The effectiveness of patient activation intervention on type 2 diabetes mellitus glycemic control and self-management behaviors: A systematic review of RCTs

Almutairi, Nasser; Hosseinzadeh, Hassan; Gopaldasani, Vinod

doi:10.1016/j.pcd.2019.08.009

Cited by 144Diabetes Management and EducationDiabetes Management and ResearchDiabetes Treatment and Management

The effectiveness of patient activation intervention on type 2 diabetes mellitus glycemic control and self-management behaviors: A systematic review of RCTs

Almutairi, Nasser, Hosseinzadeh, Hassan, Gopaldasani, Vinod·2020·Primary Care Diabetes

DOI 10.1016/j.pcd.2019.08.009

Open this paper in CoChat — free account

Abstract

Background Type 2 diabetes mellitus T2DM is a major health challenge and associated with several complications and mortality. Self-management behaviors SMBs such as healthy diet, physical activity, blood glucose self-monitoring, foot care and medication adherence are critical part of diabetic care. Empowered or activated patients, are more likely to practice better SMBs. However, the effectiveness of patient activation intervention on T2DM glycemic control and SMBs is not totally well understood.Aim To assess the effectiveness of patient activation intervention on T2DM glycemic control and SMBs.Method A systematic search was undertaken through five databases to find relevant studies published between 2004 and 2018. We included randomized controlled trials with sample size ≥120 and follow up period of ≥12 months and assess the effectiveness of patient activation intervention on T2DM glycemic control and SMBs.Results 10 RCTs were identified for analysis. The total sample size is 3728 and the combined mean age is 57.3 years. The combined mean BMI is 31.2kg/m 2 (obese). Seven intervention demonstrated a significant reduction in HbA1c, ranged from 0.36 to 0.80%. All interventions presented an improvement in at least one self-management behavior.Discussion and conclusion Patient activation intervention showed a significant positive effect on T2DM glycemic control and SMBs, particularly physical activity, healthy diet, foot care and blood glucose self-monitoring. The effectiveness on SMBs was seen across different intervention strategies, modes of delivery, length of intervention, and number of providers. Better effectiveness on HbA1c was associated with poorly controlled participants, culturally tailored-intervention, and in-person sessions intervention combined with telephone calls follow up.

Integrity signals

Registry

Crossref · 10.1016/j.pcd.2019.08.009

Cites

48 of 48 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

The development in technologies and infrastructures provides solid ground for digital health advancement, including penetration of cell phones and the internet.
“The development in technologies and infrastructures provide solid ground for digital health advancement, including penetration of cell phones and the internet.”
From Digital health interventions for non-communicable disease management in primary health care in low-and middle-income countries (2023) · cites this paper as [24]
Digital health designs that were integrated into existing healthcare model was a facilitator for successful uptake, and unintegrated digital health interventions that impose additional workload for primary healthcare providers is a barrier.
“Digital health designs that were integrated into existing healthcare model was a facilitator for successful uptake, and unintegrated digital health interventions that impose additional workload for primary healthcare providers is a barrier.”
From Digital health interventions for non-communicable disease management in primary health care in low-and middle-income countries (2023) · cites this paper as [24]
Motivational interviewing, patient activation, goal setting and action planning, problem-solving, tracking or self-monitoring health behaviors, and facilitating opportunities for social support are behavioral strategies with empirical support.
“Behavioral strategies with empirical support include motivational interviewing (303-305), patient activation (306), goal setting and action planning (305,307-309), problem-solving (308,310), tracking or self-monitoring health behaviors with or without feedback from a health care professional (305,307-309), and facilitating opportunities for social support (305,308,309).”
From 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes:<i>Standards of Care in Diabetes—2023</i> (2023) · cites this paper as [306]

Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study
Stratton, I. M. (2000) · BMJ · doi:10.1136/bmj.321.7258.405 · Cited by 9,059 · see citing works
Self-management education: History, definition, outcomes, and mechanisms
Lorig, K. R., & Holman, H. R. (2003) · Annals of Behavioral Medicine · doi:10.1207/s15324796abm2601_01 · Cited by 4,094 · see citing works
Medical Management of Hyperglycemia in Type 2 Diabetes: A Consensus Algorithm for the Initiation and Adjustment of Therapy
Nathan, D. M., Buse, J. B., Davidson, M. B., Ferrannini, E., Holman, R. R., Sherwin, R., & Zinman, B. (2009) · Diabetes Care · doi:10.2337/dc08-9025 · Cited by 3,834 · see citing works
Self-management approaches for people with chronic conditions: a review
Barlow, J., Wright, C., Sheasby, J., Turner, A., & Hainsworth, J. (2002) · Patient Education and Counseling · doi:10.1016/s0738-3991(02)00032-0 · Cited by 2,800 · see citing works
Development of the Patient Activation Measure (PAM): Conceptualizing and Measuring Activation in Patients and Consumers
Hibbard, J. H., Stockard, J., Mahoney, E. R., & Tusler, M. (2004) · Health Services Research · doi:10.1111/j.1475-6773.2004.00269.x · Cited by 2,748 · see citing works
Development and Testing of a Short Form of the Patient Activation Measure
Hibbard, J. H., Mahoney, E. R., Stockard, J., & Tusler, M. (2005) · Health Services Research · doi:10.1111/j.1475-6773.2005.00438.x · Cited by 1,939 · see citing works
Self-Management Education for Adults With Type 2 Diabetes
Norris, S. L., Lau, J., Smith, S. J., Schmid, C. H., & Engelgau, M. M. (2002) · Diabetes Care · doi:10.2337/diacare.25.7.1159 · Cited by 1,750 · see citing works
Why Does Patient Activation Matter? An Examination of the Relationships Between Patient Activation and Health-Related Outcomes
Greene, J., & Hibbard, J. H. (2011) · Journal of General Internal Medicine · doi:10.1007/s11606-011-1931-2 · Cited by 1,030 · see citing works
Diabetes self-management education for adults with type 2 diabetes mellitus: a systematic review of the effect on glycemic control
Chrvala, C. A., Sherr, D., & Lipman, R. D. (2016) · Patient Education and Counseling · doi:10.1016/j.pec.2015.11.003 · Cited by 914 · see citing works
Do increases in patient activation result in improved self-management behaviors?
Hibbard, J. H., Mahoney, E. R., Stock, R., & Tusler, M. (2007) · Health Services Research · doi:10.1111/j.1475-6773.2006.00669.x · Cited by 906 · see citing works
6. Glycemic Targets: Standards of Medical Care in Diabetes—2018
American Diabetes Association (2017) · Diabetes Care · doi:10.2337/dc18-s006 · Cited by 764 · see citing works
Systematic review and meta-analysis of randomised controlled trials of psychological interventions to improve glycaemic control in patients with type 2 diabetes
Ismail, K., Winkley, K., & Rabe-Hesketh, S. (2004) · The Lancet · doi:10.1016/s0140-6736(04)16202-8 · Cited by 531 · see citing works
Is Patient Activation Associated With Outcomes of Care for Adults With Chronic Conditions?
Mosen, D. M., Schmittdiel, J. A., Hibbard, J. H., Sobel, D. S., Remmers, C., & Bellows, J. (2007) · Journal of Ambulatory Care Management · doi:10.1097/00004479-200701000-00005 · Cited by 478 · see citing works
A systematic review of interventions to improve diabetes care in socially disadvantaged populations
Glazier, R. H., Bajcar, J., Kennie, N. R., & Willson, K. (2006) · Diabetes Care · doi:10.2337/dc05-1942 · Cited by 385 · see citing works
Structured patient education: the Diabetes X‐PERT Programme makes a difference
Deakin, T., Cade, J. E., Williams, R., & Greenwood, D. C. (2006) · Diabetic Medicine · doi:10.1111/j.1464-5491.2006.01906.x · Cited by 374 · see citing works
Changes in Diabetes Self-Care Behaviors Make a Difference in Glycemic Control
Jones, H., Edwards, L., Vallis, M., Ruggiero, L., Rossi, S. R., Rossi, J. S., Greene, G. W., Prochaska, J. O., & Zinman, B. (2003) · Diabetes Care · doi:10.2337/diacare.26.3.732 · Cited by 311 · see citing works
Participatory Decision Making, Patient Activation, Medication Adherence, and Intermediate Clinical Outcomes in Type 2 Diabetes: A STARNet Study
Parchman, M. L., Zeber, J. E., & Palmer, R. F. (2010) · The Annals of Family Medicine · doi:10.1370/afm.1161 · Cited by 251 · see citing works
Toward a theory of patient and consumer activation
Hibbard, J. H., & Mahoney, E. R. (2010) · Patient Education and Counseling · doi:10.1016/j.pec.2009.12.015 · Cited by 238 · see citing works
Randomized Trial of a Literacy-Sensitive, Culturally Tailored Diabetes Self-Management Intervention for Low-Income Latinos
Rosal, M. C., Ockene, I. S., Restrepo, A., White, M. J., Borg, A., Olendzki, B. C., Scavron, J., Candib, L. M., Welch, G. W., & Reed, G. W. (2011) · Diabetes Care · doi:10.2337/dc10-1981 · Cited by 227 · see citing works
Behavioral Programs for Type 2 Diabetes Mellitus: A Systematic Review and Network Meta-analysis
Pillay, J., Armstrong, M. J., Butalia, S., Donovan, L. E., Sigal, R. J., Vandermeer, B., Chordiya, P., Dhakal, S., Hartling, L., Nuspl, M., et al. (2015) · Annals of Internal Medicine · doi:10.7326/m15-1400 · Cited by 223 · see citing works
A systematic review of telemedicine interventions to support blood glucose self‐monitoring in diabetes
Farmer, A., Gibson, O. J., Tarassenko, L., & Neil, A. (2005) · Diabetic Medicine · doi:10.1111/j.1464-5491.2005.01627.x · Cited by 211 · see citing works
Twelve-month outcomes of an Internet-based diabetes self-management support program
Glasgow, R. E., Kurz, D., King, D. K., Dickman, J. M., Faber, A. J., Halterman, E., Woolley, T., Toobert, D. J., Strycker, L. A., Estabrooks, P. A., et al. (2011) · Patient Education and Counseling · doi:10.1016/j.pec.2011.07.024 · Cited by 205 · see citing works
Simultaneous vs Sequential Counseling for Multiple Behavior Change
Hyman, D. J., Pavlik, V. N., Taylor, W. C., Goodrick, G. K., & Moye, L. (2007) · Archives of Internal Medicine · doi:10.1001/archinte.167.11.1152 · Cited by 188 · see citing works
Behavioral Programs for Type 1 Diabetes Mellitus
Pillay, J., Armstrong, M. J., Butalia, S., Donovan, L., Sigal, R. J., Chordiya, P., Dhakal, S., Vandermeer, B., Hartling, L., Nuspl, M., et al. (2015) · Annals of Internal Medicine · doi:10.7326/m15-1399 · Cited by 180 · see citing works
Patient Activation and Adherence to Physical Therapy in Persons Undergoing Spine Surgery
Skolasky, R. L., MacKenzie, E. J., Wegener, S. T., & Riley, L. H. (2008) · Spine · doi:10.1097/brs.0b013e31818027f1 · Cited by 178 · see citing works
Results of a Successful Telephonic Intervention to Improve Diabetes Control in Urban Adults
