical activity levels for adults with type 2 diabetes across all weight classes. PSYCHOL HEALTH MED 2020; 26:381-394. [PMID: 32266821 DOI: 10.1080/13548506.2020.1749292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Physical activity is an evidence-based, effective treatment for type 2 diabetes mellitus (T2D), yet insufficient numbers of adults achieve recommended daily levels, particularly amongst higher weight classes. This cross-sectional study assessed whether the Information-Motivation-Behavioural Skills (IMB) Model explained physical activity levels in adults with T2D across different body mass index (BMI) levels (N = 381). Measures included the American Adults Knowledge of Exercise Recommendations (AAKER), Behavioural Regulation in Exercise Questionnaire (BREQ-2), Barriers Specific Self-Efficacy Scale (BARSE) and the outcome measure, International Physical Activity Questionnaire (IPAQ-short form). Analyses included structural equation modelling (SEM) and ordinal logistic regression models. SEM demonstrated a good fit of the IMB Model to the data, accounting for 44% of variance in physical activity levels. Both motivation and self-efficacy had a direct effect, and motivation indirectly predicted physical activity through self-efficacy. Further analyses found the effect of the IMB predictors did not vary according to BMI status. This study supports the application of the IMB Model in explaining physical activity behavior in adults with T2D. In particular, the contribution of motivation and self-efficacy as substantive and modifiable predictors of physical activity will facilitate the development of targeted and evidence-based interventions for individuals of all BMI classes.
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Affiliation(s)
- Madeleine Ferrari
- School of Psychology, Australian Catholic University, Strathfield, Australia.,School of Psychology, University of Sydney, Sydney, Australia
| | - Jane Speight
- Centre for Mental Health and Wellbeing Research, School of Psychology, Deakin University, Burwood, Australia.,The Australian Centre for Behavioural Research in Diabetes, Diabetes Australia Vic, Melbourne, VIC, Australia.,AHP Research, Hornchurch, UK
| | - Alissa Beath
- Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - Jessica L Browne
- Centre for Mental Health and Wellbeing Research, School of Psychology, Deakin University, Burwood, Australia.,The Australian Centre for Behavioural Research in Diabetes, Diabetes Australia Vic, Melbourne, VIC, Australia.,Centre for Evidence and Implementation, Carlton, VIC, Australia
| | - Kylie Mosely
- BodyMatters Australasia, Sydney, NSW, Australia.,Graduate School of Health, University of Technology, Sydney, NSW, Australia
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17
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Choudhry FR, Munawar K, Kassab YW, Bakrin FS, Al-Worafi YM, Khan TM. Public Perception About the Zika Virus in Working Professionals: A Qualitative Inquiry. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2020; 41:199-207. [PMID: 32249680 DOI: 10.1177/0272684x20916621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIMS The Global Outbreak Alert and Response Network recently warned that the Zika virus-containing mosquitoes are being found in Pakistan and the health sector is on high alert. It is thus significant to understand public beliefs and perceptions of the Zika virus and vaccination in the current scenario of Pakistan. METHODS Twenty semistructured qualitative interviews were conducted and analyzed through an inductive approach to analysis. RESULTS The findings were presented in three main categories which were coded: Reality vs. Conspiracy, Vaccination Concerns, and Public Worries. The majority believed that the Zika virus is a real problem and that authorities might be trying to hide the Zika cases in Pakistan. Moreover, they believed that health organizations are being incompetent by failing to take timely remedial measures to manage the Zika. However, 20% have an opposing view and believed that the Zika virus is a conspiracy against Pakistan from the West. CONCLUSION Overall, most participants were concerned about the lack of treatment and preventive methods and emphasized the need to create awareness among the public. It is observed that the participants' perceptions ranged from perceiving the Zika virus as real to as a conspiracy.
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Affiliation(s)
- Fahad Riaz Choudhry
- Department of Psychology, Kulliyyah of Islamic Revealed Knowledge and Human Sciences, International Islamic University Malaysia
| | - Khadeeja Munawar
- Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Subang Jaya, Malaysia.,Department of Psychology, University of Wah, Pakistan
| | - Yaman W Kassab
- Department of Hospital and Clinical Pharmacy, Cyberjaya University College of Medical Sciences, Cyberjaya, Malaysia
| | | | - Yaser Mohammed Al-Worafi
- Clinical Pharmacy Department, College of Pharmacy, University of Science and Technology of Fujairah, Fujairah, UAE.,College of Pharmacy, University of Science and Technology, Sana'a, Yemen
| | - Tahir Mehmood Khan
- Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan.,School of Pharmacy, Monash University Malaysia, Sunway City, Selangor, Malaysia
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18
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Yang C, Hui Z, Zeng D, Liu L, Lee DTF. Examining and adapting the information-motivation-behavioural skills model of medication adherence among community-dwelling older patients with multimorbidity: protocol for a cross-sectional study. BMJ Open 2020; 10:e033431. [PMID: 32209623 PMCID: PMC7202708 DOI: 10.1136/bmjopen-2019-033431] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Multimorbidity is highly prevalent among older patients and has been shown to be associated with poor health outcomes and lower quality of life. Adherence to medication treatments is essential in order to maximise the efficacy of treatments and improve health outcomes. However, nearly half of the older patients with multimorbidity fail to adhere to their medications, which can result in an increased risk of adverse health events, lower quality of life and higher healthcare cost. Only a few studies have explored the underlying mechanism and influencing factors of medication adherence among older patients with multimorbidity, which are inadequate to provide robust evidence for the development and evaluation of the medication adherence interventions. This study aims to examine and adapt the information-motivation-behavioural skills (IMB) model, a widely used social behaviour theory, to explain the medication adherence behaviour among community-dwelling older patients with multimorbidity. METHODS AND ANALYSIS A cross-sectional study will be conducted in community settings in China. Around 309 older patients with multimorbidity will be recruited to complete questionnaires on adherence knowledge, adherence motivation, adherence self-efficacy, medication adherence, medication treatment satisfaction, depressive symptoms, treatment burden, disease burden and basic demographic information. Structural equation modelling will be used to analyse and validate the relationships among variables in the IMB model. ETHICS AND DISSEMINATION This study has been approved by the Survey and Behavioral Research Ethics Committee of the Chinese University of Hong Kong (reference number SBRE-18-675). The study results will be published in peer-reviewed journals and presented in academic conferences and workshops. TRIAL REGISTRATION NUMBER ChiCTR1900024804.
