Effects of a Behavior Modification Program Based on the Transtheoretical Model Combined with Self-Regulation on Glycemic Control among Patients with Type 2 Diabetes Mellitus

Abstract

This quasi-experimental study with two-group pretest-posttest design aimed to examine effectiveness of a behavior modification program based on the Transtheoretical Model combined with self-regulation on glycemic control for patients with type 2 diabetes mellitus (DM) on self-efficacy, blood glucose control behaviors, and glycated hemoglobin (HbA1c) levels. Samples were 112 patients with uncontrolled type 2 DM receiving services at a subdistrict health promoting hospital in Ubon Ratchathani province. Participants were selected through simple random sampling and equally assigned to experimental (n=56) and control groups (n=56). The experimental group received the behavior modification program developed by the researchers, incorporating a culturally relevant nursing innovation, “Kong Khao Noi Soi Bao Wan”, while the control group received routine nursing care. Data were collected using structured questionnaires and HbA1c records. Statistical analyses included descriptive statistics, dependent t-tests, and independent t-tests with 0.05 significance level.

The results revealed that, after the intervention, the experimental group demonstrated significantly higher self-efficacy (=4.08, SD=0.16) than those from the comparison group (=3.88, SD=0.72). The experimental group also exhibited higher blood glucose control behaviors at week 12 (=3.35, SD=0.27) compared with the comparison group. In addition, the experimental group showed a lower glycated hemoglobin (HbA1c) level after the intervention (=8.55, SD=1.70) than before the intervention; however, no significant difference was found when compared with the comparison group. Therefore, relevant agencies should promote behavioral modification among patients by emphasizing self-regulation combined with continuous monitoring and follow-up, such as home visits, telephone follow-ups, or the use of health technologies (e.g., health applications and LINE groups), to effectively support the maintenance of appropriate health behaviors.