Walker, E. A., Shmukler, C., Ullman, R., Blanco, E., Scollan‐Koliopoulos, M., & Cohen, H. W. (2010) · Diabetes Care · doi:10.2337/dc10-1005 · Cited by 164 · see citing works
When activation changes, what else changes? the relationship between change in patient activation measure (PAM) and employees’ health status and health behaviors
Harvey, L., Fowles, J. B., Xi, M., & Terry, P. E. (2012) · Patient Education and Counseling · doi:10.1016/j.pec.2012.02.005 · Cited by 123 · see citing works
Community-based Diabetes Education for Latinos
Castillo, A., Giachello, A. L. M., Bates, R., Concha, J. B., Ramirez, V., Sanchez, C. M., Pinsker, E. C., & Arrom, J. O. (2010) · The Science of Diabetes Self-Management and Care · doi:10.1177/0145721710371524 · Cited by 109 · see citing works
The Effect of a Community-Based Self-Help Intervention
Kim, M. T., Kim, K. B., Huh, B., Nguyen, T. H., Han, H., Bone, L., & Levine, D. M. (2015) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2015.04.033 · Cited by 105 · see citing works
Does patient activation predict the course of type 2 diabetes? A longitudinal study
Sacks, R. M., Greene, J., Hibbard, J. H., Overton, V., & Parrotta, C. (2017) · Patient Education and Counseling · doi:10.1016/j.pec.2017.01.014 · Cited by 96 · see citing works
Glycaemic control and self‐management behaviours in Type 2 diabetes: results from a 1‐year longitudinal cohort study
Houle, J., Beaulieu, M. ‐., Chiasson, J. ‐., Lespérance, F., Côté, J., Strychar, I., Bherer, L., Meunier, S., & Lambert, J. (2015) · Diabetic Medicine · doi:10.1111/dme.12686 · Cited by 92 · see citing works
The patient from receiver of information to informed decision-maker
van den Borne, H. W. (1998) · Patient Education and Counseling · doi:10.1016/s0738-3991(97)00085-2 · Cited by 85 · see citing works
Culturally sensitive patient-centred educational programme for self-management of type 2 diabetes: A randomized controlled trial
Mohamed, H., Lenjawi, B. A., Amuna, P., Zotor, F. B., & Elmahdi, H. (2013) · Primary care diabetes · doi:10.1016/j.pcd.2013.05.002 · Cited by 82 · see citing works
Effect of Culturally Tailored Diabetes Education in Ethnic Minorities With Type 2 Diabetes
Nam, S., Janson, S. L., Stotts, N. A., Chesla, C. A., & Kroon, L. (2012) · The Journal of Cardiovascular Nursing · doi:10.1097/jcn.0b013e31822375a5 · Cited by 81 · see citing works
Evaluating the effectiveness of an empowerment program for self-care in type 2 diabetes: a cluster randomized trial
Cortez, D. N., Macêdo, M. M. L., Souza, D. A. S., dos Santos, J. C., Afonso, G. D. S., Reis, I. A., & Torres, H. D. C. (2017) · BMC Public Health · doi:10.1186/s12889-016-3937-5 · Cited by 77 · see citing works
Telephone follow‐up to improve glycaemic control in patients with Type 2 diabetes: systematic review and meta‐analysis of controlled trials
Wu, L., Forbes, A., Griffiths, P., Milligan, P., & While, A. (2010) · Diabetic Medicine · doi:10.1111/j.1464-5491.2010.03113.x · Cited by 67 · see citing works
The association between patient activation and self‐care practices: A cross‐sectional study of an Australian population with comorbid diabetes and chronic kidney disease
Zimbudzi, E., Lo, C., Ranasinha, S., Kerr, P. G., Polkinghorne, K. R., Teede, H. J., Usherwood, T., Walker, R. G., Johnson, G., Fulcher, G., et al. (2017) · Health Expectations · doi:10.1111/hex.12577 · Cited by 66 · see citing works
Diabetes self-management interventions for adults with type 2 diabetes living in rural areas: A systematic literature review
Lepard, M. G., Joseph, A. L., Agne, A. A., & Cherrington, A. L. (2015) · Current Diabetes Reports · doi:10.1007/s11892-015-0608-3 · Cited by 62 · see citing works
Management of type 2 diabetes in China: the Happy Life Club, a pragmatic cluster randomised controlled trial using health coaches
Browning, C., Chapman, A., Yang, H., Liu, S., Zhang, T., Enticott, J. C., & Thomas, S. A. (2016) · BMJ Open · doi:10.1136/bmjopen-2015-009319 · Cited by 58 · see citing works
Telephone-Delivered Lifestyle Support With Action Planning and Motivational Interviewing Techniques to Improve Rehabilitation Outcomes
Dobler, A., Belnap, B. H., Pollmann, H., Farin, E., Raspe, H., & Mittag, O. (2018) · Rehabilitation Psychology · doi:10.1037/rep0000224 · Cited by 51 · see citing works
How health literacy and patient activation play their own unique role in self-management of chronic obstructive pulmonary disease (COPD)?
Yadav, U. N., Hosseinzadeh, H., Lloyd, J., & Harris, M. (2018) · Chronic Respiratory Disease · doi:10.1177/1479973118816418 · Cited by 51 · see citing works
Self-citation
Effect of Culturally Tailored Diabetes Education in Ethnic Minorities With Type 2 Diabetes
Nam, S., Janson, S. L., Stotts, N. A., Chesla, C. A., & Kroon, L. J. (2011) · Cited by 50 · see citing works
Self-management experiences among middle-aged population of rural area of Pakistan with type 2 diabetes: A qualitative analysis
Ansari, R. M., Hosseinzadeh, H., Harris, M., & Zwar, N. A. (2018) · Clinical Epidemiology and Global Health · doi:10.1016/j.cegh.2018.04.003 · Cited by 43 · see citing works
Self-citation
Association of health literacy with type 2 diabetes mellitus self-management and clinical outcomes within the primary care setting of Iran
Niknami, M., Mirbalouchzehi, A., Zareban, I., Kalkalinia, E., Rikhtgarha, G., & Hosseinzadeh, H. (2018) · Australian Journal of Primary Health · doi:10.1071/py17064 · Cited by 42 · see citing works
Self-citation
Effectiveness of chronic obstructive pulmonary disease self-management interventions in primary care settings: a systematic review
Hosseinzadeh, H., & Shnaigat, M. (2019) · Australian Journal of Primary Health · doi:10.1071/py18181 · Cited by 32 · see citing works
Self-citation
Health literacy and health-promoting behaviours among Australian-Singaporean communities living in Sydney metropolitan area
Ho, T. G., Hosseinzadeh, H., Rahman, B., & Sheikh, M. (2017) · Proceedings of Singapore Healthcare · doi:10.1177/2010105817741906 · Cited by 30 · see citing works
Self-citation
The impact of structured physical activity on glycaemic control in diabetes prevention programmes: A systematic review
Edwards, J. F., & Hosseinzadeh, H. (2017) · Proceedings of Singapore Healthcare · doi:10.1177/2010105817739924 · Cited by 25 · see citing works
Self-citation
Effect of case management on glycemic control and behavioral outcomes for chinese people with type 2 diabetes: A 2-year study
Yuan, X., Wang, F., Fish, A. F., Xue, C., Chen, T., Liu, C., & Lou, Q. (2016) · Patient Education and Counseling · doi:10.1016/j.pec.2016.03.010 · Cited by 17 · see citing works