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Affiliation(s)
- Chen Yang
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Zhaozhao Hui
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Dejian Zeng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Li Liu
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Diana Tze Fan Lee
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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Sittig S, Wang J, Iyengar S, Myneni S, Franklin A. Incorporating Behavioral Trigger Messages Into a Mobile Health App for Chronic Disease Management: Randomized Clinical Feasibility Trial in Diabetes. JMIR Mhealth Uhealth 2020; 8:e15927. [PMID: 32175908 PMCID: PMC7105932 DOI: 10.2196/15927] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 11/13/2019] [Accepted: 02/10/2020] [Indexed: 12/23/2022] Open
Abstract
Background Although there is a rise in the use of mobile health (mHealth) tools to support chronic disease management, evidence derived from theory-driven design is lacking. Objective The objective of this study was to determine the impact of an mHealth app that incorporated theory-driven trigger messages. These messages took different forms following the Fogg behavior model (FBM) and targeted self-efficacy, knowledge, and self-care. We assess the feasibility of our app in modifying these behaviors in a pilot study involving individuals with diabetes. Methods The pilot randomized unblinded study comprised two cohorts recruited as employees from within a health care system. In total, 20 patients with type 2 diabetes were recruited for the study and a within-subjects design was utilized. Each participant interacted with an app called capABILITY. capABILITY and its affiliated trigger (text) messages integrate components from social cognitive theory (SCT), FBM, and persuasive technology into the interactive health communications framework. In this within-subjects design, participants interacted with the capABILITY app and received (or did not receive) text messages in alternative blocks. The capABILITY app alone was the control condition along with trigger messages including spark and facilitator messages. A repeated-measures analysis of variance (ANOVA) was used to compare adherence with behavioral measures and engagement with the mobile app across conditions. A paired sample t test was utilized on each health outcome to determine changes related to capABILITY intervention, as well as participants’ classified usage of capABILITY. Results Pre- and postintervention results indicated statistical significance on 3 of the 7 health survey measures (general diet: P=.03; exercise: P=.005; and blood glucose: P=.02). When only analyzing the high and midusers (n=14) of capABILITY, we found a statistically significant difference in both self-efficacy (P=.008) and exercise (P=.01). Although the ANOVA did not reveal any statistically significant differences across groups, there is a trend among spark conditions to respond more quickly (ie, shorter log-in lag) following the receipt of the message. Conclusions Our theory-driven mHealth app appears to be a feasible means of improving self-efficacy and health-related behaviors. Although our sample size is too small to draw conclusions about the differential impact of specific forms of trigger messages, our findings suggest that spark triggers may have the ability to cue engagement in mobile tools. This was demonstrated with the increased use of capABILITY at the beginning and conclusion of the study depending on spark timing. Our results suggest that theory-driven personalization of mobile tools is a viable form of intervention. Trial Registration ClinicalTrials.gov NCT04132089; http://clinicaltrials.gov/ct2/show/NCT004122089
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Affiliation(s)
- Scott Sittig
- School of Computing, University of South Alabama, Mobile, AL, United States
| | - Jing Wang
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Sriram Iyengar
- College of Medicine Phoenix, The University of Arizona, Phoenix, AZ, United States
| | - Sahiti Myneni
- School of Biomedical Informatics, University of Texas Health Science Center Houston, Houston, TX, United States
| | - Amy Franklin
- School of Biomedical Informatics, University of Texas Health Science Center Houston, Houston, TX, United States
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20
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Steinman L, van Pelt M, Hen H, Chhorvann C, Lan CS, Te V, LoGerfo J, Fitzpatrick AL. Can mHealth and eHealth improve management of diabetes and hypertension in a hard-to-reach population? -lessons learned from a process evaluation of digital health to support a peer educator model in Cambodia using the RE-AIM framework. Mhealth 2020; 6:40. [PMID: 33437836 PMCID: PMC7793020 DOI: 10.21037/mhealth-19-249] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 05/22/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The burden of non-communicable diseases (NCDs) is increasing in low- and middle-income countries (LMICs) where NCDs cause 4:5 deaths, disproportionately affect poorer populations, and carry a large economic burden. Digital interventions can improve NCD management for these hard-to-reach populations with inadequate health systems and high cell-phone coverage; however, there is limited research on whether digital health is reaching this potential. We conducted a process evaluation to understand challenges and successes from a digital health intervention trial to support Cambodians living with NCDs in a peer educator (PE) program. METHODS MoPoTsyo, a Cambodian non-governmental organization (NGO), trains people living with diabetes and/or hypertension as PEs to provide self-management education, support, and healthcare linkages for better care management among underserved populations. We partnered with MoPoTsyo and InSTEDD in 2016-2018 to test tailored and targeted mHealth mobile voice messages and eHealth tablets to facilitate NCD management and clinical-community linkages. This cluster randomized controlled trial (RCT) engaged 3,948 people and 75 PEs across rural and urban areas. Our mixed methods process evaluation was guided by RE-AIM to understand impact and real-world implications of digital health. Data included patient (20) and PE interviews (6), meeting notes, and administrative datasets. We triangulated and analyzed data using thematic analysis, and descriptive and complier average causal effects statistics (CACE). RESULTS Reach: intervention participants were more urban (66% vs. 44%), had more PE visits (39 vs. 29), and lower uncontrolled hypertension [12% and 7% vs. 23% and 16% uncontrolled systolic blood pressure (SBP) and diastolic blood pressure (DBP)]. Adoption: patients were sent mean [standard deviation (SD)] 30 [14] and received 14 [8] messages; 40% received no messages due to frequent phone number changes. Effectiveness: CACE found clinically but not statistically significant improvements in blood pressure and sugar for mHealth participants who received at least one message vs. no messages. Implementation: main barriers were limited cellular access and that mHealth/eHealth could not solve structural barriers to NCD control faced by people in poverty. Maintenance: had the intervention been universally effective, it could be paid for from additional revolving drug fund revenue, new agreements with mobile networks, or the government. CONCLUSIONS Evidence for digital health to improve NCD outcomes in LMICs are limited. This study suggests digital health alone is insufficient in countries with low resource health systems and that high cell phone coverage did not translate to access. Adding digital health to an NCD peer network may not significantly benefit an already effective program; mHealth may be better for hard-to-reach populations not connected to other supports. As long as mHealth remains an individual-level intervention, it will not address social determinants of health that drive outcomes. Future digital health research and practice to improve NCD management in LMICs requires engaging government, NGOs, and technology providers to work together to address barriers.
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Affiliation(s)
- Lesley Steinman
- Department of Health Services, School of Public Health, University of Washington, Seattle, Washington, USA
| | | | - Heang Hen
- MoPoTsyo Patient Information Center, Phnom Penh, Cambodia
| | | | | | - Vannarath Te
- National Institute of Public Health, Phnom Penh, Cambodia
| | - James LoGerfo
- Department of Global Health, Schools of Public Health and Medicine, University of Washington, Seattle, Washington, USA
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Annette L. Fitzpatrick
- Department of Global Health, Schools of Public Health and Medicine, University of Washington, Seattle, Washington, USA
- Department of Family Medicine, School of Medicine, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
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MOHAMMADI-NASRABADI M, SADEGHI R, RAHIMI-FORUSHANI A, MOHAMMADI-NASRABADI F, SHOJAEIZADE D, MONTAZERI A. Structural equation modeling analysis of Iranian women’s food consumption: influence of socio-demographic characteristics and the Information, Motivation, and Behavioral skills Model. REV NUTR 2020. [DOI: 10.1590/1678-9865202033e180268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective This study aimed at examining whether food consumption varies in accordance with socio-demographic and behavioral factors in the conceptual model, analyzing adult women in Tehran, Iran, for that purpose. Methods This cross-sectional study was conducted with 247 women in childbearing age, who were selected through systematic cluster sampling from five regions in Tehran. Dietary assessment was done through a Food Frequency Questionnaire, and the anthropometric indices were measured. Data on socio-economic status and information-motivation-behavioral skills model were obtained through a questionnaire. Then, subjects were stratified according to the socio-economic status and model components. Statistical analysis was done using analysis of variance and structural equation modeling. Results Consumption of food groups among the participating women differed based on their living region, education, occupation, household expenditure, and model components (p<0.05). Intake of red and processed meat (p<0.05) was at the lowest level in illiterate or low educated women. Those with lower total expenditure had higher consumption of fats and oils (p<0.05). Women with higher perceived social support consumed more milk and dairy products (p<0.05), fats and oils (p<0.05), and less bread and cereals (p<0.05). Model components including information, attitude, social support, self-efficacy, and self-regulation were the most important factors negatively affecting the consumption of unhealthy foods (red and processed meat, fats and oils, sugar, and salty foods). Conclusion Considering the impact of model components on women’s eating behaviors, the specific integration strategies delineated for each construct of the model can be utilized to design model-based interventions targeting the promotion of healthy nutritional behavior.
