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

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.

Barriers to Effective Diabetes Mellitus Self-Management (DMSM) Practice for Glycemic Uncontrolled Type 2 Diabetes Mellitus (T2DM): A Socio Cultural Context of Indonesian Communities in West Sulawesi.

Diabetes mellitus self-management (DMSM) is an essential strategy used to maintain blood glucose levels and to prevent severe complications. Several barriers have been documented while implementing DMSM practices. A qualitative study aimed to explore barriers to effective DMSM practice among uncontrolled glycemic type 2 diabetes mellitus (T2DM) patients in Indonesia. We conducted in-depth interviews and focus group discussions (FGDs) among 28 key informants, including patients, family members, healthcare providers (HCPs), and village health volunteers (VHVs). The interviews and FGDs were audiotaped and transcribed verbatim. The results revealed six core themes with sub-categories of themes used by all participants to describe the barriers to effective DMSM practice among uncontrolled T2DM patients. The critical barriers of DMSM practice included low perception of susceptibility to and severity of the illness; inadequate knowledge and skill of diabetes mellitus self-management; lack of motivation to perform diabetes mellitus self-management; insufficient human resources; lack of social engagement; and social exclusion and feelings of embarrassment. Our findings provide valuable information regarding the barriers while implementing the DMSM practice. Healthcare providers should negotiate with both T2DM patients and caretakers to participate in a DMSM program at a community health care level.

A Systematic Review: Family Support Integrated with Diabetes Self-Management among Uncontrolled Type II Diabetes Mellitus Patients.

The rate of type-2 diabetes mellitus (T2D) is dramatically increasing worldwide. Continuing diabetes mellitus (DM) care needs effective self-management education and support for both patients and family members. This study aimed to review and describe the impacts of diabetes mellitus self-management education (DSME) that involve family members on patient outcomes related to patient health behaviors and perceived self-efficacy on self-management such as medication adherence, blood glucose monitoring, diet and exercise changes, health outcomes including psychological well-being and self-efficacy, and physiological markers including body mass index, level of blood pressure, cholesterol level and glycemic control. Three databases, PubMed, CINAHL, and Scopus were reviewed for relevant articles. The search terms were "type 2 diabetes," "self-management," "diabetes self-management education (DSME)," "family support," "social support," and "uncontrolled glycaemia." Joanna Briggs Institute (JBI) guidelines were used to determine which studies to include in the review. Details of the family support components of DSME intervention and the impacts of these interventions had on improving the health outcomes patients with uncontrolled glycaemia patients. A total of 22 intervention studies were identified. These studies involved different DSME strategies, different components of family support provided, and different health outcomes to be measured among T2D patients. Overall, family support had a positive impact on healthy diet, increased perceived support, higher self-efficacy, improved psychological well-being and better glycemic control. This systematic review found evidence that DSME with family support improved self-management behaviors and health outcomes among uncontrolled glycaemia T2D patients. The findings suggest DSME models that include family engagement can be a useful direction for improving diabetes care.

A Cosmetic Content-Based Nutrition Education Program Improves Fruit and Vegetable Consumption Among Grade 11 Thai Students.

OBJECTIVE: To examine and compare the effectiveness of a cosmetic content-based nutrition education (CCBNEd) program and a health content-based nutrition education (HCBNEd) program on the promotion of fruit and vegetable (F&V) consumption. DESIGN: Quasi-experimental. SETTING: Three secondary schools in Nonthaburi, Thailand. PARTICIPANTS/INTERVENTIONS: Three classes of students were randomly assigned to 3 study groups: experimental group 1 (n = 41) participated in the CCBNEd program, experimental group 2 (n = 35) experienced the HCBNEd program, and a comparison group (n = 37) did not participate in a program. All groups received F&V information. Data were collected between July and September, 2013. MAIN OUTCOME MEASURES: Knowledge about F&V, attitude toward F&V consumption, and the amount and variety of F&V consumed were measured at baseline, posttest, and follow-up. ANALYSIS: Nonparametric statistics were used to compare the programs' effectiveness. RESULTS: After the test, experimental group 1 had significantly increased knowledge scores, attitude scores, and the amount and variety of F&V consumed compared with those at baseline (P < .001). These positive changes were maintained until follow-up. In experimental group 2, knowledge and attitude scores increased (P < .001) at posttest and then decreased at follow-up whereas the comparison group positively changed only in knowledge. CONCLUSIONS AND IMPLICATIONS: The CCBNEd program was most effective at increasing F&V consumption.