Flagged first, then by citations

2 of the 50 references couldn’t be matched to a known paper.

Sorted by citations

5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes:<i>Standards of Care in Diabetes—2023</i>
ElSayed, N. A., Aleppo, G., Aroda, V. R., Bannuru, R. R., Brown, F. M., Bruemmer, D., Collins, B. S., Hilliard, M. E., Isaacs, D., Johnson, E. L., et al. (2023) · Diabetes Care · doi:10.2337/dc23-s005 · Cited by 362 · see citing works
5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes—2025
American Diabetes Association Professional Practice Committee, ElSayed, N. A., McCoy, R. G., Aleppo, G., Balapattabi, K., Beverly, E. A., Briggs Early, K., Bruemmer, D., Echouffo-Tcheugui, J. B., Eichorst, B., et al. (2025) · Diabetes Care · doi:10.2337/dc25-s005 · Cited by 305 · see citing works
5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes—2024
ElSayed, N. A., Aleppo, G., Bannuru, R. R., Beverly, E. A., Bruemmer, D., Collins, B. S., Darville, A. K., Ekhlaspour, L., Hassanein, M. M., Hilliard, M. E., et al. (2023) · Diabetes Care · doi:10.2337/dc24-s005 · Cited by 325 · see citing works
Digital health interventions for non-communicable disease management in primary health care in low-and middle-income countries
Xiong, S., Lu, H., Peoples, N., Duman, E. K., Najarro, A., Ni, Z., Gong, E., Yin, R., Ostbye, T., Palileo-Villanueva, L. M., et al. (2023) · npj Digital Medicine · doi:10.1038/s41746-023-00764-4 · Cited by 126 · see citing works
5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes—2026
Bajaj, M. S., McCoy, R. G., Balapattabi, K., Bannuru, R. R., Bellini, N. J., Bennett, A. K., Beverly, E. A., Early, K. B., ChallaSivaKanaka, S., Echouffo-Tcheugui, J. B., et al. (2025) · Diabetes Care · doi:10.2337/dc26-s005 · Cited by 178 · see citing works
Association of health literacy and diabetes self-management: a systematic review
Dahal, P. K., & Hosseinzadeh, H. (2019) · Australian Journal of Primary Health · doi:10.1071/py19007 · Cited by 79 · see citing works
“T2DM self-management includes physical activity, healthy eating, medication adherence, blood glucose monitoring and diabetes self-care-related problem solving (Funnell et al. 2011; Almutairi et al. 2019).”
BackgroundSelf-citation
Nursing interventions to promote patient engagement in cancer care: A systematic review
Bonetti, L., Tolotti, A., Anderson, G., Nania, T., Vignaduzzo, C., Sari, D., & Barello, S. (2022) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2022.104289 · Cited by 66 · see citing works
The effectiveness of diabetes self-management education intervention on glycaemic control and cardiometabolic risk in adults with type 2 diabetes in low- and middle-income countries: A systematic review and meta-analysis
Chowdhury, H. A., Harrison, C. L., Siddiquea, B. N., Tissera, S., Afroz, A., Ali, L., Joham, A. E., & Billah, B. (2024) · PLoS ONE · doi:10.1371/journal.pone.0297328 · Cited by 83 · see citing works
Seated Pulmonary Artery Pressure Monitoring in Patients With Heart Failure
Guichard, J. L., Bonno, E. L., Nassif, M. E., Khumri, T. M., Miranda, D., Jonsson, O., Shah, H., Alexy, T., MACALUSO, G. P., Sur, J. P., et al. (2024) · JACC Heart Failure · doi:10.1016/j.jchf.2024.05.017 · Cited by 58 · see citing works
A systematic review and meta-analysis of patient activation in people living with chronic conditions
Cuevas, H. E., Heitkemper, E., Huang, Y., Jang, D. E., García, A. A., & Zuniga, J. A. (2021) · Patient Education and Counseling · doi:10.1016/j.pec.2021.02.016 · Cited by 53 · see citing works
Impact of Telehealth Care among Adults Living with Type 2 Diabetes in Primary Care: A Systematic Review and Meta-Analysis of Randomised Controlled Trials
Robson, N., & Hosseinzadeh, H. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph182212171 · Cited by 55 · see citing works
Self-citation
Change is possible: How increased patient activation is associated with favorable changes in well-being, self-management and health outcomes among people with type 2 diabetes mellitus: A prospective longitudinal study
Regeer, H., van Empelen, P., Bilo, H. J. G., de Koning, E. J. P., & Huisman, S. D. (2021) · Patient Education and Counseling · doi:10.1016/j.pec.2021.07.014 · Cited by 50 · see citing works
Person-centered diabetes care and patient activation in people with type 2 diabetes
Rutten, G. E. H. M., van Vugt, H. A., & de Koning, E. J. P. (2020) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2020-001926 · Cited by 49 · see citing works
The mediating effect of self-efficacy on the relationship between diabetes self-management ability and patient activation in older adults with type 2 diabetes
Zhang, A., Wang, J., Wan, X., Guo, Z., Zhang, Z., Zhao, S., Bai, S., Miao, Y., & Zhang, J. (2023) · Geriatric Nursing · doi:10.1016/j.gerinurse.2023.02.017 · Cited by 50 · see citing works
The effectiveness of an intervention designed based on health action process approach on diet and medication adherence among patients with type 2 diabetes: a randomized controlled trial
Ranjbaran, S., Shojaeizadeh, D., Dehdari, T., Yaseri, M., & Shakibazadeh, E. (2022) · Diabetology & Metabolic Syndrome · doi:10.1186/s13098-021-00773-x · Cited by 45 · see citing works
“A systematic review conducted by Almutairi in 2020 showed that patient activation concept used in the theory-based interventions including HAPA, health belief model, social cognitive theory, and PRECEDE- PROCEED was effective in selfmanagement behaviors (physical activity, healthy diet, food care and blood glucose sel…”
BackgroundMethodInfluential
Patient activation and Type 2 diabetes mellitus self-management: a systematic review and meta-analysis
Hosseinzadeh, H., Verma, I., & Gopaldasani, V. (2020) · Australian Journal of Primary Health · doi:10.1071/py19204 · Cited by 44 · see citing works
Self-citation
Enhancing Patient Activation and Self-Management Activities in Patients With Type 2 Diabetes Using the US Department of Defense Mobile Health Care Environment: Feasibility Study
Gimbel, R. W., Rennert, L., Crawford, P. F., Little, J. R., Truong, K. D., Williams, J. E., Griffin, S. F., Shi, L., Chen, L., Zhang, L., et al. (2020) · Journal of Medical Internet Research · doi:10.2196/17968 · Cited by 40 · see citing works
“Several studies have demonstrated a relationship between increased patient activation and improved clinical outcomes (eg, hypertension, smoking, BMI, and glycated hemoglobin [HbA1c]) [5,16,25,34-38], whereas other studies did not achieve significant improvement in clinical outcomes [5,37,39].”
BackgroundResult
Self-management practices for preventing complications of type II diabetes mellitus in low and middle-income countries: A scoping review
Maina, P. M., Pienaar, M., & Reid, M. (2023) · International Journal of Nursing Studies Advances · doi:10.1016/j.ijnsa.2023.100136 · Cited by 47 · see citing works
“Self-management refers to a person ’ s ability to adequately handle or cope with the symptoms, treatment, physical and psychosocial consequences, and lifestyle modifications involved in daily living with a chronic condition (Almutairi et al., 2020).”
Background
Effectiveness of health literacy- and patient activation-targeted interventions on chronic disease self-management outcomes in outpatient settings: a systematic review