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Affiliation(s)
| | | | | | | | | | - Ali MONTAZERI
- Iranian Institute for Health Sciences Research, Iran
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Tajik E, Latiff LA, Yit Siew C, Awang H, Adznam SNA. Designing and Validating a Questionnaire on Healthy Lifestyle to Reduce Depressive Symptoms among Adolescents. IRANIAN JOURNAL OF PSYCHIATRY 2020; 15:27-40. [PMID: 32377212 PMCID: PMC7193242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objective: Most adolescents do not meet national recommendations for healthy lifestyle and reducing depressive symptom. A comprehensive educational program with its specified questionnaire is needed to improve healthy lifestyle to assess the lifestyle components. This study aimed to confirm the validity of a healthy lifestyle questionnaire to assess depressive symptoms among adolescents. Method : A descriptive predictive study using simple random sampling was performed in a secondary school in Kuala Lumpur, Malaysia, among 235 school-going adolescents (13-15 years old) with Malaysian nationality. The instrument consisted of a set of dual language (English and Malay) for both researcher-administered questionnaires (knowledge, attitude, eating behavior, and relaxation activities) and standard-validated questionnaires (Physical Activity questionnaire for Adolescents, Depression, Anxiety, and Stress Scale- 21, and Brief Copping). Data were analyzed using the kappa statistics (k) and the intraclass correlation coefficient test for reliability and Partial Least Squares (PLS) for validity. Results: The reliability of all variables was over the substantial level (ICC and/or k > 0.61). The model and construct variables were predictive of depressive symptoms by 49.4%. To analyze the validity of the questions, 11 questions were removed from the initial model for factorial loading less than 0.5. In convergent validity of theory of information-motivation-behavioral skills, AVE (average variance construct), the outer loading, was higher than 0.5. Conclusion: PLS confirmed the existence of sufficient correlations between different items of the construct. Thus, the weights of indicators appeared to be appropriate indicators for the model. The results proved that the information, motivation, and behavioral skills model was efficient for healthy lifestyle and can be a good base for further research.
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Affiliation(s)
- Esra Tajik
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, School of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran., Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran., Department of Nutrition and Dietetics, School of Medicine and Health Sciences, University Putra Malaysia, Serdang, 43400, Selangor, Malaysia.,Corresponding Authors: Latiffah Abd Latiff. Address: Department of Community Health, School of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia, Postal Code: 43400. Tel: 60-389472537, Fax: 60-389450151, Esra Tajik. Address: Department of Community Nutrition, School of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Postal Code: 1931985567. Tel: 98-2122693133, Fax: 98-2122671935, ;
| | - Latiffah Abd Latiff
- Department of Community Health, School of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, 43400, Selangor, Malaysia.,Corresponding Authors: Latiffah Abd Latiff. Address: Department of Community Health, School of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia, Postal Code: 43400. Tel: 60-389472537, Fax: 60-389450151, Esra Tajik. Address: Department of Community Nutrition, School of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Postal Code: 1931985567. Tel: 98-2122693133, Fax: 98-2122671935, ;
| | - Chin Yit Siew
- Department of Nutrition and Dietetics, School of Medicine and Health Sciences, University Putra Malaysia, Serdang, 43400, Selangor, Malaysia
| | - Hamidin Awang
- Department of Psychiatry, School of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, 43400, Selangor, Malaysia
| | - Siti Nur' Asyura Adznam
- Department of Nutrition and Dietetics, School of Medicine and Health Sciences, University Putra Malaysia, Serdang, 43400, Selangor, Malaysia
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Si M, Su X, Jiang Y, Qiao Y, Liu Y. Interventions to improve human papillomavirus vaccination among Chinese female college students: study protocol for a randomized controlled trial. BMC Public Health 2019; 19:1546. [PMID: 31752785 PMCID: PMC6873719 DOI: 10.1186/s12889-019-7903-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 11/05/2019] [Indexed: 02/07/2023] Open
Abstract
Background While the HPV vaccines have been approved by the US FDA since 2006, in recent years an increasing number of women are living with cervical cancer globally. Among them, Chinese women have a higher cervical cancer incidence and mortality rate than the global average, with mortality rates being almost twice the global average. However, the current approach of HPV vaccination in China is not satisfactory given the high disease burden of cervical cancer. The current study is a randomized controlled trial designed to identify the barriers and facilitators of HPV vaccination among Chinese female students. This study will also test a health intervention measure via a popular form of new media in order to improve the HPV vaccine uptake under the framework of Information-Motivation-Behavioral skill Model (IMB). Methods This investigation is a multicenter, school-based, prospective, randomized, parallel group, double-blind, blank-controlled trial involving a 7-day education intervention with a further 6-month follow-up. We will enroll at least 3360 participants older than 18 years. The enrolled participants will be randomly divided into two groups (1:1 ratio). The intervention group will be offered a 7-day mobile health education, and participants in both groups will fill out 4 questionnaires at the baseline, 1 month, 3 months and 6 months after the intervention. The primary outcome is the difference in HPV vaccination or reservation for the HPV vaccine between the intervention and control groups. Secondary outcomes will include the comparison of (1) knowledge, attitudes, motivation, beliefs and behavioral skill about HPV and cervical cancer prevention, and (2) the willingness to uptake HPV vaccination. Discussion This study will examine the theory-based intervention in improving HPV vaccination among Chinese female college students. We will conduct the randomized controlled trial to provide scientific evidence on the potential effect of the IMB theory-based intervention. Findings from this study will contribute to a growing research field which assesses the effectiveness of mobile-based, school-targeted and theoretically guided interventions for promoting HPV vaccination in adolescents. Trial registration Chinese Clinical Trial Registry (ChiCTR), ChiCTR1900025476; Registered on 27 August 2019.
