The efficacy of theory driven treatment adherence promotion program among type 2 diabetic patients: application of intervention mapping and mHealth.

Abstract

Mobile health interventions (mHealth) may improve health-related lifestyle behaviors and disease management. Successful management of diabetes is patient-centered responsibility. The aim of this research was to determine the efficacy of the theory driven program of promoting treatment adherence in type 2 diabetes (T2DM) patients based on mHealth. This quasi-experimental research was conducted on 70 T2DM patients in Tehran, Iran. Participants were randomly divided into intervention (n = 35) or control (n = 35) groups. The data collection tool was a questionnaire based on some of constructs Social Cognitive Theory (SCT) which elicit from formative evaluation. The SCT theory-based intervention program was developed, implemented, and evaluated based on Intervention Mapping (IM) as a framework in 8 sessions using online WhatsApp application. The data was collected through by online interviews before and one month after the implementation of the program and analyzed in SPSS version 16. After the implementation of the program, a significant increase in self-efficacy (P = 0.009), outcome expectations (P < 0.001), and also diabetes treatment adherence behaviors (P = 0.024) were indicated in the intervention group. The estimated effect sizes for self-efficacy, outcome expectations, social support, and diabetes treatment adherence behaviors were 0.78, 0.06, 0.07, and 0.62, respectively. Estimated effect size of the implemented intervention was evaluated as "large" effect for diabetes treatment adherence behaviors. Findings indicated the usefulness and efficacy of the mHealth educational program based on SCT constructs and the IM approach in treatment adherence behaviors promotion among T2DM patients in Iran. The online version contains supplementary material available at 10.1007/s40200-023-01291-5.