Hosseinzadeh, H., Downie, S. R., & Shnaigat, M. (2022) · Australian Journal of Primary Health · doi:10.1071/py21176 · Cited by 39 · see citing works
Self-citation
Effectiveness of patient activation interventions on chronic obstructive pulmonary disease self-management outcomes: A systematic review.
Shnaigat, M., Downie, S., & Hosseinzadeh, H. (2022) · The Australian journal of rural health · doi:10.1111/ajr.12828 · Cited by 27 · see citing works
Self-citation
The effect of education given to type 2 diabetic individuals on diabetes self-management and self-efficacy: Randomized controlled trial
EROĞLU, N., & Sabuncu, N. (2021) · Primary care diabetes · doi:10.1016/j.pcd.2021.02.011 · Cited by 32 · see citing works
The impact of peer coach-led type 2 diabetes mellitus interventions on glycaemic control and self-management outcomes: A systematic review and meta-analysis
Verma, I., Gopaldasani, V., Jain, V., Chauhan, S., Chawla, R., Verma, P. K., & Hosseinzadeh, H. (2022) · Primary care diabetes · doi:10.1016/j.pcd.2022.10.007 · Cited by 32 · see citing works
Self-citation
Influence of chronic illness resources on self‐management and the mediating effect of patient activation among patients with coronary heart disease
Zhang, X., Chen, H., Liu, Y., & Yang, B. X. (2021) · Nursing Open · doi:10.1002/nop2.1031 · Cited by 30 · see citing works
“A systematic review summarized that patient activation was an effect intervention on improving self- management behaviours in diabetes patients (Almutairi et al., 2020).”
Background
The effects of message framing on self-management behavior among people with type 2 diabetes: A randomized controlled trial
Gao, R., Guo, H., Liu, Y., Pang, Y., Zhang, X., Lian, X., Yu, T., Zhu, L., & Li, F. (2023) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2023.104491 · Cited by 30 · see citing works
The effects of diabetes self‐management interventions on physiological outcomes in people living with diabetes in Africa: A systematic review and meta‐analysis
Diriba, D. C., Leung, D. Y. P., & Suen, L. K. P. (2020) · Diabetic Medicine · doi:10.1111/dme.14501 · Cited by 27 · see citing works
The TELE-DD Randomised Controlled Trial on Treatment Adherence in Patients with Type 2 Diabetes and Comorbid Depression: Clinical Outcomes after 18-Month Follow-Up
del Hoyo, M. L. L., Fernández‐Rodrigo, M. T., Urcola‐Pardo, F., Monreal‐Bartolomé, A., Ruiz, D. C. G., Borao, M. G., Alcázar, A. B. A., Casbas, J. P. M., Casas, A. A., Funcia, M. T. A., et al. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20010328 · Cited by 25 · see citing works
“[44] identified telephone interventions”
Same goals, different challenges: A systematic review of perspectives of people with diabetes and healthcare professionals on Type 2 diabetes care
Catapan, S. D. C., Nair, U., Gray, L., Calvo, M. C. M., Bird, D., Janda, M., Fatehi, F., Menon, A., & Russell, A. W. (2021) · Diabetic Medicine · doi:10.1111/dme.14625 · Cited by 23 · see citing works
The evaluation of cognitive-behavioral therapy-based intervention on type 2 diabetes patients with comorbid metabolic syndrome: a randomized controlled trial
Li, Y., Buys, N. J., Ferguson, S., Li, Z., Shi, Y., Li, L., & Sun, J. (2023) · Diabetology & Metabolic Syndrome · doi:10.1186/s13098-023-01100-2 · Cited by 28 · see citing works
“Previous studies illustrated that self-management programs were beneficial in improving patients’ self-care behaviors [20, 21], including dietary behaviors [22], physical activity [23], and medication adherence [24].”
Background
A Mobile-Based Intervention for Glycemic Control in Patients With Type 2 Diabetes: Retrospective, Propensity Score-Matched Cohort Study
Li, J., Sun, L., Wang, Y., Guo, L., Li, D., Liu, C., Sun, N., Xu, Z., Li, S., Jiang, Y., et al. (2020) · JMIR mhealth and uhealth · doi:10.2196/15390 · Cited by 21 · see citing works
“There may be many reasons for poor glycemic control in patients older than 75 years of age in the mHealth group, including decreased self-management ability, inadequate exercise, irregular glycemic monitoring, and poor convenience in using apps, among other reasons [21,23,43].”
Background
Tailoring nursing interventions to empower patients: personal coping strategies and self-management in type 2 diabetes care
Ibrahim, A. M., Gano, F. A. E. L., Abdel‐Aziz, H. R., Elneblawi, N. H., Zaghamir, D. E. F., Negm, L. M. M. A., Sweelam, R. K., Ahmed, S. I., Mohamed, H. A. O., Hassabelnaby, F. G. E., et al. (2024) · BMC Nursing · doi:10.1186/s12912-024-02573-w · Cited by 22 · see citing works
Inadequate diabetes knowledge is associated with poor glycemia control in patients with type 2 diabetes
López, L. V., Muñoz-Torres, A. V., Medina‐Bravo, P., & Escobedo, J. (2023) · Atención Primaria · doi:10.1016/j.aprim.2023.102604 · Cited by 30 · see citing works
Patient activation in adults attending appointments in general practice: a cross-sectional study
Hernar, I., Graue, M., Igland, J., Richards, D. A., Riise, H. K. R., Haugstvedt, A., & Kolltveit, B. H. (2023) · BMC Family Practice · doi:10.1186/s12875-023-02102-9 · Cited by 20 · see citing works
“Here targeted patient activation and self-management interventions that fit individual needs are important [12, 34].”
BackgroundResult
Strategies for Patient, Family, and Caregiver Engagement
Bennett, W. L., Pitts, S. I., Aboumatar, H. J., Sharma, R., Smith, B. M., Das, A., Day, J., Holzhauer, K., & Bass, E. B. (2020) · doi:10.23970/ahrqepctb36 · Cited by 19 · see citing works
Healthcare Professionals’ Perspectives of Patients’ Experiences of the Self-Management of Type 2 Diabetes in the Rural Areas of Pakistan: A Qualitative Analysis
Ansari, R. M., Harris, M., Hosseinzadeh, H., & Zwar, N. A. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18189869 · Cited by 18 · see citing works
“The disease requires patient commitment and the ability to carry out self-management activities in their routine life [2].”
BackgroundSelf-citation
The Effect of a Patient Activation Tailored Intervention on Type 2 Diabetes Self-Management and Clinical Outcomes: A Study from Saudi Arabian Primary Care Settings
Almutairi, N., Gopaldasani, V., & Hosseinzadeh, H. (2023) · Journal of Diabetes Research · doi:10.1155/2023/2074560 · Cited by 17 · see citing works
Self-citation
The My Diabetes Care Patient Portal Intervention: Usability and Pre-Post Assessment
Martínez, W., Hackstadt, A. J., Hickson, G. B., KNOERL, T., Rosenbloom, S. T., Wallston, K. A., & Elasy, T. A. (2021) · Applied Clinical Informatics · doi:10.1055/s-0041-1730324 · Cited by 16 · see citing works
Effectiveness of a nurse‐led personalized patient engagement program to promote type 2 diabetes self‐management: A randomized controlled trial
Cengiz, D., & Korkmaz, F. (2023) · Nursing and Health Sciences · doi:10.1111/nhs.13048 · Cited by 15 · see citing works
“We propose that PHEinAction ® , which follows similar methods as reported in previous studies (Almutairi et al., 2020), enables the nurse to maintain contact with patients through in-person and telephone interviews, also employing motivational interviewing techniques.”
Effect of mHealth Interventions on Glycemic Control and HbA1c Improvement among Type II Diabetes Patients in Asian Population: A Systematic Review and Meta-Analysis