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Affiliation(s)
- Mingyu Si
- School of Public Health, Chinese Academy of Medical Sciences &Peking Union Medical College, 5 DongDanSanTiao, Dongcheng District, Beijing, China
| | - Xiaoyou Su
- School of Public Health, Chinese Academy of Medical Sciences &Peking Union Medical College, 5 DongDanSanTiao, Dongcheng District, Beijing, China.
| | - Yu Jiang
- School of Public Health, Chinese Academy of Medical Sciences &Peking Union Medical College, 5 DongDanSanTiao, Dongcheng District, Beijing, China
| | - Youlin Qiao
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuanli Liu
- School of Public Health, Chinese Academy of Medical Sciences &Peking Union Medical College, 5 DongDanSanTiao, Dongcheng District, Beijing, China
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Mano F, Ikeda K, Uchida Y, Liu ITHC, Joo E, Okura M, Inagaki N. Novel psychosocial factor involved in diabetes self-care in the Japanese cultural context. J Diabetes Investig 2019; 10:1102-1107. [PMID: 30516357 PMCID: PMC6626943 DOI: 10.1111/jdi.12983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 10/31/2018] [Accepted: 11/18/2018] [Indexed: 11/30/2022] Open
Abstract
AIMS/INTRODUCTION Recent evidence shows that cultural context can influence the management of diabetes mellitus. The aim of the present study was to examine the relationship between interdependence, which is valued in the Eastern cultural context, and diabetes self-care behavior in Japanese patients with type 2 diabetes mellitus. MATERIAL AND METHODS We carried out a cross-sectional survey of 161 Japanese adults with type 2 diabetes mellitus using well-established questionnaires. The association of an interdependent tendency with diabetes self-care activities was analyzed using multiple regression analysis. RESULTS Diabetes self-care activities had a negative correlation with interdependent tendency (r = -0.16, P = 0.047), and they had positive correlations with age (r = 0.42, P < 0.001), emotional support (r = 0.25, P = 0.001) and diabetes self-care support (r = 0.36, P < 0.001). When patients were divided into two groups at the median age (68 years), multiple regressions showed that interdependent tendency (β = -0.20, P = 0.048), male sex (β = -0.24, P = 0.023), emotional support (β = 0.22, P = 0.028) and diabetes self-care support (β = 0.39, P < 0.001) were significant determinants of diabetes self-care activities only in the younger group. CONCLUSIONS Interdependence might influence diabetes self-care behavior, and intervention focusing on support from close others might lead patients to more successful care among Japanese adults with type 2 diabetes mellitus, especially those aged <68 years.
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Affiliation(s)
- Fumika Mano
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kaori Ikeda
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yukiko Uchida
- Kokoro Research Center, Kyoto University, Kyoto, Japan
| | | | - Erina Joo
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - Nobuya Inagaki
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Salari R, Niakan Kalhori SR, Fatehi F, Ghazisaeedi M, Nazari M. Determining minimum set of features for diabetes mobile apps. J Diabetes Metab Disord 2019; 18:333-340. [PMID: 31890658 DOI: 10.1007/s40200-019-00417-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 05/30/2019] [Indexed: 12/25/2022]
Abstract
Purpose Interest in mobile health applications (apps) for diabetes self-care is growing. Mobile health is a promising new treatment modality for diabetes, though few smartphone apps have been designed based on a proper study and prioritization. The aim of this study was to determine a minimum set of features for diabetes mobile apps. Methods This study was conducted in three steps: 1.A review of the literature to collect all available features, 2. Assessing the validity of suggested features by Content Validity Index (CVI) and Content Validity Ratio (CVR), 3. Examining the importance of features by Friedman test. Results We retrieved all features of available mobile apps for type 2 diabetes, which are suggested and discussed in literature and compiled as a single list comprising of 33 features. Then, a survey of expert's opinion produced a set of 23 final minimum features which includes all types of tracking, mealtime tagging, food database, diet management, educational materials, healthy coping, reducing risks, problem solving, Email, color coding, alerts, reminder, target range setting, trend chart view, logbook view, numerical indicators view, customizable theme, preset notes, and custom notes. According to the mean rank which indicates the priority of each feature, the most important one was blood glucose tracking (with 16.71 mean rank) and the least important feature was the numerical indicators like such as standard deviation or average (with 6.50 mean rank). Conclusions The present study is the first step towards the development of our mobile apps for people with type II diabetes, and highest the essential features that are required for an optimal self-care comprehensively.
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Affiliation(s)
- Raheleh Salari
- 1Department of Health Information Management, Tehran University of Medical Sciences, Floor 3, No. 17, Faredanesh Alley, Ghods St, Tehran, Iran
| | - Sharareh R Niakan Kalhori
- 1Department of Health Information Management, Tehran University of Medical Sciences, Floor 3, No. 17, Faredanesh Alley, Ghods St, Tehran, Iran
| | - Farhad Fatehi
- 2Australian e-Health Research Centre, CSIRO, Brisbane, Australia.,3Centre for Online Health, The University of Queensland, Brisbane, Australia
| | - Marjan Ghazisaeedi
- 1Department of Health Information Management, Tehran University of Medical Sciences, Floor 3, No. 17, Faredanesh Alley, Ghods St, Tehran, Iran
| | - Mahin Nazari
- 4Department of Health Education and Health Promotion, School of Public Health, Shiraz University of Medical Sciences, Shiraz, Iran
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Wang X, Luo JF, Qi L, Long Q, Guo J, Wang HH. Adherence to self-monitoring of blood glucose in Chinese patients with type 2 diabetes: current status and influential factors based on electronic questionnaires. Patient Prefer Adherence 2019; 13:1269-1282. [PMID: 31413552 PMCID: PMC6662864 DOI: 10.2147/ppa.s211668] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 06/30/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND AND PURPOSE Self-monitoring of blood glucose (SMBG) is important to the management of diabetes mellitus, yet most patients with type 2 diabetes mellitus (T2DM) do not perform SMBG as recommended. The current status and influential factors of SMBG in China have not been well investigated. This study aimed to describe the present status of SMBG adherence in China and investigate the influential factors based on electronic questionnaires. PATIENTS AND METHODS A cross-sectional study was conducted from June to July of 2017 at hospitals in Changsha, China. Seven hundred and twenty-one patients with T2DM completed the information‑motivation‑behavioral (IMB) skills questionnaire and other electronic questionnaires composed of demographic and clinical characteristics as well as diabetes-related and psychological scales. Univariate comparisons and multivariate logistic regression were used to explore the relationships among SMBG adherence and related factors. RESULTS Seven hundred and twenty-one patients with valid questionnaires were included. Only 27.5% (198/721) of the patients with T2DM were SMBG adherent based on the guideline of the Chinese Diabetes Society (CDS) in 2017. Among all groups of treatment regimens, the rate of SMBG adherence was highest at 36.6% (82/224) in patients on oral hypoglycaemic drugs (OHAs). In multivariable analysis, the treatment of OHAs (OR =3.731, CI 2.162-6.437) and diet/exercise (OR =3.534, CI 1.841-6.783), the patient having their own blood glucose meter (OR =6.916, CI 4.054-11.800) and a higher education level (OR =3.780, CI 1.688-8.466) were significantly associated with SMBG adherence. CONCLUSION Most Chinese patients with T2DM did not perform SMBG as recommended. The treatment of OHAs and diet/exercise, the patient having their own blood glucose meter, a higher education level and other factors were correlates of SMBG adherence. There is clearly a need for prospective, multicenter, large-scale studies to explore the reasons for patients' failure to practice SMBG adherence.
