Perceived barriers and facilitators to diet and physical activity among adults diagnosed with type 2 diabetes in Malawi

Mphwanthe, Getrude; Carolan, Marsha; Earnesty, Dawn; Weatherspoon, Lorraine

doi:10.1080/17441692.2020.1805784

Cited by 22 publications

(63 citation statements)

References 26 publications

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“…Good DM knowledge was associated with good overall self-care practice although it was not statistically signi cant. This nding is similar to the ndings from other local studies [11,15,16] as well as studies reporting from other parts of the globe [17,18]. These studies cite about knowledge de ciencies, inconsistent information sources and at times 'misconceptions' with regards to the details of recommendations regarding appropriate diets and physical exercises.…”

Section: Discussionsupporting

confidence: 89%

Self-Care Practice and Associated Factors Among Patients with Type 2 Diabetes Mellitus at a Referral Hospital in Northern Ethiopia – a Mixed Methods Study

Zewdie

Moges

Andargie

et al. 2022

Preprint

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Introduction: Diabetes self-care is important to maintain optimal glycemic control and prevent debilitating and costly complications. Diabetes self-care may be improved through the identification of individual and group barriers to regimen adherence and subsequent development of specific plans to overcome these barriers. This study assessed the self-care practice and associated factors among type 2 diabetes patients attending their treatment at Dessie Referral Hospital, Dessie, North-Eastern Ethiopia. Methods: The study employed parallel mixed methods design which followed a cross-sectional interview and in-depth interview methods respectively from September to October 2019. The collected data were subjected to descriptive and inferential analysis for the quantitative part and a thematic analysis for the qualitative part. The protocol for this study was ethically approved (CMHS/013/519/12). Results: A total of 328 type 2 diabetes patients participated in the study of which 50.3% reported good self-care practice. Being in the age category of 60–69 years old (AOR = 0.334, 95% CI (0.135, 0.951)), being ≥ 70 years old (AOR = 0.359, 95% CI (0.135,0.951)), having complications (AOR = 1.956, 95% CI (1.172, 3.262)), having co-morbidity (AOR = 0.443, 95%CI (0.262, 0.749)) and diabetes education (AOR = 2.684, 95%CI (1.633,4.412) were significantly associated with good diabetes self-care. Accessibility, social support, knowledge and beliefs and diabetes related morbidities were identified as barriers to diabetes self-care by the patients. Conclusion: The findings from this study revealed that only half of the type 2 diabetes patients who participated in this study reported good self-care practice. Different factors including diabetes education were significantly associated with good diabetes self-care according to the quantitative study. This was supported by the findings from the qualitative part and thus the recommendation to strengthen diabetes health education to patients and their families.

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Section: Discussionsupporting

confidence: 89%

Self-Care Practice and Associated Factors Among Patients with Type 2 Diabetes Mellitus at a Referral Hospital in Northern Ethiopia – a Mixed Methods Study

Zewdie

Moges

Andargie

et al. 2022

Preprint

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“…Five essential self‐management behaviours consistently have been emphasized, namely health eating, exercise engagement, blood glucose self‐monitoring, medication adherence and foot care. Despite extensive efforts and advancements in diabetes self‐management interventions, patients often fail to initiate and integrate desirable activities into their daily routine life because of the difficulties encountered in the dynamic and complex context (Bekele et al, 2020; Mphwanthe et al, 2020). Suboptimal self‐management behaviours have been frequently observed, especially in the young to middle‐aged population.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of smartphone application–based self‐management interventions in patients with type 2 diabetes: A systematic review and meta‐analysis of randomized controlled trials