Verma, D., Bahurupi, Y. A., Kant, R., Singh, M., Aggarwal, P., & Saxena, V. (2021) · Indian Journal of Endocrinology and Metabolism · doi:10.4103/ijem.ijem_387_21 · Cited by 14 · see citing works
The Effectiveness of Telehealth Interventions on Medication Adherence Among Patients with Type 2 Diabetes: A Meta-Analysis
Gürçay, B., Yılmaz, F. T., & Bilgin, A. (2023) · Telemedicine Journal and e-Health · doi:10.1089/tmj.2023.0088 · Cited by 14 · see citing works
The relationship between diabetes self-care management and blood glucose level among type 2 diabetes mellitus patients
Dewi, E. U., Widari, N. P., Nursalam, N., Mahmudah, M., Sari, E. Y., & Susiana, Y. F. N. (2023) · International Journal of Public Health Science (IJPHS) · doi:10.11591/ijphs.v12i3.22228 · Cited by 13 · see citing works
Generic and disease‐specific self‐care instruments in older patients affected by multiple chronic conditions: A descriptive study
Maria, M. D., Saurini, M., Erba, I., Vellone, E., Riegel, B. J., Ausili, D., & Matarese, M. (2024) · Journal of Clinical Nursing · doi:10.1111/jocn.17397 · Cited by 13 · see citing works
Motiva.DM2 project. A pilot behavioral intervention on diet and exercise for individuals with type 2 diabetes mellitus
Martín‐Payo, R., Cano, C. P., Fernández-Raigada, R. I., Santos-Granda, M. I., Cuesta, M., & González-Méndez, X. (2020) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2020.108579 · Cited by 13 · see citing works
Effectiveness of case scenario‐based teaching to transition international Master of Public Health students specialising in health promotion from memorization to critical thinking
Hosseinzadeh, H., Ratan, Z. A., Shnaigat, M., Edwards, J. F., Verma, I., Niknami, M., & Dadich, A. (2022) · Health Promotion Journal of Australia · doi:10.1002/hpja.631 · Cited by 12 · see citing works
Self-citation
Self-Efficacy, Patient Activation, and the Burden of Inflammatory Bowel Disease on Patients’ Daily Lives
Sheehan, J. L., Greene-Higgs, L., Resnicow, K., Patel, M. R., Barnes, E. L., Waljee, A. K., Higgins, P., & Cohen‐Mekelburg, S. (2024) · Digestive Diseases and Sciences · doi:10.1007/s10620-024-08712-2 · Cited by 12 · see citing works
“Higher levels of patient activation have been associated with improved outcomes for patients with chronic conditions and have been the target for self-management intervention for other chronic disease models, such as heart failure and diabetes [4, 5].”
Fatalism, Social Support and Self-Management Perceptions among Rural African Americans Living with Diabetes and Pre-Diabetes
Abbott, L. S., Slate, E. H., Graven, L. J., Lemacks, J. L., & Grant, J. S. (2021) · Nursing Reports · doi:10.3390/nursrep11020024 · Cited by 12 · see citing works
“A systematic review of randomized controlled trials showed that improved HbA1C levels were associated with culturally relevant and face-to-face interventions [48].”
Background
Factors associated with patient activation among patients with diabetes on hemodialysis: a multicenter cross-sectional study from a developing country
Zeidalkilani, J., Milhem, Y. A., Shorafa, R. N., Taha, S., Koni, A. A., Al‐Jabi, S. W., & Zyoud, S. H. (2024) · BMC Nephrology · doi:10.1186/s12882-024-03674-z · Cited by 11 · see citing works
“High activation in patients with DM was found to be associated with fewer admissions, better glycemic control, blood glucose monitoring, physical exercise, improved nutritional habits, and adherence to recommended eye examinations and foot care [17–19].”
Background
Diabetes self-care intervention strategies and their effectiveness in Sub-Saharan Africa: A systematic review
Ageru, T. A., Le, C. N., Wattanapisit, A., Woticha, E. W., Truong, N. T., Stanikzai, M. H., Abiso, T. L., & Suwanbamrung, C. (2024) · PLoS ONE · doi:10.1371/journal.pone.0305860 · Cited by 11 · see citing works
Effectiveness of a Diabetes Education Program based on Tailored interventions and Theory of Planned Behaviour: Cluster randomized controlled trial protocol
Caro, J., Villa‐Estrada, F., Gómez‐González, A. J., Lupiáñez‐Pérez, I., Herrera, J. C. M., Kaknani‐Uttumchandani, S., García‐Mayor, S., & Morales‐Asencio, J. M. (2020) · Journal of Advanced Nursing · doi:10.1111/jan.14580 · Cited by 11 · see citing works
Identifying type 1 / type 2 diabetes in medico-administrative database to improve health surveillance, medical research and prevention in diabetes: Algorithm development and application
Fuentes, S., Hrzic, R., Haneef, R., Kab, S., Cosson, E., & Fosse‐Edorh, S. (2023) · Diabetes Epidemiology and Management · doi:10.1016/j.deman.2023.100137 · Cited by 10 · see citing works
Research status and hotspots of patient engagement: A bibliometric analysis
Man, C., Liu, T., Yan, S., Xie, Q., & Liu, H. (2024) · Patient Education and Counseling · doi:10.1016/j.pec.2024.108306 · Cited by 10 · see citing works
Participatory Development of an Integrated, eHealth-Supported, Educational Care Pathway (Diabetes Box) for People With Type 2 Diabetes: Development and Usability Study
de Frel, D. L., Schroijen, M. A., Aardoom, J. J., van Gils, W., Huisman, S. D., Janssen, V. R., Versluis, A., Kleinsmann, M. S., Atsma, D. E., & Pijl, H. (2023) · JMIR Human Factors · doi:10.2196/45055 · Cited by 8 · see citing works
“Yet, another systematic review reported that encouraging patients to play an active role in self-management, so-called patient activation or empowerment, can also improve glucose regulation [13].”
Background
Effectiveness of telemonitoring intervention on glycaemic control in patients with type 2 diabetes mellitus: a systematic review and meta-analysis
Cai, J., Xu, H., Jiang, S., Sung, J., Sawhney, R., Broadley, S., & Sun, J. (2023) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2023.110727 · Cited by 8 · see citing works
Symptoms of depression, perceived social support, and medical coping modes among middle-aged and elderly patients with type 2 diabetes
Zhang, C., Wu, Z., Lopez, E. R., Magboo, R. G., & Hou, K. (2023) · Frontiers in Molecular Biosciences · doi:10.3389/fmolb.2023.1167721 · Cited by 8 · see citing works
“Biological and psychosocial factors are constantly interconnected and influenced by each other, so it is not enough to control the metabolism of diabetes in diabetes treatment only by drugs, etc., (Almutairi et al., 2020; Que et al., 2021;Wu et al., 2023).”
Background
Effectiveness of a personal health coaching intervention (diabetescoach) in patients with type 2 diabetes: protocol for an open-label, pragmatic randomised controlled trial
Hohberg, V., Kreppke, J.-N., Kohl, J., Seelig, E., Zahner, L., Streckmann, F., Gerber, M., König, D., & Faude, O. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-057948 · Cited by 8 · see citing works
Intermittent Use of Continuous Glucose Monitoring in Type 2 Diabetes Is Preferred: A Qualitative Study of Patients’ Experiences
Bendixen, B. E., Wilhelmsen‐Langeland, A., Lomborg, K. E., Måkestad, E., Iversen, M. M., Søfteland, E. W., & Haugstvedt, A. (2025) · The Science of Diabetes Self-Management and Care · doi:10.1177/26350106251326517 · Cited by 8 · see citing works
Participant-directed intervention tailoring is associated with improvements in glycemic control for South Asian adults with type 2 diabetes