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Affiliation(s)
- Xin Wang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, People’s Republic of China
| | - Jun-Fei Luo
- The College of Literature and Journalism, Central South University, Changsha, Hunan, People’s Republic of China
| | - Lin Qi
- Department of Orthopaedics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China
- Hunan Key Laboratory of Tumor Models and Individualized Medicine, the Second Xiangya Hospital, Changsha, Hunan, People’s Republic of China
| | - Qing Long
- Xiangya School of Nursing, Central South University, Changsha, Hunan, People’s Republic of China
| | - Jia Guo
- Xiangya School of Nursing, Central South University, Changsha, Hunan, People’s Republic of China
- Correspondence: Jia GuoXiangya School of Nursing, Central South University, No. 172 Tongzipo Road, Changsha410013, Hunan, People’s Republic of ChinaTel +86 1 387 594 7418Email
| | - Hong-Hong Wang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, People’s Republic of China
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Liu T, Wu D, Wang J, Li C, Yang R, Ge S, Du Y, Wang Y. Testing the information-motivation-behavioural skills model of diabetes self-management among Chinese adults with type 2 diabetes: a protocol of a 3-month follow-up study. BMJ Open 2018; 8:e020894. [PMID: 30297344 PMCID: PMC6194399 DOI: 10.1136/bmjopen-2017-020894] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Currently, China leads the world in the number of people with diabetes, making it home to a third of the global diabetic population. Persons with diabetes have to carry out 95% of their self-care. As an important component of diabetes care, diabetes self-management (DSM) is defined as everyday behaviours that persons carry out to control diabetes. Consistent findings have been reported that level of compliance to suggested DSM behaviours is not considered optimal among Chinese adults with type 2 diabetes (T2D). The underlying reasons for suboptimal DSM behaviours among Chinese adults are not well known and no conceptual model has been developed to guide DSM interventions in this population. Although the information-motivation-behavioural skills model has been tested among Chinese adults with T2D, some key components of the original model were not tested. In this proposed study protocol, we will refine and test a culturally tailored model of DSM longitudinally among 250 Chinese adults residing in China. METHODS AND ANALYSIS This is a descriptive, repeated-measure study to be conducted at a tertiary hospital in Chengdu, China. A total of 250 adults with T2D will be enrolled and followed for 3 months in this study. Information of multiple domains will be collected, including demographics, diabetes knowledge, health education form, provider-patient communication, health beliefs, social support, diabetes self-efficacy, the medical coping modes, the diabetes self-care, depression, diabetes-dependent quality of life, haemoglobin A1c, blood pressure and blood lipids at baseline and 3-month follow-up. Main analyses comprise linear regression modelling controlling for covariates and structural equation modelling. ETHICS AND DISSEMINATION Ethical approval has been obtained through the Fourth People's Hospital of Chengdu Research Ethics Committee (study approval number 2017017). We aim to disseminate the findings through international conferences, international peer-reviewed journals and social media. TRIAL REGISTRATION NUMBER ChiCTR-ROC-17013592.
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Affiliation(s)
- Tingting Liu
- University of Arkansas Eleanor Mann School of Nursing, Fayetteville, AR, USA
| | - Dongmei Wu
- Department of Nursing, The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
| | - Jing Wang
- UT Health San Antonio School of Nursing, San Antonio, TX, USA
| | - Changwei Li
- Department of Epidemiology and Biostatistics, University of Georgia College of Public Health, Athens, GA, USA
| | - Rumei Yang
- University of Utah College of Nursing, Salt Lake City, UT, USA
| | - Song Ge
- Department of Natural Sciences/Nursing, University of Houston-Downtown, Houston, TX, USA
| | - Yan Du
- Department of Biostatistics, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Yanyan Wang
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
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Wang X, Jia M, Li Y, Bao Y, Zhang C, Zhou C, Wang L, Cao X, Jiang R, Li F. Validation of an information–motivation–behavioral skills model of upper limb functional exercise adherence among Chinese postoperative patients with breast cancer. Breast Cancer 2018; 26:198-205. [DOI: 10.1007/s12282-018-0911-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Accepted: 09/20/2018] [Indexed: 11/29/2022]
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Chen Q, Wang H, Wang Y, Wang Z, Zhao D, Cai Y. Exploring effects of self-management on glycemic control using a modified information-motivation-behavioral skills model in type 2 diabetes mellitus patients in Shanghai, China: A cross-sectional study. J Diabetes 2018; 10:734-743. [PMID: 29457694 DOI: 10.1111/1753-0407.12655] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 01/24/2018] [Accepted: 02/14/2018] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The original information-motivation-behavioral skills (IMB) model has been verified in type 2 diabetes mellitus (T2DM) patients, but the effects of the model on glycemic control remain unclear. The aim of this study was to modify the IMB model to explore the effects of self-management on glycemic control in T2DM patients in Shanghai, China. METHODS A cross-sectional study was conducted on participants recruited using a convenience sampling method between June and August 2015 in three tertiary hospitals and four community health service centers; 796 participants meeting the inclusion criteria (age ≥18 years and a diagnosis of T2DM) completed a questionnaire and blood test for glycemic control. Structural equation models were used to test the IMB framework. RESULTS The modified model demonstrated an acceptable fit of the data. Paths from information to self-management behaviors (β = 0.119, P = 0.001) and HbA1c (β = -0.140, P < 0.001), from motivation to behavioral skills (β = 0.670, P < 0.001), from behavioral skills to self-management behaviors (β = 0.562, P < 0.001), and from self-management behaviors to HbA1c (β = -0.343, P < 0.001) were all significant and in the predicted direction. Information and motivation varied with each other (r = 0.350, P < 0.001). CONCLUSIONS Glycemic control can be incorporated into the IMB model. The utility of the modified model in the study population is validated. Type 2 diabetes mellitus patients with poor control of glucose levels may be a better target population for application of the modified IMB model.
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Affiliation(s)
- Qi Chen
- Department of Human Resources, Ruijin Hospital, Affiliated with the School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Huwen Wang
- Department of Community Health and Behavioral Medicine, School of Public Health, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Yichen Wang
- Department of Hospital Infection Control, Ruijin Hospital, Affiliated with the School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Zezhou Wang
- Department of Community Health and Behavioral Medicine, School of Public Health, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Daijun Zhao
- Department of Chronic Disease Prevention, Shanghai Hongkou Center for Disease Control and Prevention, Shanghai, China
| | - Yong Cai
- Department of Community Health and Behavioral Medicine, School of Public Health, School of Medicine, Shanghai Jiaotong University, Shanghai, China
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Jeon E, Park HA. Development of the IMB Model and an Evidence-Based Diabetes Self-management Mobile Application. Healthc Inform Res 2018; 24:125-138. [PMID: 29770246 PMCID: PMC5944187 DOI: 10.4258/hir.2018.24.2.125] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 02/19/2018] [Accepted: 03/14/2018] [Indexed: 11/23/2022] Open
Abstract
Objectives This study developed a diabetes self-management mobile application based on the information-motivation-behavioral skills (IMB) model, evidence extracted from clinical practice guidelines, and requirements identified through focus group interviews (FGIs) with diabetes patients. Methods We developed a diabetes self-management (DSM) app in accordance with the following four stages of the system development life cycle. The functional and knowledge requirements of the users were extracted through FGIs with 19 diabetes patients. A system diagram, data models, a database, an algorithm, screens, and menus were designed. An Android app and server with an SSL protocol were developed. The DSM app algorithm and heuristics, as well as the usability of the DSM app were evaluated, and then the DSM app was modified based on heuristics and usability evaluation. Results A total of 11 requirement themes were identified through the FGIs. Sixteen functions and 49 knowledge rules were extracted. The system diagram consisted of a client part and server part, 78 data models, a database with 10 tables, an algorithm, and a menu structure with 6 main menus, and 40 user screens were developed. The DSM app was Android version 4.4 or higher for Bluetooth connectivity. The proficiency and efficiency scores of the algorithm were 90.96% and 92.39%, respectively. Fifteen issues were revealed through the heuristic evaluation, and the app was modified to address three of these issues. It was also modified to address five comments received by the researchers through the usability evaluation. Conclusions The DSM app was developed based on behavioral change theory through IMB models. It was designed to be evidence-based, user-centered, and effective. It remains necessary to fully evaluate the effect of the DSM app on the DSM behavior changes of diabetes patients.
