Positive Psychology Interventions to Improve Wellbeing and Health Behaviour Adherence in Patients with Type 2 Diabetes Mellitus: A Scoping Review and Meta-analyses

The aim of this review was to evaluate the effectiveness of positive psychological interventions (PPIs) to improve well-being and health behaviour adherence among patients with type 2 diabetes mellitus (T2DM). Medline, PsycINFO, the Cochrane register, EMBASE, and Google Scholar were systematically searched to find relevant studies until January 2020. The primary outcome was reduction in risk factors of cardiovascular disease including HbA1c, systolic blood pressure (SBP), and diastolic blood pressure along with improvement in positive affect, optimism, self-efficacy, and health behaviour adherence such as diet, exercise and medication. The secondary outcomes were reduction in depression, anxiety and stress. A random-effect model was used to compare group effect size at post-test. We identified a total of 11 studies (N=1594 participants) with substantial variability in the interventions. Overall, the results provide evidence that multi-component PPIs have a small but significant effect on positive affect, optimism, health behaviour, self-care and BMI. Further, the review demonstrates that PPIs can be effective in the reduction of anxiety and stress symptoms. However, studies included in this review are heterogenous due to methodological variation, therefore, in future more studies across a wide range of PP interventions needs to be included in order to validate the findings and for conclusive evidence.