scholarly journals Adhering to lifestyle change recommendations via the trans-theoretical model: a mixed-methods study among type 2 diabetes patients

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Noraishah Mohamed Nor ◽  
Suriati Sidek ◽  
Nurulwahidah Saad ◽  
Nurul Hazirah Jaafar ◽  
Nor Azwani Mohd Shukri
Keyword(s):  
Type 2 Diabetes ◽  
Theoretical Model ◽  
Stages Of Change ◽  
Lifestyle Change ◽  
Lifestyle Changes ◽  
Care Providers ◽  
Content Type ◽  
Action Group ◽  
Trans Theoretical Model

Purpose This paper aims to identify and explore the factors affecting type 2 diabetes mellitus (T2DM) patients' adherence to lifestyle change recommendations, with the guidance of the trans-theoretical model (stages of change). Design/methodology/approach This study was conducted in two parts. In Part A, 163 randomly selected participants were asked to complete a cross-sectional survey. Data regarding demographics, stages of change and levels of confidence to engage in lifestyle changes were collected. In Part B, in-depth interviews were conducted among 30 individuals, aged between 30 and 65 years, had been diagnosed with T2DM and had seen dietitian at least once. Purposive sampling was used to recruit participants with different sociodemographic characteristics. Findings Part A showed that most of the participants were in the pre-action group (60%), with a higher mean HbA1c (8.9%) as compared to the action group (40%) which had a mean HbA1c of 6.9%. Part B further revealed the pre-action group and action group identified four key themes concerning lifestyle changes adherence: stumbling block; self-care belief; knowledge implementation; and self-empowerment. Practical implications Health-care providers should identify patients' stages of change before lifestyle changes implementation. Originality/value This study highlighted that many factors might influence a T2DM patient's adherence to lifestyle change recommendations. Determining the stages of change and self-confidence of T2DM patients is needed to ascertain long-term adherence.

Applying the trans-theoretical model to determine the mediating effect self-efficacy in breakfast consumption among children

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Mahsa Mohajeri ◽  
Sajad Narimani ◽  
Fardin Shahbazzadeh ◽  
Saniyeh Bahrampanah ◽  
Vida Ghaderi
Keyword(s):  
Elementary Schools ◽  
Theoretical Model ◽  
Elementary Students ◽  
Stages Of Change ◽  
Self Efficacy ◽  
Mediating Effect ◽  
Mediating Effects ◽  
Content Type ◽  
Breakfast Consumption ◽  
Trans Theoretical Model

Purpose Regular breakfast with a variety of nutrients can lead to improving educational performance, learning ability, reducing behavioral problems in elementary students. This study aims to use the Trans-Theoretical Model (TTM) to assess the mediating effect of self-efficacy in regular breakfast consumption among children of Ardabil elementary schools. Design/methodology/approach This cross-sectional study was performed between 300 students from elementary schools of different regions of Ardabil city by cluster sampling method. The instrument used in this study was the TTM standard questionnaire. Data was analyzed with Spearman correlation and regression using SPSS v18 software to identify the mediating effects of self-efficacy. Findings The mean age (SD) OF children was 11.2 (1.26) and 50% of them were female. Self-efficacy was the strongest predictor in stage promotion (ß = 0.44, P = 0.001), as well as had a mediating effect on the impact of other constructs of the model such as experiential processes (ß = 0.35, P = 0.04) and pros (ß = 0.44, P = 0.03) with stages of change. Pros were a significant predictor of self-efficacy in the first equation (ß = 0.17, P = 0.001) and Pros were a significant predictor of stages of change in the second equation when mediated by self-efficacy (ß = 0.11, P = 0.03). In the third equation, both the mediator, myself-efficacy and the predictor, Pros of breakfast consumption, were significantly associated with stages of change. The mediating effects of self-efficacy on the association between experiential processes and stages of change were also confirmed. The increased standardized beta coefficients of experiential processes between equations 3(ß = 0.35) and 2(ß = 0.29). Originality/value Due to the importance of eating a healthy breakfast regularly in children, this study aimed to use TTM to assess mediating effects of self-efficacy in regular breakfast consumption in Ardabil elementary students.

scholarly journals Effectiveness of a Digital Lifestyle Change Program in Obese and Type 2 Diabetes Populations: Service Evaluation of Real-World Data (Preprint)