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Affiliation(s)
- Eunjoo Jeon
- College of Nursing, Seoul National University, Seoul, Korea
| | - Hyeoun-Ae Park
- College of Nursing, Seoul National University, Seoul, Korea.,Systems Biomedical Informatics Research Center, Seoul National University, Seoul, Korea
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Al Slamah T, Nicholl BI, Alslail FY, Melville CA. Self-management of type 2 diabetes in gulf cooperation council countries: A systematic review. PLoS One 2017; 12:e0189160. [PMID: 29232697 PMCID: PMC5726716 DOI: 10.1371/journal.pone.0189160] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 11/20/2017] [Indexed: 11/30/2022] Open
Abstract
Aims This study aimed to systematically review intervention studies on self-management of type 2 diabetes in Gulf Cooperation Council (GCC) countries to determine the most effective self-management strategies for individuals with type 2 diabetes in this region. Methods A search strategy was developed using multiple databases: Medline and Embase (via Ovid), CINAHL (via EBSCO), and PubMed. Study and intervention characteristics, intervention structure, content, cultural adaptation, and outcomes were extracted from the included studies. To be included in the review the studies should have met the following criteria: have examined the effectiveness of at least one intervention involving a type 2 DSME programme, have involved participants over 18 years old diagnosed with type 2 diabetes, have taken place to in a GCC country, have a study design that was observational, quasi-experimental or controlled, have reported at least one individual and have a quantitative outcome. A narrative data synthesis was used to describe the studies and comment on their methodological quality. Results Of the 737 retrieved papers, only eight met the inclusion criteria. Only one study was a randomised controlled trial. A statistically significant improvement in HbA1c was reported in five of the eight studies. There was a significant improvement in physical activity levels as reported in four of the eight studies. Only three studies referred to aspects of cultural design or adaptation of the intervention implemented. Conclusions Self-management interventions may have a positive impact on HbA1 levels in patients with type 2 diabetes in the GCC area. A greater emphasis placed on culturally appropriate self-management programmes may improve the effectiveness of self-management interventions for adults with type 2 diabetes in the GCC.
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Affiliation(s)
- Thamer Al Slamah
- General Practice and Primary Care, Institute of Health and Wellbeing College of Medicine, Veterinary and Life Science, University of Glasgow, Glasgow, United Kingdom
| | - Barbara I. Nicholl
- General Practice and Primary Care, Institute of Health and Wellbeing College of Medicine, Veterinary and Life Science, University of Glasgow, Glasgow, United Kingdom
| | - Fatima Y. Alslail
- Director of the National Diabetes Control and Prevention Program, Ministry of Health, Riyadh, Kingdom of Saudi Arabia
| | - Craig A. Melville
- Mental Health and Wellbeing, Institute of Health and Wellbeing, College of Medicine, Veterinary and Life Science, University of Glasgow, Glasgow, United Kingdom
- * E-mail:
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Meunier S, Coulombe S, Beaulieu MD, Côté J, Lespérance F, Chiasson JL, Bherer L, Lambert J, Houle J. Longitudinal testing of the Information-Motivation-Behavioral Skills model of self-care among adults with type 2 diabetes. PATIENT EDUCATION AND COUNSELING 2016; 99:1830-1836. [PMID: 27373961 DOI: 10.1016/j.pec.2016.06.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 05/19/2016] [Accepted: 06/16/2016] [Indexed: 05/28/2023]
Abstract
OBJECTIVE The study's aim was to test prospective associations between information, motivation, and behavioral skills (IMB model) and self-care behaviors (diet, exercise, and blood glucose testing) among patients with type 2 diabetes. METHODS 295 participants were surveyed one (T1), six (T2), and 12 (T3) months after a diabetes course. Cross-lagged panel analyses were performed to test unidirectional and bidirectional relationships between IMB model variables and self-care behaviors. RESULTS Blood-glucose testing at T1 was positively related to information at T2, which in turn was positively related to blood-glucose testing at T3. Controlled motivation at T1 was positively related to exercise at T2. Autonomous motivation at T2 was positively associated with exercise at T3. There was a positive bidirectional relationship across time between behavioral skills and general diet. CONCLUSION Patterns of prospective associations between IMB model variables and diabetes self-care depend on the self-care behavior considered. This model offers an interesting framework for examining how diabetes self-care behaviors evolve. PRACTICE IMPLICATIONS Diabetes education programs should provide information about current health status and promote experiential learning to help patients realize the impact of their behaviors on glycemic control; should foster autonomous motivation for long-term change; and should build on patients' strengths and skills.
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Affiliation(s)
- Sophie Meunier
- Department of Psychology, Université du Québec à Montréal, Montréal, Canada.
| | - Simon Coulombe
- Department of Psychology, Université du Québec à Montréal, Montréal, Canada.
| | - Marie-Dominique Beaulieu
- CHUM Research Center, Montréal, Canada; Department of Family and Emergency Medicine, Université de Montréal, Montréal, Canada.
| | - José Côté
- CHUM Research Center, Montréal, Canada; Faculty of Nursing, Université de Montréal, Montréal, Canada.
| | - François Lespérance
- CHUM Research Center, Montréal, Canada; Department of Psychiatry, Université de Montréal, Montréal, Canada.
| | - Jean-Louis Chiasson
- CHUM Research Center, Montréal, Canada; Department of Medicine, Université de Montréal, Montréal, Canada.
| | - Louis Bherer
- PERFORM Centre, Concordia University, Montréal, Canada; Institut universitaire de gériatrie de Montréal, Montréal, Canada.
| | - Jean Lambert
- Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montréal, Canada.
| | - Janie Houle
- Department of Psychology, Université du Québec à Montréal, Montréal, Canada; CHUM Research Center, Montréal, Canada.
