The Effect of Blended Educational Program on Improving Health Promoting Behaviors in Patients with Type 2 Diabetes
Author(s): Fereshteh Majlesi, Abbas Rahimi Foroshanie, Azar Tal, Jaleh Nasrolahnejad
Diabetes is the most common endocrine disease worldwide and is responsible for around 4 million deaths per year. In general, diabetes is a chronic disease with different clinical manifestations and progression. In addition, it is the most common form of diabetes around the world. Considering the significance of health promotion behaviors in type 2 diabetic patients and high prevalence of type 2 diabetes in Iran, especially in the major metropolitan regions, the present study aimed to evaluate health promotion behaviors in type 2 diabetic patients. This randomized clinical trial study with pre and posttest design was performed on type 2 diabetic patients referred to Shahid Bahonar and Imam Khomeini hospitals in Karaj, Iran. For this purpose, 200 patients (100 males and 100 females from either hospital) were selected and randomly divided into four blocks of two training and comparison (control) groups. Then, the subjects in the comparison group proceeded to receive the common training program according to the previous procedure and separately completed the questionnaires (health promotion behaviors questionnaire). The patients in the intervention group were divided into two groups (25 males and females) and received the content of blended educational program based on the improvement of health promotion behaviors using lectures, slides, questions and answers and group discussion in 6 sessions of 60-90 minutes. Then, three months after the intervention, the subjects of both groups separately completed the questionnaires. The data were analyzed using descriptive and inferential statistics via SPSS20 software and the P value was set less than the significance level (0.05). According to the results, the subjects in the training group scored significantly higher than those in the control group (P = 0.001). Based on Spearman's correlation coefficient, there was a significant reverse correlation between age and all scores of both groups (P = 0.001). The variables of weight, height, duration of the disease were correlated with some factors. In addition, no relation was found between the HbA1C scores in the training group; however, the linear correlation was observed in the control group (P = 0.001). Further, the variables of gender, marital status, family history, occupation, and smoking did not correlate with any of the scores obtained in all groups (P> 0.05). The educational level had a significant correlation with all the scores obtained in the both groups (P = 0.001). Family income also had a significant association with the scores of many variables obtained in groups other than healthy diet and physical activity (P = 0.001). There was a significant relationship between the type of treatment with the most scores obtained from healthy diets and physical activity in the training group (P = 0.001), but no significant relationship was observed in the control group (P> 0.05). The results of this study indicate that the promotion of appropriate public knowledge can lead to behavioral changes and promotion of health among at-risk people. Furthermore, it seems that the application of interventions based on health education and promotion theories along with its environmental, social, cultural and behavioral aspects is essential for achieving these aims.