Identification of Potential Leverage Points for Self-Management Support Intervention in Thais with Type 2 Diabetes

Jiamjarasrangsi, W.; Navicharern, R.; Attavorrarat, S.; Manit, A.; Aekplakorn, W.; Keesukphan, P.

Journal of the Medical Association of Thailand 100(3): 326-338

2017


ISSN/ISBN: 0125-2208
PMID: 29911793
Document Number: 17355
Although social-ecological models and multi-level interventions have been recommended for implementing the holistic self-management support for patients with type 2 diabetes, they are complex, costly, and need long-term effort. A more realistic approach would be to identify and implement a single or limited leverage point(s) that is most effective and feasible to create change. To assess the independent relationships of the social-environmental supports with self-management behaviors in Thai patients with type 2 diabetes. A cross-sectional survey was conducted among 1,000 type 2 diabetic patients from 64 healthcare facilities throughout Bangkok. A set of structured questionnaires were used to collect data related to social-environmental supports, and self-management behaviors. The predictor-outcome relationships were presented by beta (β) coefficients (95% confidence limits). Personal support was significantly associated with the overall self-management, dietary, physical activity, and medication taking behaviors. Neighborhood support was significantly associated with the overall self-management, physical activity, and medication taking behaviors. Personal support was found to interact negatively with neighborhood support on the overall self-management and medication taking behaviors. Personal and neighborhood supports are two potential leverage points for self-management support interventions for Thai patients with type 2 diabetes. Patients with low and high personal supports may need different strategies for neighborhood support.

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Identification of Potential Leverage Points for Self-Management Support Intervention in Thais with Type 2 Diabetes