2019 ◽  
Author(s):  
Iskandar Idris ◽  
James Hampton ◽  
Fiona Moncrieff ◽  
Michael Whitman
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Weight Management ◽  
Lifestyle Change ◽  
Service Evaluation ◽  
Lifestyle Changes ◽  
Real World Data ◽  
Structured Education ◽  
Change In Mean

BACKGROUND The prevalence of type 2 diabetes mellitus (T2DM) and obesity is increasing, and the way people interact with health care is evolving. People traditionally access advice and support to improve their lifestyle and learn more about the self-management of T2DM in a face-to-face setting. Although these services have a strong evidence base, they have limitations for reaching specific groups of people. Digital programs could provide a new delivery model to help more people access health education and behavior change support, but long-term data supporting these programs are limited. OBJECTIVE The purpose of this service evaluation was to analyze the weight change of people who participated in OurPath (also known as Second Nature), a UK-based digital lifestyle change program, for either weight management or diabetes-related weight management and structured education at 6 and 12 months. METHODS Participants either paid to access the program privately (self-funded clients) or were referred by their general practitioner to participate in the program free of charge (funded by the National Health Service). Additional follow-up support was provided to help people to maintain lifestyle changes. To retrospectively assess potential weight loss, the analysis included data from participants who submitted weight readings at baseline and 6 and 12 months after starting the program. Changes in weight after 6 and 12 months were primary outcome measures. RESULTS For the 896 participants who submitted baseline and 6- and 12-month data, a significant change in mean weight of −7.12 kg (−7.50%; SD 6.37; <italic>P</italic>&lt;.001) was observed at 6 months. Data from the same participants at 12 months showed a change in mean weight when compared with a baseline of −6.14 kg (−6.48%; SD 6.97; <italic>P</italic>&lt;.001). CONCLUSIONS The data presented here had several limitations, and there were too many uncertainties to make any reliable conclusions. However, these results suggest that digital lifestyle change programs could provide a new way to help people to access nutritional advice and support to achieve weight loss. Further research into digital education and coaching platforms is needed to establish their effectiveness.

scholarly journals Incorporating Aboriginal Women’s Voices in Improving Care and Reducing Risk for Women With Diabetes in Pregnancy - A Phenomenological Study.

2020 ◽  
Author(s):  
Anna Wood ◽  
Sian Graham ◽  
Jacqueline Boyle ◽  
Beverley Marcusson-Rababi ◽  
Shonada Anderson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Health Care Providers ◽  
Lifestyle Change ◽  
Indigenous Women ◽  
Care Providers ◽  
Diabetes In Pregnancy ◽  
Indigenous Australian ◽  
Health Lifestyle ◽  
In Pregnancy

Abstract Background: There is a high burden of gestational diabetes (GDM) and type 2 diabetes in pregnancy for Indigenous women globally. Postpartum diabetes programmes have the potential to prevent recurrent GDM and improve management of type 2 diabetes. However, data on such programmes, particularly in the Indigenous context are limited. We aimed to explore Indigenous Australian women’s and health providers’ preferences for a program to prevent and improve diabetes after pregnancy. Methods: A phenomenological methodology underpinned semi-structured in-depth interviews with 11 Indigenous women and seven health professionals across the Northern Territory. Interviews were analysed using an inductive and descriptive approach to address the barriers and enablers of proposed diabetes prevention programs identified by participants.Results: Identified structural barriers to lifestyle change included: food insecurity, persuasive marketing of unhealthy food options, lack of facilities and cultural inappropriateness of previous programs. Enablers to lifestyle change included: a strong link between a healthy lifestyle and connection with the land, family and community. Suggested strategies to improve lifestyle included: co-designed cooking classes or a community kitchen, team sports and structural change (targeting the social determinants of health). Lifestyle change was preferred over metformin to prevent and manage diabetes after pregnancy by participants and health care providers. Conclusions: We recommend individual level programs be designed alongside policies that address systemic inequalities. A postpartum lifestyle program should be co-designed with community members and grounded in Indigenous conceptions of health to adequality address the health disparities experienced by Indigenous people in remote communities.

scholarly journals Efficacy of Brief Lifestyle Change in conjunction with Dental Care (Brief-LCDC) Programs on glycemic and periodontal status among DM patients