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Kumar PDM, Mohandoss AA, Walls T, Rooban T, Vernon LT. Using smartphone video "selfies" to monitor change in toothbrushing behavior after a brief intervention: A pilot study. Indian J Dent Res 2016; 27:268-77. [PMID: 27411655 PMCID: PMC5986070 DOI: 10.4103/0970-9290.186241] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Attempts to refine toothbrushing (TB) technique, an ingrained habit in adults, can meet with some challenges. Recently, the role of proactive interference as a barrier to improving the learning of proper brushing has been proposed. This pilot feasibility study was designed to investigate TB behavior and to see how it changes after training. Smartphone video "selfies" (SPVSs) are increasingly being used in the medical field to assess, monitor, and determine the progression of diseases. MATERIALS AND METHODS We used SPVS to study TB skills in a small sample of volunteers. Over a period of 14 days, after a one-time group training session, we observed TB behavior of volunteers using self-captured SPVS. RESULTS Following the brief intervention, we observed an 8% of improvement in TB skills. DISCUSSION To the best of our knowledge, this is the first report using SPVS to study TB behavior. We demonstrated initial feasibility of using SPVS in the dental setting. We observed modest improvements in toothbrushing accuracy and quality, and we generated important experiences about the use of Selfies for TB monitoring and intervention, and some interesting insights about where in the toothbrushing is more or less effective. CONCLUSION Further investigation using a larger sample size is needed to thoroughly assess the effectiveness of this approach to improve TB skills and better understand the role of proactive interference.
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Affiliation(s)
| | - Anusa Arunachalam Mohandoss
- Department of Psychiatry, Shri Sathya Sai Medical College and Research Institute, Kancheepuram, Tamil Nadu, India
| | - Theodore Walls
- Center for Health Monitoring and Intervention, University of Rhode Island, Kingston, RI
| | - Thavarajah Rooban
- Department of Public Health Dentistry and Oral and Maxillofacial Pathology and Microbiology, Ragas Dental College and Hospital, Chennai
| | - Lance T Vernon
- Department of Pediatric and Community Dentistry, School of Dental Medicine, Case Western Reserve University, Ohio, USA
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Talley CH, Yang L, Williams KP. Breast Cancer Screening Paved with Good Intentions: Application of the Information–Motivation–Behavioral Skills Model to Racial/Ethnic Minority Women. J Immigr Minor Health 2016; 19:1362-1371. [DOI: 10.1007/s10903-016-0355-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Luo X, Liu T, Yuan X, Ge S, Yang J, Li C, Sun W. Factors Influencing Self-Management in Chinese Adults with Type 2 Diabetes: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:11304-27. [PMID: 26378555 PMCID: PMC4586677 DOI: 10.3390/ijerph120911304] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 08/26/2015] [Accepted: 09/02/2015] [Indexed: 01/18/2023]
Abstract
Diabetes is a major public health problem in China. Diabetes self-management is critical for patients to achieved better health outcomes, however, previous studies have shown suboptimal diabetes self-management performance. We conducted a systematic review and meta-analysis to identify factors associated with diabetes self-management in Chinese adults. The results showed that confrontation, resignation, overall health beliefs, perceived susceptibility, perceived barriers, and self-efficacy were factors associated with overall diabetes self-management performance and six aspects of diabetes self-management behaviors. There is some limited evidence to suggest that provider-patient communication, married individuals, higher educational level, and higher household income level may also be linked to better diabetes self-management practice. Having healthcare insurance and utilizing chronic illness resources generally appeared to have a favorable effect on diabetes self-management performance. In addition, there were a number of factors for which the evidence is too limited to be able to ascertain its strength of association with diabetes self-management practice. The findings of this review suggest that diabetes self-management behaviors are affected by a wide range of personal and environmental factors, which allow health care providers to develop theory-based strategies to improve diabetes-self-management behaviors in this population.
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Affiliation(s)
- Xiaoping Luo
- Anesthesia Department of Zhongshan People's Hospital, Zhongshan 528403, China.
| | - Tingting Liu
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA 30322, USA.
| | - Xiaojing Yuan
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA.
| | - Song Ge
- School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA.
| | - Jing Yang
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.
| | - Changwei Li
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA.
| | - Wenjie Sun
- School of Food Science, Guangdong Pharmaceutical University, Zhongshan 528458, China.
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Jones ER, Goldman RS. Managing Disruptive Behavior by Patients and Physicians: A Responsibility of the Dialysis Facility Medical Director. Clin J Am Soc Nephrol 2015; 10:1470-5. [PMID: 25403921 DOI: 10.2215/cjn.05220514] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The Centers for Medicare & Medicaid Services' Conditions for Coverage make the medical director of an ESRD facility responsible for all aspects of care, including high-quality health care delivery (e.g., safe, effective, timely, efficient, and patient centered). Because of the high-pressure environment of the dialysis facility, conflicts are common. Conflict frequently occurs when aberrant behaviors disrupt the dialysis facility. Patients, family members, friends, and, less commonly appreciated, nephrology clinicians (i.e., nephrologists and advanced care practitioners) may manifest disruptive behavior. Disruptive behavior in the dialysis facility impairs the ability to deliver high-quality care. Furthermore, disruptive behavior is the leading cause for involuntary discharge (IVD) or involuntary transfer (IVT) of a patient from a facility. IVD usually results in loss of continuity of care, increased emergency department visits, and increased unscheduled, acute dialysis treatments. A sufficient number of IVDs and IVTs also trigger an extensive review of the facility by the regional ESRD Networks, exposing the facility to possible Medicare-imposed sanctions. Medical directors must be equipped to recognize and correct disruptive behavior. Nephrology-based literature and tools exist to help dialysis facility medical directors successfully address and resolve disruptive behavior before medical directors must involuntarily discharge a patient or terminate an attending clinician.
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Affiliation(s)
- Edward R Jones
- Nephrology Section, Chestnut Hill Hospital, Delaware Valley Nephrology and Hypertension, Philadelphia, Pennsylvania, and
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Chang SJ, Choi S, Kim SA, Song M. Intervention Strategies Based on Information-Motivation-Behavioral Skills Model for Health Behavior Change: A Systematic Review. Asian Nurs Res (Korean Soc Nurs Sci) 2014. [DOI: 10.1016/j.anr.2014.08.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Wai Leng C, Jundong J, Li Wei C, Joo Pin F, Kwong Ming F, Chen R. Telehealth for improved glycaemic control in patients with poorly controlled diabetes after acute hospitalization – a preliminary study in Singapore. J Telemed Telecare 2014; 20:317-23. [DOI: 10.1177/1357633x14544441] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We evaluated a disease management and education programme delivered via telephone support (TS) to patients with poorly controlled diabetes (HbA1c >7%). All eligible patients were invited to participate in the programme, which involved education on lifestyle modification and disease management delivered via three scheduled monthly calls by trained nurses. Patients who declined or could not be contacted acted as the controls (usual care, UC). A per protocol analysis was conducted using a mixed effect model for two subgroups with different baseline HbA1c levels (i.e. baseline HbA1c <8.0% and HbA1c ≥8.0%). A total of 2646 patients with diabetes were eligible for enrolment. Of these, 1391 participants had HbA1c measurements available. The study comprised 633 patients (46%) who completed the programme (TS), 598 (43%) who were not contactable or refused to participate at the first telephone call (UC) and 160 patients who dropped out. In the patients with HbA1c ≥8%, TS reduced the adjusted mean HbA1c by 0.38% ( P = 0.022) but the reduction in diabetes-related admissions (4.2% lower adjusted mean admission rate) was not significant. In patients with HbA1c <8%, TS had no additional effect on glycaemic control or diabetes-related admission. Telephone support appeared effective in improving glycaemic control in patients with poor diabetes control.
