Long-Term Effects of Transtheoretical Model-Based Lifestyle Intervention on Self-efficacy and Self-management in Patients with Type 2 Diabetes — Randomised Controlled Trial

Abstract

Background Self-efficacy and self-management are fundamental factors for successful treatment of type 2 diabetes, but long-term studies are rare. The aim of the present study is to investigate whether the effects achieved in the context of a lifestyle intervention based on the transtheoretical model can be maintained by the patients in the long term. Method A two-arm randomised controlled trial examined whether long-term effects of self-efficacy, self-management, and HbA1c can be achieved by a lifestyle intervention of 12 months and persisted beyond the intervention. During the intervention, the intervention group (n = 86, mean age 59.7 years) was supported by a telephone coach and telemedical devices, while the control group (n = 65, mean age 58.8 years) received regular care. In the year after intervention, both groups received standard care. Results The intervention group achieved significantly better self-management after 12 and 24 months (12M, 1.11 (0.81; 1.41) p < .000; 24M, 0.52 (0.19; 0.85) p = .002) as well as self-efficacy (12M, 1.18 (0.83; 1.52) p < .000; 24M, 0.76 (0.39; 1.13) p < .000) and HbA1c than the control group. Conclusion TTM-based lifestyle interventions show a long-term effect beyond the duration of the intervention in most areas, and behavioural changes can be sustained by patients.