2019 ◽  
Vol 33 (3) ◽  
pp. 247-259
Author(s):  
Saruta Saengtipbovorn
Keyword(s):  
Type 2 Diabetes ◽  
Dental Care ◽  
Lifestyle Modification ◽  
Intervention Group ◽  
Lifestyle Change ◽  
Control Group ◽  
Content Type ◽  
Periodontal Status ◽  
Glycemic Level

Purpose A global trend of type 2 diabetes prevalence is rising. Preventing and managing of systemic and dental complications is crucial to decrease negative effects on glycemic control. The purpose of this paper is to estimate the efficacy of Brief Lifestyle Change in conjunction with Dental Care (Brief-LCDC) Programs to decrease glycemic level and improve periodontal status in patients with type 2 diabetes. Design/methodology/approach Health Center 54 conducted randomized controlled trial among 192 patients (96 intervention and 96 control) from February to August 2018. Group education for lifestyle modification, individual oral hygiene instruction and lifestyle counseling by motivational interviewing was provided to the intervention group at baseline. Motivation of lifestyle modification every month by multimedia was also provided to the intervention group. The usual program was provided to the control group. At baseline and a six-month follow-up, glycemic level and periodontal status were assessed from participants. Data were analyzed by descriptive statistic, t-test, χ2 test, Fisher’s exact test, Repeated measure ANOVA and multiple linear regression. Findings Glycemic level and periodontal status were lower in the intervention group than the control group at the sixth-month followed up with statistical significances. Glycemic level and periodontal status had negatively correlated to intervention group with statistically significant. Originality/value Brief-LCDC Program which incorporated lifestyle modification and oral health care had efficacious to decrease glycemic level and improve periodontal status in patients with type 2 diabetes. Early prevention program by Brief-LCDC Program is crucial to prevent dental complications.

scholarly journals Incorporating Aboriginal women’s voices in improving care and reducing risk for women with diabetes in pregnancy - A phenomenological study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anna J Wood ◽  
Sian Graham ◽  
Jacqueline A Boyle ◽  
Beverley Marcusson-Rababi ◽  
Shonada Anderson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Health Care Providers ◽  
Phenomenological Study ◽  
Aboriginal People ◽  
Lifestyle Change ◽  
Care Providers ◽  
Diabetes In Pregnancy ◽  
Health Lifestyle ◽  
In Pregnancy

Abstract Background There is a high burden of gestational diabetes (GDM) and type 2 diabetes in pregnancy for Aboriginal and Torres Strait Islander women. Postpartum diabetes programs have the potential to prevent recurrent GDM and improve management of type 2 diabetes. However, data on such programs are limited, particularly in the Indigenous context. We aimed to explore Aboriginal Australian women’s and health providers’ preferences for a program to prevent and improve diabetes after pregnancy. Methods A phenomenological methodology underpinned semi-structured in-depth interviews with eleven Aboriginal women and seven health professionals across the Northern Territory from October 2019- February 2020. Interviews were analysed using an inductive analysis framework to address the barriers and enablers of proposed diabetes prevention programs identified by participants. Results Identified structural barriers to lifestyle change included: food insecurity, persuasive marketing of unhealthy food options, lack of facilities and cultural inappropriateness of previous programs. Enablers to lifestyle change included: a strong link between a healthy lifestyle and connection with Country, family and community. Suggested strategies to improve lifestyle included: co-designed cooking classes or a community kitchen, team sports and structural change (targeting the social determinants of health). Lifestyle change was preferred over metformin to prevent and manage diabetes after pregnancy by participants and health care providers. Conclusions We recommend individual level programs be designed alongside policies that address systemic inequalities. A postpartum lifestyle program should be co-designed with community members and grounded in Aboriginal conceptions of health to adequality address the health disparities experienced by Aboriginal people in remote communities.

scholarly journals 1407Erectile dysfunction among type 2 diabetes patients and its correlates

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Vignesh Viswanath Shanmugasundaram
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Health Care Providers ◽  
Erectile Function ◽  
Demographic Factors ◽  
Lifestyle Changes ◽  
Diabetic Patients ◽  
Care Providers ◽  
Duration Of Diabetes

