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Open Access 01-12-2022 | Diabetes | Study protocol

Application of Pender’s health promotion model for type 2 diabetes treatment adherence: protocol for a mixed methods study in southern Iran

Authors: Nahid Shahabi, Zahra Hosseini, Teamur Aghamolaei, Amin Ghanbarnejad, Ahmad Behzad

Published in: Trials | Issue 1/2022

Abstract

Background

Type 2 diabetes (T2D) mellitus treatment as a chronic disease requires adequate adherence to treatment including controlling blood glucose levels and lifestyle management. The aim of this study is to investigate the factors affecting of adherence to T2D treatment from the perspective of patients and design an intervention program based on Pender’s health promotion model (HPM) to increase T2D treatment adherence in Bandar Abbas, a city located in the south of Iran.

Methods

This mixed method study will consist of qualitative stage, questionnaire design and a randomized, open-label, parallel-group interventional study based on HPM in southern Iran. Sampling for qualitative stage will continue until reaching the saturation. In the intervention stage, participants will be 166 T2D patients referring to the Bandar Abbas Diabetes Clinic will be randomized into intervention and control groups (allocation 1:1). After identifying the factors affecting adherence to treatment in T2D patients by qualitative study and literature review, a questionnaire based on HPM will be designed. In the next stage, 10 sessions of intervention for the intervention group will be designed. To evaluate the effect of the intervention, intervention and control groups will be tested for hemoglobin A1c (HbA1c) before and 3 months after the intervention.

Discussion

This designed study is a program for improving treatment adherence in T2D based on the HPM model and contributes to a better understanding of effective factors in adherence to treatment in T2D patients. The results of this project can be used for macro-diabetic planning.

Trial registration

This study is registered on the Iranian Registry of Clinical Trials (IRCT20211228053558N1: https://www.irct.ir/trial/61741) and first release date of 17th March 2022.

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Campbell MD, Sathish T, Zimmet PZ, Thankappan KR, Oldenburg B, Owens DR, et al. Benefit of lifestyle-based T2DM prevention is influenced by prediabetes phenotype. Nat Rev Endocrinol. 2020;16(7):395–400. https://doi.org/10.1038/s41574-019-0316-1.CrossRef

Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB, et al. IDF diabetes atlas: global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. 2022;183:109119. https://doi.org/10.1016/j.diabres.2021.109119.CrossRef

Esteghamati A, Etemad K, Koohpayehzadeh J, Abbasi M, Meysamie A, Noshad S, et al. Trends in the prevalence of diabetes and impaired fasting glucose in association with obesity in Iran: 2005-2011. Diabetes Res Clin Pract. 2014;103(2):319–27. https://doi.org/10.1016/j.diabres.2013.12.034.CrossRef

Javanbakht M, Mashayekhi A, Baradaran HR, Haghdoost A, Afshin A. Projection of diabetes population size and associated economic burden through 2030 in Iran: evidence from micro-simulation markov model and Bayesian meta-analysis. PLoS One. 2015;10(7):e0132505. https://doi.org/10.1371/journal.pone.0132505.CrossRef

Association AD. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes—2019. Diabetes Care. 2019;42(Supplement 1):S13–28.CrossRef

Sabaté E, Sabaté E. Adherence to long-term therapies: evidence for action: World Health Organization; 2003.

Wibowo MINA, Yasin NM, Kristina SA, Prabandari YS. Exploring of determinants factors of anti-diabetic medication adherence in several regions of Asia - a systematic review. Patient Prefer Adherence. 2022;16:197–215. https://doi.org/10.2147/PPA.S347079.CrossRef

Esteghamati A, Larijani B, Aghajani MH, Ghaemi F, Kermanchi J, Shahrami A, et al. Diabetes in Iran: prospective analysis from first nationwide diabetes report of National Program for prevention and control of diabetes (NPPCD-2016). Sci Rep. 2017;7(1):13461. https://doi.org/10.1038/s41598-017-13379-z.CrossRef

Nejat N, Khan Mohamadi Hezave A, Aghae Pour SM, Rezaei K, Moslemi A, Mehrabi F. Self-care and related factors in patients with type II diabetes in Iran. J Diab Metab Disord. 2021;20(1):635–9. https://doi.org/10.1007/s40200-021-00791-6.CrossRef

10.

Suzuki R, Saita S, Nishigaki N, Kisanuki K, Shimasaki Y, Mineyama T, et al. Factors associated with treatment adherence and satisfaction in type 2 diabetes management in Japan: results from a web-based questionnaire survey. Diabetes Ther. 2021;12(9):2343–58. https://doi.org/10.1007/s13300-021-01100-3.CrossRef

11.

Coningsby I, Ainsworth B, Dack C. A qualitative study exploring the barriers to attending structured education programmes among adults with type 2 diabetes. BMC Health Serv Res. 2022;22(1):584. https://doi.org/10.1186/s12913-022-07980-w.CrossRef

12.

