Promoting self-care behavior among older adults with type 2 diabetes by the combined mindfulness and self-regulatory intervention via social media: a three-arm cluster randomized controlled trial

Abstract

ABSTRACTDeveloping self-care behaviors is a fundamental yet challenging strategy to prevent the complications of diabetes. This three-arm randomized controlled trial aimed to compare the effectiveness of combined mindfulness and self-regulation-based intervention with self-regulation-based intervention on self-care behaviors of Iranian older adults with diabetes in 2021–2022. Three public diabetic clinics were randomly assigned to three study groups and then 45 participants were randomly recruited from every clinic. 24-week educational interventions via WhatsApp included a self-regulation-based intervention (SRIP), a combined mindfulness and self-regulation intervention (CMSRIP), and routine care with training on COVID-19 prevention were performed in two intervention groups and a control group respectively. Data were collected at baseline and four and 16 weeks using a Mindfulness-based questionnaire (MSCS) and a summary of the diabetes self-care activities scale (SDSCA). The SPSS software (V. 22) was used to analyze data through ANOVA test, chi-square tests, one-way ANOVA, Levene’s test, and Repeated measures MANCOVA at a significance level of less than 0.05. The total scores of MSCS and SDSCA in four and 16 weeks significantly increased compared to the baseline in both SRIP and CMSRIP groups (P < .001), but not in the control group. The mean scores of MSCS and SDSCA at week 4 in CMSRIP group improved significantly more than SRIP group (98.43 ± 5.83 vs. 90.31 ± 12.62 and 70.38 ± 4.18 vs. 62.35 ± 5.53). Combined mindfulness and self-regulation education are significantly effective in promoting self-care skills and improving cognitive processes and can used to improve older adults’ self-care behaviors.Trial registration numberThis trial (ISRCTN77260130) was retrospectively registered on 28/09/2021. AcknowledgementsWe are grateful to dear seniors who participated in the study, as without their support the study could not have been conducted.Disclosure statementNo potential conflict of interest was reported by the authors.Ethics approval and consent to participateThis study was approved by the Ethics Committee of Shiraz University of Medical Science (Ref. no: IR.SUMS.REC.1398.1365), which is available from: https://ethics.research.ac.ir/. The trial registration number of this study is ISRCTN77260130, which is available from: https://www.isrctn.com/ISRCTN77260130. All participants were informed that participation in the study was voluntary. Initially, verbal consent to participate in the study was obtained from the selected participants by telephone, and then a written informed consent link was sent to them via WhatsApp and signed by them. They were also assured that the data collected would remain confidential. All methods were performed in accordance with the WMA Declaration of Helsinki, ethical principles for medical research involving human subjects.Additional informationFundingThis work was supported by the Vice-Chancellor for Research, Shiraz University of Medical Sciences [no].