The effect of a community-based health behaviour intervention on health-related quality of life in people with Type 2 diabetes in Nepal: a Cluster Randomized Controlled Trial.
Ashmita Karki, Corneel Vandelanotte, M Mamun Huda, Lal B Rawal
{"title":"The effect of a community-based health behaviour intervention on health-related quality of life in people with Type 2 diabetes in Nepal: a Cluster Randomized Controlled Trial.","authors":"Ashmita Karki, Corneel Vandelanotte, M Mamun Huda, Lal B Rawal","doi":"10.1007/s11136-025-03971-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Little is known about the effectiveness of health behaviour intervention in improving health-related quality of life (HRQOL) despite HRQOL being an important outcome in Type 2 diabetes (T2DM) management. This study examined the effectiveness of a culturally appropriate health behavioural intervention in improving HRQOL of people with T2DM in Nepal.</p><p><strong>Methods: </strong>A cluster randomized controlled trial was conducted among 481 people with T2DM from 30 randomly selected healthcare facilities in Kavrepalanchok and Nuwakot districts. The intervention group received 12 culturally tailored and group-based intervention sessions for six months whereas, the control group received usual care. The primary outcomes of this study were changes in the EuroQOL (EQ5D-3L) index score and EuroQOL visual analogue scale (EQVAS) score between baseline and six-month post-intervention. The intervention effect was assessed using generalized estimating equation models.</p><p><strong>Results: </strong>At six-months post-intervention, there was a positive and statistically significant effect on EQVAS (β<sub>1</sub> = 3.61, 95%CI: 0.05, 7.17) in the intervention group compared to control group. No statistically significant effect was observed in EQ5D-3L index score. A statistically significant increase in EQVAS score of 0.5 was observed per session attended by the study participants (β<sub>1</sub> = 0.49, 95%CI: 0.01, 0.98).</p><p><strong>Conclusion: </strong>The health behaviour intervention led to improved HRQOL. An increase in the number of intervention sessions attended was significantly associated with higher EQVAS scores, emphasizing the need for longer-term and engaging interventions that are well adhered to. Longer term assessment of change in HRQOL outcomes are needed when actual changes in HRQOL are more likely to be observed.</p><p><strong>Trial registration: </strong>Australia and New Zealand Clinical Trial Registry (ACTRN12621000531819).</p>","PeriodicalId":20748,"journal":{"name":"Quality of Life Research","volume":" ","pages":""},"PeriodicalIF":3.3000,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Quality of Life Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11136-025-03971-6","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: Little is known about the effectiveness of health behaviour intervention in improving health-related quality of life (HRQOL) despite HRQOL being an important outcome in Type 2 diabetes (T2DM) management. This study examined the effectiveness of a culturally appropriate health behavioural intervention in improving HRQOL of people with T2DM in Nepal.
Methods: A cluster randomized controlled trial was conducted among 481 people with T2DM from 30 randomly selected healthcare facilities in Kavrepalanchok and Nuwakot districts. The intervention group received 12 culturally tailored and group-based intervention sessions for six months whereas, the control group received usual care. The primary outcomes of this study were changes in the EuroQOL (EQ5D-3L) index score and EuroQOL visual analogue scale (EQVAS) score between baseline and six-month post-intervention. The intervention effect was assessed using generalized estimating equation models.
Results: At six-months post-intervention, there was a positive and statistically significant effect on EQVAS (β1 = 3.61, 95%CI: 0.05, 7.17) in the intervention group compared to control group. No statistically significant effect was observed in EQ5D-3L index score. A statistically significant increase in EQVAS score of 0.5 was observed per session attended by the study participants (β1 = 0.49, 95%CI: 0.01, 0.98).
Conclusion: The health behaviour intervention led to improved HRQOL. An increase in the number of intervention sessions attended was significantly associated with higher EQVAS scores, emphasizing the need for longer-term and engaging interventions that are well adhered to. Longer term assessment of change in HRQOL outcomes are needed when actual changes in HRQOL are more likely to be observed.
Trial registration: Australia and New Zealand Clinical Trial Registry (ACTRN12621000531819).
期刊介绍:
Quality of Life Research is an international, multidisciplinary journal devoted to the rapid communication of original research, theoretical articles and methodological reports related to the field of quality of life, in all the health sciences. The journal also offers editorials, literature, book and software reviews, correspondence and abstracts of conferences.
Quality of life has become a prominent issue in biometry, philosophy, social science, clinical medicine, health services and outcomes research. The journal''s scope reflects the wide application of quality of life assessment and research in the biological and social sciences. All original work is subject to peer review for originality, scientific quality and relevance to a broad readership.
This is an official journal of the International Society of Quality of Life Research.