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

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.

A Narrative Review of Qualitative Studies Describing Access to Kidney Transplantation

Background: This review used the Information-Motivation-Behavioral Skills (IMB) model of health behavior change to conceptualize the determinants of kidney transplant access behavior for adult patients with end-stage renal disease (ESRD). Methods: A narrative review of qualitative studies of patient access to kidney transplantation was undertaken. Only articles in English were accessed. The existing literature was critically analyzed using theoretical constructs of the IMB model and thematic synthesis was performed. Results: Results suggest patients having more information (greater transplant knowledge), more personal motivation (higher transplant outcomes expectations), more social motivation (more social and provider support), and more selfefficacy (confidence in navigating the transplant continuum) may be more likely to perform transplant access behaviors. Conclusion: Our findings provide a framework for considering patients’ levels of knowledge, motivation, and self-efficacy in future educational and behavioral interventions for ESRD patients.

Integrated Diabetes Self-Management Program Using Smartphone Application: A Randomized Controlled Trial

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.

Improving malaria preventive practices and pregnancy outcomes through a health education intervention: A randomized controlled trial

Background The prevalence of malaria in pregnancy and its complications, remain very high in Nigeria. This study aimed to determine the effects of a malaria health educational intervention based on the information-motivation-behavioural skills (IMB) model on malaria preventive practices and pregnancy outcomes. Methods The study was a randomized controlled parallel-group study, where 372 randomly selected antenatal care attendees were randomly assigned to one of either two groups after collecting baseline data. The intervention group then received a four-hour health education intervention in Hausa language, which was developed based on the IMB model, while the control group received a similarly designed health education on breastfeeding. Follow up data were then collected from the participants at a first (2 months post-intervention) and second (4 months post-intervention) follow up, and at the end of their pregnancies. Results For both groups, reported ITN use had increased from baseline (Intervention: Often–14.0%, Almost always–9.1; Control: Often–12.4%; Almost always 16.1%) to the time of second follow up (Intervention: Often –28.10%, Almost always–24.5; Control: Often–17.2%; Almost always 19.5%). Reported IPTp uptake at second follow up was also higher for the intervention group (Intervention: Two doses–59.0%, Three doses 22.3%; Control group: Two doses–48.4%, Three doses–7.0%). The drop in the haematocrit levels was greater for the control group (32.42% to 30.63%) compared to the intervention group (33.09% to 31.93%). The Generalized Linear Mixed Models (GLMM) analysis revealed that the intervention had significantly improved reported ITN use, reported IPTp uptake, and haematocrit levels, but had no significant effect on the incidence of reported malaria diagnosis or babies’ birth weights. Conclusions The intervention was effective in improving ITN use, IPTp uptake, and haematocrit levels. It is, therefore, recommended for the modules to be adopted and incorporated into the routine antenatal care programmes in health centres with predominantly Hausa speaking clients. Trial registration: Pan African Clinical Trial Registry, PACTR201610001823405. Registered 26 October 2016, www.pactr.org.

Improving malaria preventive practices and pregnancy outcomes through a health education intervention: a randomized controlled trial

BackgroundThe prevalence of malaria in pregnancy and its complications, remain very high in Nigeria. This study aimed to determine the effects of a malaria health educational intervention based on the information-motivation-behavioural skills (IMB) model on malaria preventive practices and pregnancy outcomes. MethodsThe study was a randomized controlled parallel-group study, where 372 randomly selected antenatal care attendees were randomly assigned to one of either two groups after collecting baseline data. The intervention group then received a four-hour health education intervention in Hausa language, which was developed based on the IMB model, while the control group received a similarly designed health education on breastfeeding. Follow up data were then collected from the participants at a first (two months post-intervention) and second (four months post-intervention) follow up, and at the end of their pregnancies. ResultsFor both groups, reported ITN use had increased from baseline (Intervention: Often – 14.0%, Almost always – 9.1; Control: Often – 12.4%; Almost always 16.1%) to the time of second follow up (Intervention: Often – 28.10%, Almost always – 24.5; Control: Often – 17.2%; Almost always 19.5%). Reported IPTp uptake at second follow up was also higher for the intervention group (Intervention: Two doses – 59.0%, Three doses 22.3%; Control group: Two doses – 48.4%, Three doses – 7.0%). The drop in the haematocrit levels was greater for the control group (32.42% to 30.63%) compared to the intervention group (33.09% to 31.93%). The Generalized Linear Mixed Models (GLMM) analysis revealed that the intervention had significantly improved reported ITN use, reported IPTp uptake, and haematocrit levels, but had no significant effect on the incidence of reported malaria diagnosis or babies’ birth weights. ConclusionsThe intervention was effective in improving ITN use, IPTp uptake, and haematocrit levels. It is, therefore, recommended for the modules to be adopted and incorporated into the routine antenatal care programmes in health centres with predominantly Hausa speaking clients.