Abstract Background Erectile Dysfunction (ED), is a common complication in type 2 diabetic men. Present study was undertaken to investigate the association between demographic factors, metabolic parameters and medication use with ED among type 2 diabetics. Methods This was a cross-sectional study. Married men aged 20-60 years with a diagnosis of type 2 diabetes attending the outpatient unit of Department of Endocrinology at PSG Hospitals during the months of May and June 2019 were enrolled. The severity of erectile function was assessed using the validated International Index of Erectile Function (IIEF-5) questionnaire. All subjects were evaluated based on demographic factors, clinical parameters and medications used. Results Out of the 204 patients enrolled, 65 (31.86%) were found to have ED. ED was significantly associated with patients who were having less physical activity, hypertension, obesity and diabetic retinopathy. A significant increase in the prevalence of ED with duration of diabetes was observed. In patients with diabetes, for 1-5, 6-10 and 11-30 years, the prevalence was 24.1%, 27.7% and 53.1% respectively. Conclusions For type 2 diabetes, increasing duration of diabetes poses a greater risk for ED. Hypertension, less physical activity and some medications increase the prevalence of ED. Key messages Our results suggest that health care providers who address sexual dysfunction issues with their diabetic patients early may be able to reduce the severity or delay the onset of ED by implementing intensive lifestyle changes as the first step management for type 2 diabetes.

Promoting Cultural Capital in a Medical Camp for American Indian Youth with Diabetes

2014 ◽  
Vol 38 (1) ◽  
pp. 123-144 ◽  
Author(s):  
Jennie Joe
Keyword(s):  
Type 2 Diabetes ◽  
Cultural Capital ◽  
American Indian ◽  
American Indians ◽  
Health Care Providers ◽  
Lifestyle Changes ◽  
Self Management ◽  
Care Providers ◽  
American Indian Youth

Type 2 diabetes mellitus, a disease that previously was characterized with an onset in the fourth decade of life or later, is now being diagnosed in children, particularly children from minority groups, including American Indians. Because children with the disease are frequently asymptomatic, they tend to ignore recommendations from their health care providers about appropriate self-management behaviors, thus increasing their risk for early onset of secondary complications, including retinopathy and end-stage renal disease. This problem with self-management can in part be attributed to a lack of knowledge as well as to denial about their disease. This article describes an intervention that encourages and motivates American Indian youth with type 2 diabetes to improve their diabetes self-management. The Medical Wellness Camp is a partnership program hosted by several Arizona tribes and the University of Arizona. The camp provided these youth with the education and the skills needed to prevent or delay diabetes-related complications that will negatively impact their quality of life. This camp is unique because it builds on and integrates an intertribal "cultural capital" model to help them learn how to adopt the lifestyle changes necessary to live with this chronic disease. The program emphasis is on education, not research. This position honors the wishes of tribal partners whose communities have been reluctant to involve their children in research, a reluctance fueled by reports about unethical research practices that have harmed other tribal communities.

scholarly journals Effectiveness of a Digital Lifestyle Change Program in Obese and Type 2 Diabetes Populations: Service Evaluation of Real-World Data

JMIR Diabetes ◽  
10.2196/15189 ◽  
2020 ◽  
Vol 5 (1) ◽  
pp. e15189 ◽  
Author(s):  
Iskandar Idris ◽  
James Hampton ◽  
Fiona Moncrieff ◽  
Michael Whitman
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Weight Management ◽  
Lifestyle Change ◽  
Service Evaluation ◽  
Lifestyle Changes ◽  
Real World Data ◽  
Structured Education ◽  
Change In Mean

