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Educational Intervention Based on the Extended Parallel Process Model Improves Adherence to Diabetic Diet and Glycemic Control Indices: A Randomized, Double-Blind, Controlled, Factorial Field Trial Publisher Pubmed



Dehghan T1 ; Mohsenpour MA1, 2 ; Karimi M3 ; Mehrabi M4 ; Zare M5 ; Akbarzadeh M5 ; Kohansal A5 ; Fathi F6 ; Sohrabi Z5
Authors
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Authors Affiliations
  1. 1. Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
  2. 2. Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
  3. 3. Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
  4. 4. Department of E-learning in Medical Sciences, Virtual School, Shiraz University of Medical Sciences, Shiraz, Iran
  5. 5. Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
  6. 6. School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

Source: British Journal of Nutrition Published:2024


Abstract

Nutritional education is pivotal in the medical nutritional therapy of type 2 diabetes Mellitus (T2DM). The extended parallel process model (EPPM) is a health education method for inducing desirable health behaviors. The present study aimed to investigate the effect of nutritional education based on the EPPM in T2DM patients on knowledge, attitude, practice (KAP), anthropometric indices, glycemic factors, lipid profile, and adherence to the diabetic diet. A randomized, double-blind, controlled, factorial field trial was designed for T2DM patients aged 30-59 (n=88). Participants were randomly allocated into four groups to receive EPPM-based nutritional education through Gain Framed Message (GFM), Loss Framed Message (LFM), their combination (G\LFM), or usual diabetic education in the control group (CG). Participants were assessed before and after the study duration. After 3 months of intervention, 80 participants finished the study. The EPPM-Based intervention increased participants' knowledge, behavioral intention, perceived sensitivity, severity, self-efficacy (P<0.001 for all), and response efficacy (P=0.029) in comparison with CG. GFM (P=0.004) and G\FLM (P=0.034) reduced carbohydrate intake, and LFM (P=0.034) and G\LFM (P=0.047) decreased fat intake. Between-group analysis indicated interventions reduced weight (P=0.046), body mass index (P=0.038), fasting blood sugar (P=0.030), 2-hour postprandial blood glucose (P=0.027), and triglycerides (P=0.002) in comparison with the CG. Results were not significant for protein intake, waist and hip circumference, waist-to-hip ratio, HbA1c, total cholesterol, LDL, and HDL. Nutritional education based on EPPM could increase the knowledge and awareness of T2DM patients. Also, it could be beneficial for blood glucose amendment. Further investigations are recommended. © The Authors 2024.
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