Taggart L, Truesdale M, Dunkley A, House A, Russell AM. Health promotion and wellness initiatives targeting chronic disease prevention and management for adults with intellectual and developmental disabilities: recent advancements in type 2 diabetes. Curr Dev Disord Rep. 2018;5(3):132–42. https://doi.org/10.1007/s40474-018-0142-5.CrossRef

13.

Lari H, Noroozi A, Tahmasebi R. Impact of short message service (SMS) education based on a health promotion model on the physical activity of patients with type II diabetes. Malays J Med Sci. 2018;25(3):67–77. https://doi.org/10.21315/mjms2018.25.3.7.CrossRef

14.

Mehrabbeik A, Mahmoodabad SSM, Khosravi HM, Fallahzadeh H. Breakfast consumption determinants among female high school students of Yazd Province based on Pender’s health promotion model. Electron Physician. 2017;9(8):5061–7. https://doi.org/10.19082/5061.CrossRef

15.

Pender NJ, Murdaugh CL, Parsons MA. Health promotion in nursing practice; 2006.

16.

Khamseh ME, Sepanlou SG, Hashemi-Madani N, Joukar F, Mehrparvar AH, Faramarzi E, et al. Nationwide prevalence of diabetes and prediabetes and associated risk factors among Iranian adults: analysis of data from PERSIAN cohort study. Diab Ther. 2021;12(11):2921–38. https://doi.org/10.1007/s13300-021-01152-5.CrossRef

17.

Shaghaghi A, Ahmadi A. Evidence gap on the prevalence of non-conventional risk factors for type 2 diabetes in Iran. Osong Public Health Res Perspect. 2014;5(5):292–7. https://doi.org/10.1016/j.phrp.2014.08.002.CrossRef

18.

Nejatizadeh A, Eftekhar E, Shekari M, Farshidi H, Davoodi SH, Shahmoradi M, et al. Cohort profile: Bandar Kong prospective study of chronic non-communicable diseases. PLoS One. 2022;17(5):e0265388. https://doi.org/10.1371/journal.pone.0265388.CrossRef

19.

Masumeh Hemmati M, Shahin A, Nader A, Hamidreza K. The effect of family-centered care on adherence to treatment in patients with type 2 diabetes. Birjand Univ Med Sci. 2020;27(2):161–71.

20.

Charan J, Biswas T. How to calculate sample size for different study designs in medical research? Indian J Psychol Med. 2013;35(2):121–6. https://doi.org/10.4103/0253-7176.116232.CrossRef

21.

Speziale HS, Streubert HJ, Carpenter DR. Qualitative research in nursing: advancing the humanistic imperative: Lippincott Williams & Wilkins; 2011.

22.

Rouholamini S, Gheibizadeh M, Maraghi E, Jahanshahi A. The effects of a training program based on the health promotion model on physical activity in women with type 2 diabetes: a randomized controlled clinical trial. Iran J Nurs Midwifery Res. 2020;25(3):224–31. https://doi.org/10.4103/ijnmr.IJNMR_97_19.CrossRef

23.

Loykaew K, Vorapongsathorn S, Vorapongsathorn T, Chooratna K. The effectiveness of a health education program applying Pender’s health promotion model on self health-care behavioral modification of patients with type 2 diabetes mellitus in sub-district health promoting hospital, Bankha District, Ratchaburi province. Vajira Med J: J Urban Med. 2019;63(4):283–96.

24.

Sabooteh S, Feizi A, Shekarchizadeh P, Shahnazi H, Mostafavi F. Designing and evaluation of E-health educational intervention on students’ physical activity: an application of Pender’s health promotion model. BMC Public Health. 2021;21(1):657. https://doi.org/10.1186/s12889-021-10641-y.CrossRef

25.

Khodaveisi MP, Omidi AM, Farokhi SM, Soltanian ARP. The effect of Pender’s health promotion model in improving the nutritional behavior of overweight and obese women. Int J Commun Based Nurs Midwifery. 2017;5(2):165–74.

Title: Application of Pender’s health promotion model for type 2 diabetes treatment adherence: protocol for a mixed methods study in southern Iran
Authors: Nahid Shahabi
Zahra Hosseini
Teamur Aghamolaei
Amin Ghanbarnejad
Ahmad Behzad
Publication date: 01-12-2022
Publisher: BioMed Central
Keywords: Diabetes
Type 2 Diabetes
Published in: Trials / Issue 1/2022
Electronic ISSN: 1745-6215
DOI: https://doi.org/10.1186/s13063-022-07027-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Application of Pender’s health promotion model for type 2 diabetes treatment adherence: protocol for a mixed methods study in southern Iran

Abstract

Background

Methods

Discussion

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Discussion

Trial registration

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