Validation of the parenting sense of competence scale in fathers: Thai version.

The role of the parent is a significant family factor that can impact the child cognitively, emotionally, and socially. Strengthening parents' competence improves their performance as parents. This study is the development and validation of the Thai Parenting Sense of Competence scale (Thai PSOC scale) for assessing the parenting competence of Thai fathers. The Thai PSOC scale was revised from the PSOC scale developed by Gibaud-Wallston and Wandersman (1978). The scale consists of 17 items with 2 subscales: skill/knowledge (8 items) and valuing/comfort (9 items). The scale was tested with 195 Thai fathers-to-be/ fathers. The results showed high internal consistency: 0.78 for the total scale and 0.73 and 0.80 for the skill/knowledge and valuing/comfort subscales, respectively. Confirmatory factor analysis (CFA) led to a revision of the Thai PSOC scale with better goodness of fit indices for the sample. In the revised scale with Item 17 was omitted, several goodness of fit indices improved significantly with a more acceptable, good fit (Chi(2)/df = 1.63; RMSEA = 0.06; GFI = 0.91; AGFI = 0.88; NFI = 0.80; TLI = 0.90; CFI = 0.91). With revision, the Thai PSOC scale is a potential instrument to measure parenting competence in Thai fathers.

Predictors of family management behavior for children with thalassemia.

Children with thalassemia can thrive with quality care by their families. The purpose of this study was to examine predictors of family care behavior by family caregivers of children with thalassemia. Eighty-eight family caregivers for children with thalassemia aged 1-16 years were recruited by purposive sampling from in-patient and out-patient clinics in an eastern regional hospital in Thailand. Research instruments were 5 self-administered questionnaires: 1) demographics of family caregivers, 2) perceived family management, 3) medical adherence, 4) health literacy, and 5) family management behavior. Data were analyzed by percentages, means, standard deviations, Pearson's product moment correlation and multiple regression. The strongest predictor for family management behavior was perceived family management (B = 0.550, p < 0.001), it accounted for 26.3% of the variance. Health literacy (B = 0.337, p = 0.024) accounted for 4.5% of the variance. When these two dependent measures were combined, they accounted for 30.8% of the variance (R2 = 0.308, F = 18.933, p < 0.001). Within the three subscales of family management behavior (medical, role, and psychosocial management), medical adherence, health literacy and perceived family management, together accounted for 22.6% of the variance for medical management. Perceived family management and health literacy together accounted for 30.3% of the variance in role management. Perceived family management accounted for 20.9% of the variance in psychosocial management. These findings suggest a tailored intervention program should emphasize promoting family management and increasing health literacy to improve the quality of family management behavior for children with thalassemia.

Validity and reliability of the Early Childhood Caries Perceptions Scale (ECCPS) to assess health beliefs related to early childhood caries prevention among primary caregivers of children under 5 years of age.

Primary caregivers' child oral health care beliefs and practices are major factors in the prevention of Early Childhood Caries (ECC). This study assessed the validity and reliability of a newly-developed scale--the Early Childhood Caries Perceptions Scale (ECCPS)--used to measure beliefs regarding ECC preventive practices among primary caregivers of young children. The ECCPS was developed based on the Health Belief Model. The construct validity and reliability of the ECCPS were examined among 254 low-socioeconomic status primary caregivers with children under five years old, recruifed from 4 Bangkok Metropolitan Administration Health Centers and a kindergarten school. Exploratory factor analysis (EFA) revealed a four-factor structure. The four factors were labeled as Perceived Susceptibility, Perceived Severity, Perceived Benefits and Perceived Barriers. Internal consistency measured by the Cronbach's coefficient alpha for those four factors were 0.897, 0.971, 0.975 and 0.789, respectively. The ECCPS demonstrated satisfactory levels of reliability and validity for assessing the health beliefs related to ECC prevention among low-socioeconomic primary caregivers.