The impact of educational intervention on physical activity, nutrition and laboratory parameters in type II diabetic patients

Effect of nutritional promotion intervention on dietary adherence among type II diabetes patients in North Shoa Zone Amhara Region: quasi-experimental study

BACKGROUND

Diabetes is a major global public health problem that requires self-management behavior. However, this is difficult to implement in practice and requires new approaches. The purpose of this study was to evaluate nutritional promotion interventions for dietary adherence and lessons learned to improve self-management.

METHODS

A quasi-experimental study was conducted from January 2020 to February 2021 in North Shoa Zone public hospital. The study enrolled 216 type II diabetic patients from four public hospitals. Study participants were randomly assigned to intervention and control groups at an individual level. Data were measured twice (baseline and end line survey after six months using interviewer-administered questionnaires). Data were entered into Epi Data V.3.1 and analyzed using SPSS version 22. Data were presented as means of standard deviations for continuous variables and percentages for categorical variables. Intervention and control groups were compared before and after intervention using independent t tests. A p-value less than 0.05 was considered significant for all statistical tests.

RESULTS

A total of 216 type II diabetics participated in this study. Nutritional promotion intervention programs increased adherence to the mean number of days adhering to a healthy diet (p < 0.0001). Specifically, the nutrition promotion program improved daily intake of fruits and vegetables, low glycemic index foods, high fiber foods, healthy fish oils, low sugar foods, and healthy eating plans (p ≤ 0.050). Mean fasting blood glucose levels were significantly decreased after the educational intervention (p ≤ 0.05).

CONCLUSION

This study demonstrates that a nutrition-promoting intervention can significantly change patients' adherence to healthy eating behaviors and effectively improve their glycemic control. Health care providers should integrate programs that promote nutrition education into existing health systems service. Primary care platforms such as health posts and health centers can play a key role in integrating health promotion programs to improve self-management behaviors.

The effectiveness of self-management program for people with type 2 diabetes mellitus based on PRECEDE-PROCEDE model

AIMS

Diabetes mellitus (DM) is one of the most common chronic diseases worldwide that requires a person with diabetes to make a multitude of daily self-management decisions. This study sought to evaluate the effectiveness of a self-management program based on PRECEDE-PROCEDE model on self-management behaviors in patients with type 2 diabetes.

METHODS

This experimental study was conducted on 86 diabetic patients referred to the diabetes clinics in Ardabil, Iran, in 2017. From a total of 326 patients with diabetes medical records in those clinics, 86 (26.3%) patients agreed to participate in this study. They were then randomly divided into two groups; intervention (n = 43) and control (n = 43). The intervention group received eight sessions of PRECEDE model-based self-management education program while the control group did not receive any education program. Both groups were assessed at baseline and six months after the intervention.

RESULTS

The mean age of the participants was 55.69 ± 12.04 years (range 32-86 years). 41 patients were men, and 45 were women. The mean time since the first diagnosis of diabetes was 8.6 years (SD = 5.2), and the mean BMI of the patients was 31.63 (SD = 4.20). At baseline, 35.01% of patients had poor self-management behaviors. All PRECEDE variables, including predisposing factors (knowledge, attitude, and self-efficacy), enabling factors, and reinforcing factors, as well as self-management behaviors, were significantly improved in those of intervention group after the education program.

CONCLUSION

Self-management education program substantially enhances the self-management behaviors in patients with type two diabetes.

Effect of educational intervention based on PRECEDE-PROCEED model combined with self-management theory on self-care behaviors in type 2 diabetic patients

AIMS

Diabetes mellitus is a chronic and progressive disease which requires ongoing medical care as well as patient's self-care skills to prevent acute complications. The purpose of this study is to determine the effect of the PRECEDE-PROCEED model combined with self-management theory on self-care behaviors in type 2 diabetic patients.

METHODS

In this semi-experimental study, 86 type 2 diabetic patients referred to the diabetes clinic of Ardabil were randomly selected and divided into two groups (n = 43). Patients in group 1 received educations based on PRECEDE-PROCEED model combined with self-management theory while patients in group 2 received only educations based on PRECEDE-PROCEED model. The self-made questionnaire was used to measure demographic information and PRECEDE-PROCEED model variables at baseline and one month after the intervention.

RESULTS

The mean scores of knowledge, attitude, self-efficacy (p = 0.001), self-care (p = 0.001), enabling factors, and reinforcing factors had significant differences in both groups before and after the intervention (p < 0.05). In addition, one month after the intervention, the mean scores of attitude, self-efficacy, self-care, and reinforcing factors were significantly higher in group 1 compared to group 2.

CONCLUSION

The results indicate the effectiveness of an educational intervention based on PRECEDE-PROCEED model combined with self-management theory to improve self-care behaviors in patients with type 2 diabetes.