Background The prevalence of type 2 diabetes mellitus (T2DM) and obesity is increasing, and the way people interact with health care is evolving. People traditionally access advice and support to improve their lifestyle and learn more about the self-management of T2DM in a face-to-face setting. Although these services have a strong evidence base, they have limitations for reaching specific groups of people. Digital programs could provide a new delivery model to help more people access health education and behavior change support, but long-term data supporting these programs are limited. Objective The purpose of this service evaluation was to analyze the weight change of people who participated in OurPath (also known as Second Nature), a UK-based digital lifestyle change program, for either weight management or diabetes-related weight management and structured education at 6 and 12 months. Methods Participants either paid to access the program privately (self-funded clients) or were referred by their general practitioner to participate in the program free of charge (funded by the National Health Service). Additional follow-up support was provided to help people to maintain lifestyle changes. To retrospectively assess potential weight loss, the analysis included data from participants who submitted weight readings at baseline and 6 and 12 months after starting the program. Changes in weight after 6 and 12 months were primary outcome measures. Results For the 896 participants who submitted baseline and 6- and 12-month data, a significant change in mean weight of −7.12 kg (−7.50%; SD 6.37; P<.001) was observed at 6 months. Data from the same participants at 12 months showed a change in mean weight when compared with a baseline of −6.14 kg (−6.48%; SD 6.97; P<.001). Conclusions The data presented here had several limitations, and there were too many uncertainties to make any reliable conclusions. However, these results suggest that digital lifestyle change programs could provide a new way to help people to access nutritional advice and support to achieve weight loss. Further research into digital education and coaching platforms is needed to establish their effectiveness.

Outcomes of a digitally delivered, culturally-sensitive behaviour change platform for BAME adults with type 2 diabetes: 1 year health and engagement outcomes (Preprint)

2020 ◽  
Author(s):  
Charlotte Summers
Keyword(s):  
Type 2 Diabetes ◽  
Body Weight ◽  
Health Outcomes ◽  
Behavioural Change ◽  
Culturally Sensitive ◽  
Lifestyle Changes ◽  
Haemoglobin A1c ◽  
Central Asian ◽  
Increased Risk

BACKGROUND People from Black, Asian and Minority Ethnic (BAME) groups are known to have an increased risk of developing type 2 diabetes and face greater barriers to accessing healthcare resources compared to their “white British” counterparts. The main mediators of lifestyle behavioural change are gender, generation, geography, genes, God/religion, and gaps in knowledge and economic resources. Dietary and cultural practices of these individuals significantly vary according to gender, generation, geographical origin and religion. Recognition of these factors and implementing culturally sensitive interventions for type 2 diabetes prevention and management is essential in increasing knowledge of healthy eating, engagement in physical activity and improving health outcomes in BAME communities. Few health apps are tailored for BAME populations, and BAME communities are considered hard-to-reach. OBJECTIVE Our objective was to establish whether the Low Carb Program is a viable scalable solution that can be used as an effective tailored type 2 diabetes intervention for BAME communities. We hypothesized that by taking into account cultural sensitivities, providing the platform in native languages and personalising the platform in accordance with known barriers to health disparities including gender, generation, dietary preferences and religion, the app would engage BAME communities and improve type 2 diabetes related health outcomes. METHODS The study used a quasi-experimental research design comprised of an open-label, single-arm, pre-post intervention using a sample of convenience. All 705 adults with type 2 diabetes who had activated their referral to the Low Carb Program as a result of an NHS consultation between September 2018 and March 2019 were followed for a period of 12 months; mean age 54.61 (SD 16.69) years; 58.2% (410/705) women; 45.1% (318/705) white, 28.5% (201/705) Indian/Pakistani/Bangladeshi/Other Central Asian, 10.8% (76/705) Arab, 6.2% (44/705) Mixed/Multiple ethnic groups, 6% (43/705) black, 1.8% (13/705) other, (7/705) 1% Chinese/Japanese/Other East Asian. Mean starting glycated haemoglobin A1c (HbA1c) 7.99% (SD 2.05%); mean body weight 88.96kg (SD 23.25kg). RESULTS Of the 705 study participants, 513 (72.76%) had completed the Low Carb Program at 12 months. There were statistically significant reductions in body weight and HbA1c in white, Indian/Pakistani/Bangladeshi/Other Central Asian, Arabic and black participants with the most significant differences in the Indian/Pakistani/Bangladeshi/Other Central Asian population HbA1c -1.18% (SD 1.49%) and weight 8.03kg (SD 10.65kg). 82.9% of all participants (419/705) of all participants lost at least 5% of their body weight. CONCLUSIONS Offering the culturally tailored Low Carb Program that empowers members to make dietary and lifestyle changes to different BAME groups is an effective and engaging tool in the management of type 2 diabetes. Most importantly, BAME populations in particular people from Indian/Pakistani/Bangladeshi and Arabic groups who achieve better health outcomes than their white counterparts.

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