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Affiliation(s)
- Chow Wai Leng
- Health Services Research, Eastern Health Alliance, Singapore
| | - Jiang Jundong
- Health Services Research, Eastern Health Alliance, Singapore
| | - Cho Li Wei
- Endocrinology, Changi General Hospital, Singapore
| | - Foo Joo Pin
- Endocrinology, Changi General Hospital, Singapore
| | | | - Richard Chen
- Endocrinology, Changi General Hospital, Singapore
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Tomioka M, Braun KL, Ah Cook V, Compton M, Wertin K. Improving behavioral and clinical indicators in Asians and Pacific Islanders with diabetes: findings from a community clinic-based program. Diabetes Res Clin Pract 2014; 104:220-5. [PMID: 24636628 PMCID: PMC4703033 DOI: 10.1016/j.diabres.2013.12.035] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 11/07/2013] [Accepted: 12/02/2013] [Indexed: 01/15/2023]
Abstract
AIMS This project tested the six-month impact of Stanford's Diabetes Self-Management Program (DSMP), adapted for Asians and Pacific Islanders (APIs), on behavioral and clinical indicators. METHODS Participants attended DSMP workshops at a community health center. Employing a one-group, pre-post-test design, data were collected at baseline and six-months. Ninety-six eligible API adults were enrolled. All attended four or more of the six weekly sessions, and 82 completed data collection. Measures included body mass index, blood pressure, blood lipids, blood glucose, HbA1c, as well as health behaviors. Data were analyzed by descriptive statistics and paired t-tests. RESULTS Adaptations to DSMP were minimal, but critical to the local acceptance of the program. At six-months, significant behavioral improvements included: (1) increased minutes in stretching and aerobic exercise per week (p<0.001); (2) reduced symptoms of hypoglycemia and hyperglycemia (p<0.001); (3) increased self-efficacy (p<0.001); and (4) increased number of days and times testing blood sugar levels (p<0.001). Significant clinical improvements included: (1) lower BMI (p<0.001); (2) lower HbA1c (p<0.001); (3) lower total cholesterol, triglycerides, and LDL (p<0.001); and (4) lower blood pressure (p<0.001). CONCLUSIONS Findings suggest that the DSMP can be successfully adapted to API populations and can improve clinical measures as well as health behaviors.
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Affiliation(s)
- Michiyo Tomioka
- Office of Public Health Studies, University of Hawai'i at Mānoa, 1960 East-West Road, Biomed, Honolulu, HI 96822, United States.
| | - Kathryn L Braun
- Office of Public Health Studies, University of Hawai'i at Mānoa, 1960 East-West Road, Biomed, Honolulu, HI 96822, United States
| | - Valerie Ah Cook
- Hawai'i State Department of Health, Diabetes Prevention and Control Program, 601 Kamokila Boulevard, Room 344, Kapolei, HI 96707, United States
| | - Merlita Compton
- Kokua Kalihi Valley Comprehensive Family Services, Elder Care Services Program, 1846 Gulick Avenue, Honolulu, HI 96819, United States
| | - Kristin Wertin
- Hawai'i State Department of Health, Diabetes Prevention and Control Program, 601 Kamokila Boulevard, Room 344, Kapolei, HI 96707, United States
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Fisher WA, Fisher JD, Shuper PA. Social Psychology and the Fight Against AIDS. ADVANCES IN EXPERIMENTAL SOCIAL PSYCHOLOGY 2014. [DOI: 10.1016/b978-0-12-800284-1.00003-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Celano CM, Beale EE, Moore SV, Wexler DJ, Huffman JC. Positive psychological characteristics in diabetes: a review. Curr Diab Rep 2013; 13:917-29. [PMID: 24048687 DOI: 10.1007/s11892-013-0430-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Positive psychological characteristics, such as optimism, self-efficacy, and resilience, have been increasingly associated with improved outcomes in medically ill individuals. However, there has been minimal systematic review of these characteristics and their associations with outcomes in people with diabetes. We aim to review these associations, their potential mediating mechanisms, and the evidence supporting interventions targeting these qualities. In people with diabetes, positive psychological characteristics are significantly associated with improved glycemic control, fewer complications, and reduced rates of mortality. Potential mechanisms mediating these associations include behavioral factors (e.g., improved treatment adherence), reduced inflammation, and improved neuroendocrine and autonomic functioning. Most psychosocial treatments in this population have focused on improving self-efficacy and resilience; such interventions may improve quality of life, well-being, and diabetes self-care. While untested in diabetes, interventions to boost other positive characteristics have been effective in other medically ill patients and may warrant further study in this cohort.
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Zhu C, Cai Y, Ma J, Li N, Zhu J, He Y, Redmon P, Qiao Y. Predictors of intention to smoke among junior high school students in Shanghai, China: an empirical test of the information-motivation-behavioral skills (IMB) model. PLoS One 2013; 8:e80482. [PMID: 24244690 PMCID: PMC3828279 DOI: 10.1371/journal.pone.0080482] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 10/12/2013] [Indexed: 11/30/2022] Open
Abstract
Background Adolescent smoking is a worldwide problem that is particularly severe in low- and middle-income countries. Many endogenous and environmental factors affect the intention to smoke, so a comprehensive model is needed to understand the significance and relationship of predictors. The study aimed to test the associations among information-motivation-behavioral skills (IMB) model constructs as predictors of intention to smoke in junior high school students in Shanghai, China. Methods We conducted a cross-sectional study of 16,500 junior high school students in Shanghai, China. Data on tobacco-related information, motivation, behavioral skills, and behaviors were collected from students. Structural equation model (SEM) was used to assess the IMB model. Results The mean age of participants was 13.8 years old (standard deviation = 1.02; range 11–17). The experimental smoking rate among junior high school students was 6.6% and 8.7% of the participants expected that they would be smokers in 5 years. The IMB model provided acceptable fit to the data (comparative fit index = 0.984, root mean square error of approximation = 0.04). Intention to smoke was predicted by behavioral skills (β= 0.670, P < 0.001) and motivation (β= 0.095, P<0.001) among junior high school students. Conclusion The IMB model provides a good understanding of the predictors of intention to smoke and it suggests future interventions among junior high school students should focus on improving motivation and behavioral skills.
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Affiliation(s)
- Chendi Zhu
- School of Public Health, Shanghai JiaoTong University, Shanghai, PR China
| | - Yong Cai
- School of Public Health, Shanghai JiaoTong University, Shanghai, PR China
- * E-mail: (YC); (JM)
| | - Jin Ma
- School of Public Health, Shanghai JiaoTong University, Shanghai, PR China
- * E-mail: (YC); (JM)
| | - Na Li
- School of Public Health, Shanghai JiaoTong University, Shanghai, PR China
| | - Jingfen Zhu
- School of Public Health, Shanghai JiaoTong University, Shanghai, PR China
| | - Yaping He
- School of Public Health, Shanghai JiaoTong University, Shanghai, PR China
| | - Pamela Redmon
- Global Health Institute, Emory University, Atlanta, Georgia, United States of America
| | - Yun Qiao
- Pudong Institute for Health Development, Shanghai, PR China
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