Zhao

Wang

et al. 2021

Journal of Advanced Nursing

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Aims To synthesize evidences on smartphone application–based intervention and determine its effectiveness on glycaemic control, self‐management behaviours, psychological well‐being, quality of life and cardiometabolic risk factors. Design A systematic review and meta‐analysis of randomized controlled trials (RCTs). Data sources Major English and Chinese electronic databases were searched from January 2008 to January 2021, including PubMed, Web of Science, Embase, Cochrane Central Register of Controlled Trials, Google Scholar, China National Knowledge Infrastructure (CNKI), Wanfang and Sinomed. Review methods RCTs were screened and selected if they used smartphone applications to support patients in the self‐management of diabetes. Data extraction and methodological assessment were performed by two reviewers independently. Meta‐analysis was performed to pool the intervention effect on outcomes of interest using RevMan 5.3. Results Across 19 included trials involving 2585 participants, smartphone application–based interventions were associated with a clinically and statistically significant reduction of glycated haemoglobin (HbA1c). Beneficial effects were also observed in participants’ behavioural performance, especially in medication adherence. Intervention effects on psychological status, quality of life and cardiometabolic risk factors were nonsignificant. Subgroup analysis showed interactive approach with medium frequency or flexible facilitator–patient interaction induced a larger effect on HbA1c reduction. Besides, patients with baseline HbA1c ≥9% benefited more than those with HbA1c <9% from the use of smartphone applications. Conclusions Smartphone application–based diabetes self‐management intervention could optimize patients’ glycaemic control and enhance participants’ self‐management performance. Further endeavour is required to examine the long‐term effects and cost‐effectiveness of smartphone application–based intervention before promoting the adoption and dissemination of such intervention. Impact This review supports the potential of smartphone application–based intervention as effective approach to optimize glycaemic control and promote self‐management engagement among patients with type 2 diabetes. Suggestions for future research and practice are provided and discussed.

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“…The peer supporters also recognised their own increased difficulties with small groups, negative impacts on their enthusiasm as a result of low attendance and the negative impacts of a lack of social activities within the sessions. The impacts of both positive and negative social support at the personal level are often recognised within dietary interventions (24)(25)(26)(27) , but comments related to sharing and swapping demonstrate an additional value to the peer support group, and a different type of 'communal support' that may be gained based on shared experiences, vicarious learning, commonality and a shared identity, with resultant increases in selfefficacy, confidence and coping (31)(32)(33)(34)(35)(36)(37)45,46) . This communal support is also notably different from that that may be gained from health professionals, where the provision of accurate, credible information and good role modelling is anticipated (20,45,46) .…”

Section: Discussionmentioning

confidence: 99%

A peer support dietary change intervention for encouraging adoption and maintenance of the Mediterranean diet in a non-Mediterranean population (TEAM-MED): lessons learned and suggested improvements

et al. 2023

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Peer support interventions for dietary change may offer cost-effective alternatives to interventions led by health professionals. This process evaluation of a trial to encourage the adoption and maintenance of a Mediterranean diet in a Northern European population at high CVD risk (TEAM-MED) aimed to investigate the feasibility of implementing a group-based peer support intervention for dietary change, positive elements of the intervention and aspects that could be improved. Data on training and support for the peer supporters; intervention fidelity and acceptability; acceptability of data collection processes for the trial and reasons for withdrawal from the trial were considered. Data were collected from observations, questionnaires and interviews, with both peer supporters and trial participants. Peer supporters were recruited and trained to result in successful implementation of the intervention; all intended sessions were run, with the majority of elements included. Peer supporters were complimentary of the training, and positive comments from participants centred around the peer supporters, the intervention materials and the supportive nature of the group sessions. Attendance at the group sessions, however, waned over the intervention, with suggested effects on intervention engagement, enthusiasm and group cohesion. Reduced attendance was reportedly a result of meeting (in)frequency and organisational concerns, but increased social activities and group-based activities may also increase engagement, group cohesion and attendance. The peer support intervention was successfully implemented and tested, but improvements can be suggested and may enhance the successful nature of these types of interventions. Some consideration of personal preferences may also improve outcomes.

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Perceived barriers and facilitators to diet and physical activity among adults diagnosed with type 2 diabetes in Malawi

Cited by 22 publications

References 26 publications

Self-Care Practice and Associated Factors Among Patients with Type 2 Diabetes Mellitus at a Referral Hospital in Northern Ethiopia – a Mixed Methods Study

Self-Care Practice and Associated Factors Among Patients with Type 2 Diabetes Mellitus at a Referral Hospital in Northern Ethiopia – a Mixed Methods Study

Effectiveness of smartphone application–based self‐management interventions in patients with type 2 diabetes: A systematic review and meta‐analysis of randomized controlled trials

A peer support dietary change intervention for encouraging adoption and maintenance of the Mediterranean diet in a non-Mediterranean population (TEAM-MED): lessons learned and suggested improvements

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