Development, feasibility, and preliminary effects of a culturally adapted, evidence-based, and theory-driven diabetes self-management programme for Chinese adults with type 2 diabetes receiving insulin injection therapy

• Published in: Primary care diabetes 2024-12, Vol.18 (6), p.649-659
• Main Authors: Liang, Wei, Chow, Ka Ming, Ni, Xiaoying, Tola, Yetunde Oluwafunmilayo, Lo, Suzanne Hoi Shan
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biomarkers - blood; Blood Glucose - drug effects; Blood Glucose - metabolism; China; Cultural Characteristics; Culturally Competent Care; Diabetes; Diabetes Mellitus, Type 2 - diagnosis; Diabetes Mellitus, Type 2 - drug therapy; East Asian People; Feasibility; Feasibility Studies; Female; Glycemic Control - adverse effects; Health Knowledge, Attitudes, Practice; Humans; Hypoglycemic Agents - administration & dosage; Hypoglycemic Agents - therapeutic use; Injections; Insulin - administration & dosage; Insulin - adverse effects; Insulin - therapeutic use; Male; Medical research council framework; Middle Aged; Patient Education as Topic; Program Development; Program Evaluation; Prospective Studies; Randomised controlled trial; Self Care; Self Efficacy; Self-Management; Time Factors; Treatment Outcome
• ISSN: 1751-9918; 1878-0210; 1878-0210
• DOI: 10.1016/j.pcd.2024.09.010

To describe the development of a culturally adapted, evidence-based, and theory-driven diabetes self-management programme for Chinese adults with type 2 diabetes receiving insulin injection therapy and to assess the feasibility, acceptability, and preliminary effects of the newly developed intervention. The Medical Research Council framework was adopted to guide the intervention development and a feasibility study. A prospective, two-arm, parallel-group, assessor-blinded randomised controlled trial was conducted. Participants were randomly allocated to receive either the newly developed intervention or parallel attention control contact from community nurses. Between-group differences in changes in outcome variables were analysed using the Mann-Whitney U test. The newly developed intervention consists of one individual interview session, three group-based education sessions, and two telephone-based maintenance sessions. A total of 24 participants were recruited with the recruitment rate and overall retention rate of 77.4 % and 95.8 %, respectively. The results indicated that the intervention participants reported significantly greater improvements in self-efficacy (Hedge’s g = 1.69) and self-management behaviours (Hedge’s g = 3.24), and reductions in diabetes-related distress (Hedge’s g = 1.49) compared with those in the control group (all p< 0.05). The diabetes self-management programme was feasible and acceptable. The intervention showed promising patient-centred benefits. A future large-scale randomised controlled trial is warranted. •A tailored self-management programme for insulin-treated people was developed.•The newly developed intervention was evidence-based, feasible and acceptable.•Our study enriched the role of community nurses in providing quality diabetes care.