A health-based coaching program for diabetes self-management (DSM) practice: A sequential exploratory mixed-method approach

Abstract

Background: Diabetes self-management (DSM) is crucial for glycemic control among type-2 diabetic (T2D) people.

Method: This was a sequential exploratory mixed-method approach to assess whether a health-based coaching program designed to fit the unmet needs of T2D was the best intervention for improving DSM practice. Twenty-eight participants from different backgrounds were involved in phase 1 (Qualitative study) to explore DSM knowledge and practice, any difficulties obstructing such knowledge and practice, and the feasibility of implementing an intervention program nationwide. Sixty patients were recruited for phase 2 (Quasi-experimental study). A health-based coaching program, constructed to fit the unmet needs from phase 1 was implemented among thirty patients in an experimental group. By comparison, 30 patients in the control group received their usual care. Diabetes and DSM knowledge, DSM practice, and health outcomes were measured and compared between the two groups at baseline and after the 12th week of the intervention.

Results: The following problems were found: (1) a low perception of susceptibility to and severity of illness, (2) inadequate DSM knowledge and skills, (3) a lack of motivation to perform DSM practice, and (4) social exclusion and feelings of embarrassment. After the implementation of the program among the experimental group, all the variables improved relative to baseline and to the control group.

Conclusion: A health-based coaching program can improve DSM knowledge and practice and health outcomes. A nationwide program is recommended to promote DSM practice among Indonesian communities.

Keywords: Autocontrol de la diabetes (ACD); Diabetes mellitus tipo 2; Diabetes self-management (DSM); Estudio de método mixto; Intervention program; Mixed-method study; Programa de intervención; Type 2 diabetes mellitus.