Tang, T. S., Sidhu, R., Halani, K., Elliott, T., Sohal, P., & Garg, A. (2022) · Canadian Journal of Diabetes · doi:10.1016/j.jcjd.2021.11.003 · Cited by 7 · see citing works
Patient Activation During the First 6 Months After the Start of Stroke Rehabilitation
van Meijeren-Pont, W., Tamminga, S. J., Fiocco, M. F., Avila, A. G., Volker, G., Janssen, S. M. J., Vlieland, T. P. M. V., & Oosterveer, D. M. (2022) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2022.02.017 · Cited by 7 · see citing works
Lower education and immigrant background are associated with lower participation in a diabetes education program – Insights from adult patients in the Outcomes & Multi-morbidity In Type 2 diabetes cohort (OMIT)
Strandberg, R. B., Nilsen, R. M., Pouwer, F., Igland, J., Forster, R. B., Jenum, A. K., Buhl, E. S., & Iversen, M. M. (2022) · Patient Education and Counseling · doi:10.1016/j.pec.2022.107577 · Cited by 7 · see citing works
Evaluating the impact of patient-reported outcome measures on depression and anxiety levels in people with multiple sclerosis: a study protocol for a randomized controlled trial
Chu, N. Y., Watson, K. E., Hamarneh, Y. N. A., Yushko, L., Tsuyuki, R. T., & Smyth, P. S. (2023) · BMC Neurology · doi:10.1186/s12883-023-03090-0 · Cited by 7 · see citing works
Obesity and Patient Activation: Confidence, Communication, and Information Seeking Behavior
Chang, J. E., Lindenfeld, Z., & Chang, V. W. (2022) · Journal of Primary Care & Community Health · doi:10.1177/21501319221129731 · Cited by 7 · see citing works
Analysis of Patient Cues in Asynchronous Health Interactions: Pilot Study Combining Empathy Appraisal and Systemic Functional Linguistics
Velasco, E. R., Pedersen, H. S., & Skinner, T. C. (2022) · JMIR Formative Research · doi:10.2196/40058 · Cited by 7 · see citing works
“However, we now know that these NCDs can be prevented, or substantially delayed, by changes in lifestyle (eg, factors such as diet, physical activity, stress, and sleep), as shown in numerous trials [2-4].”
Background
Stroke survivors’ patient activation and self-management: The serial mediating role of social support and resilience
Jiang, N., Feng, L., Song, N., Ye, Y., Wei, B., Tian, T., Chen, N., Li, Y., & Jiang, X. (2025) · Geriatric Nursing · doi:10.1016/j.gerinurse.2025.02.013 · Cited by 8 · see citing works
Association between patient activation, self-management behaviours and clinical outcomes in adults with type 2 diabetes: a systematic review with narrative synthesis
Thinakaran, K., Ahern, A. L., Beckett, R. S., Shaida, S. F., Wills, H. M., Richards, R., Birch, J. M., Griffin, S. J., & Mueller, J. (2025) · BMJ Open · doi:10.1136/bmjopen-2024-095456 · Cited by 6 · see citing works
“HbA 1c was the most frequently measured clinical outcome, while physical activity and smoking were the most reported SMBs. Outcomes like LDL, body weight and alcohol consumption were infrequently reported.”
Influential
Interpersonal (mis)perceptions and (mis)predictions in patient–clinician interactions
Valentine, K. D., & Scherer, L. D. (2021) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2021.07.021 · Cited by 6 · see citing works
Impact of the Interprofessional Collaborative Education Program (IPCEP) on the knowledge, attitudes, and practices of diabetic foot care among individuals with type 2 diabetes mellitus: a narrative review
Bhukya, N. K. N., Prabhath, S., Devi, E. S., Maiya, A. G., Seetharam, P., Hebbar, S., Karkada, G., Shetty, S., & Karanth, S. (2025) · BMC Health Services Research · doi:10.1186/s12913-025-13244-0 · Cited by 6 · see citing works
“A key component of IPCEP is patient activation interventions, which, as shown in randomized controlled trials, lead to marked improvements in glycemic control and self-management behaviors (SMBs) such as physical activity, healthy eating, foot care, and blood glucose monitoring [104].”
Does the short-term use of continuous glucose monitoring enhance diabetes self-management behaviour in type 2 diabetes? The DISCO GM Study: A randomised, controlled cross-over study
Parsons, S. N., Luzio, S. D., Dowrick, S. C., Dunseath, G. J., Cheung, W., Gibbs, S. L., Owens, D. R., & Stephens, J. W. (2025) · Diabetes & Metabolic Syndrome Clinical Research & Reviews · doi:10.1016/j.dsx.2025.103283 · Cited by 5 · see citing works
Effects of a nurse-led diabetes self-management programme for people with type 2 diabetes receiving insulin injection therapy: A randomised controlled trial with qualitative process evaluation
Liang, W., Chow, K. M., Ni, X., Tola, Y. O., & Lo, S. H. S. (2025) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2025.105200 · Cited by 6 · see citing works
Diabetes status modifies the efficacy of home-based kidney care for Zuni Indians in a randomized controlled trial
Pankratz, V. S., Choi, E. E., Qeadan, F., GHAHATE, D. M., Bobelu, J., Nelson, R. G., Faber, T., & Shah, V. O. (2020) · Journal of Diabetes and its Complications · doi:10.1016/j.jdiacomp.2020.107753 · Cited by 5 · see citing works
“glycemic control measured by reduction of HbA1c level (25).”
Background
The experience of blood glucose monitoring in people with type 2 diabetes mellitus (T2DM)
Stedman, M., Rea, R. D., Duff, C. J., Livingston, M. A., McLoughlin, K., Wong, L., Brown, S., Grady, K., Gadsby, R., Gibson, M., et al. (2021) · Endocrinology Diabetes & Metabolism · doi:10.1002/edm2.302 · Cited by 5 · see citing works
Global, regional and national burden of diabetes mellitus type 2 attributable to low physical activity from 1990 to 2021 and projections to 2050: a finding from the global burden of disease study 2021
Zhang, N., Qu, X., & Kang, L. (2025) · Frontiers in Clinical Diabetes and Healthcare · doi:10.3389/fcdhc.2025.1606330 · Cited by 4 · see citing works
Current Status and Influencing Factors of Self-management Positivity in Patients With Head and Neck Neoplasms
Gao, Z., Li, S., Xu, Y., & Bai, X. (2025) · Cancer Nursing · doi:10.1097/ncc.0000000000001475 · Cited by 4 · see citing works
Type 2 Diabetes Mellitus in Saudi Arabia
Tanveer, M. S., Tanveer, M. S., & Javed, M. (2021) · Journal of Diabetology · doi:10.4103/jod.jod_92_20 · Cited by 4 · see citing works
Association between patient activation, self-management behaviours and clinical outcomes in adults with diabetes or related metabolic disorders: a systematic review and meta-analysis protocol
Mueller, J., Ahern, A. L., Sharp, S. J., Richards, R., Birch, J. M., Davies, A., & Griffin, S. J. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-056293 · Cited by 5 · see citing works
Experiences With a Novel Micro-Choice-Based Concentrated Group Intervention for People With Type 2 Diabetes: A Qualitative Study
Bendixen, B. E., Wilhelmsen‐Langeland, A., Lomborg, K. E., Måkestad, E., Skogheim, T. L., Schønberg, A., Iversen, M. M., Kvale, G., Søfteland, E. W., & Haugstvedt, A. (2025) · The Science of Diabetes Self-Management and Care · doi:10.1177/26350106241304422 · Cited by 4 · see citing works
“9-13 A systematic review and meta-analysis has shown that group-based self-management education for individuals with T2DM is more effective than standardized care for improvements of lifestyle, psychosocial outcomes, and clinical outcomes.”
The effect of educational intervention on medication adherence behavior in patients with type 2 diabetes: application of social marketing model
Najafpour, Z., Zeidi, I. M., & Kalhor, R. (2021) · Clinical Diabetology · doi:10.5603/dk.a2021.0040 · Cited by 4 · see citing works
“Diabetes is a chronic and metabolic disease characterized by elevated blood glucose levels and is recognized as a major public health challenge [2, 3].”
Background
Intervención educativa de autocuidado en la prevención del pie diabético
Mesa, M. P. Q., Padilla, J. D. V., & Ortiz, E. J. R. (2022) · Avances en Enfermería · doi:10.15446/av.enferm.v40n2.101311 · Cited by 4 · see citing works
Applying the Patient Empowerment, Engagement, and Activation Survey to Improve Patient Outcomes
Stichler, J. F., & Pelletier, L. R. (2023) · JONA The Journal of Nursing Administration · doi:10.1097/nna.0000000000001364 · Cited by 4 · see citing works
Factors affecting the health status of patients with type 2 diabetes mellitus receiving insulin treatments: A multi‐mediation path analysis
Lee, K. S., Kim, H. Y., & Jin, H. Y. (2021) · Journal of Clinical Nursing · doi:10.1111/jocn.15985 · Cited by 4 · see citing works
Outreach Method Predicts Patient Re-engagement in Diabetes Care During Sustained Care Disruption
Cromwell, G. E., Hudson, M., Simonson, D. C., & McDonnell, M. E. (2021) · Endocrine Practice · doi:10.1016/j.eprac.2021.09.003 · Cited by 5 · see citing works
Sincere Integration of Patients’ Perspectives into Kidney Care: Affirming and Adopting Patient Activation
Nair, D., & Cavanaugh, K. L. (2021) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.05050421 · Cited by 4 · see citing works
Constructive communication patterns as related to relationship satisfaction, seizure severity, and patient activation among people with epilepsy
Bennett‐Brown, M., Gesselman, A. N., & Miller, W. R. (2022) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2022.108957 · Cited by 3 · see citing works
Effects of Systematic Diet Education Combined with Multidisciplinary Nursing on Nutritional Status and Calcium and Phosphorus Metabolism in Patients with Diabetic Kidney Disease in Uremic Phase after Treatment with Alogliptin
Guo, N., Li, N., Zhao, Y., Sun, H., & Liu, K. (2022) · Journal of Healthcare Engineering · doi:10.1155/2022/1120242 · Cited by 3 · see citing works
Effect of health education on treatment compliance and quality of life of patients with diabetes mellitus
Xu, L., & Chen, Y. (2022) · Minerva Medica · doi:10.23736/s0026-4806.22.08338-0 · Cited by 3 · see citing works
Physical Activity Interventions in People with Diabetes: A Systematic Review of The Qualitative Evidence
Vilafranca-Cartagena, M., Bonet, A., Colillas-Malet, E., Puiggrós-Binefa, A., & Tort‐Nasarre, G. (2024) · Healthcare · doi:10.3390/healthcare12141373 · Cited by 3 · see citing works
“Telephone follow-up and the individualization of programs can increase the effectiveness of interventions, even if they are group-based [39].”
Background
Development, feasibility, and preliminary effects of a culturally adapted, evidence-based, and theory-driven diabetes self-management programme for Chinese adults with type 2 diabetes receiving insulin injection therapy
Liang, W., Chow, K. M., Ni, X., Tola, Y. O., & Lo, S. H. S. (2024) · Primary care diabetes · doi:10.1016/j.pcd.2024.09.010 · Cited by 3 · see citing works
A Compelling Health Promoting Primary Care Clinic Using a Settings-Based Approach: A Demonstration Project
Larson, M. (2024) · American Journal of Lifestyle Medicine · doi:10.1177/15598276241303728 · Cited by 2 · see citing works
Survey of fear and compliance of Insulin Degludec and Insulin Aspart injection in type 2 diabetes mellitus patients and analysis of influencing factors
Xie, M., Chen, S., & He, Q. (2024) · Medicine · doi:10.1097/md.0000000000040286 · Cited by 2 · see citing works
“[10,11] Effective management and treatment of this condition is essential to reduce its burden on the public health system.”
Background
Evaluation of the My Diabetes Care Patient Portal Intervention: Protocol for a Pilot Randomized Controlled Trial
Martínez, W., Hackstadt, A. J., Hickson, G. B., Rosenbloom, S. T., & Elasy, T. A. (2021) · JMIR Research Protocols · doi:10.2196/25955 · Cited by 2 · see citing works
“Patient activation (ie, knowledge, skills, and confidence in managing one’s own health) is vital to achieving optimal diabetes self-management and is associated with lower health care costs [3-5].”
Background
Relationship between Self-management and Quality of Life among Patients with Diabetes Mellitus: A Cross-Sectional, Correlational Study
Al‐Gamal, E., Alnaser, Z., Mohammed, I., Kaliyaperumal, L., Qudah, A. A., Hyarat, S. Y., Alawas, H., Alrashed, J., Alhamad, A., & Long, T. (2024) · The Open Nursing Journal · doi:10.2174/0118744346309631240517111532 · Cited by 2 · see citing works
Culturally Tailored Diabetes Self-Management Educational (DSME) Program and Its Impact on Motivation and Self-efficacy Among Hispanic Adults with T2DM
van Wageningen, A. P. (2022) · doi:10.31979/etd.gs9k-vv22 · Cited by 2 · see citing works
Self-Management Perceptions and Death Concerns of Patients with Diabetes Mellitus
Keskin, A. Y., Tuna, H. İ., & Günhan, E. (2024) · Genel Tıp Dergisi · doi:10.54005/geneltip.1287564 · Cited by 1 · see citing works
Implementation of a pharmacist‐driven continuous glucose monitoring program within an American Indian/Alaska Native community
Udby, D. L., Smith, D. K., Cushman, N. A., Vue, M., Reyes‐Gastelum, D., Klapperich, A., Ohman, T., Hromika, A. J., & Mackler, E. R. (2025) · JACCP JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY · doi:10.1002/jac5.2075 · Cited by 1 · see citing works
“24,25 It is difficult to ascertain from this study if increased confidence was related to the technology (CGM), the pharmacist, or the number of visits for those within the program.”
The development of a CBT-informed approach to supporting type 2 diabetes self-management
Visagie, E., Deacon, E., & Kok, R. (2025) · Frontiers in Clinical Diabetes and Healthcare · doi:10.3389/fcdhc.2025.1421678 · Cited by 1 · see citing works
Health Literacy and Cognitive Disorders in Diabetic Patients
Florek-Łuszczki, M., Lutomski, P., Strzelecka, A., Łuszczki, J. J., & Dziemidok, P. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14092972 · Cited by 1 · see citing works
Patient Activation Impacts Exercise in Older Adults With Kidney Disease
Mirpuri, K. K., Roach, C., Woodall, E. M., Prigmore, H. L., Greevy, R. A., Wilkinson, T. J., Lightfoot, C. J., Bonnet, K. R., Cukor, D., Taylor, W. D., et al. (2025) · Kidney International Reports · doi:10.1016/j.ekir.2025.07.017 · Cited by 1 · see citing works
“28,29 The few studies of patient activation kidney disease populations exclude older adults but demonstrate associations between patient activation and health literacy, 30 diabetes self-care, 31 decisional conflict, 32 quality of life, 33 and more recently, health care utilization.”
Profiles of patient activation and osteoarthritis index among older patients with knee osteoarthritis: A cross-sectional study based on latent profile analysis
Wang, Q., Shi, X., Zhang, M., Chen, Y., Wang, L., Fan, R., & Lin, Y. (2025) · Geriatric Nursing · doi:10.1016/j.gerinurse.2025.103540 · Cited by 1 · see citing works
Evaluating a Digital Chronic Condition Prevention Intervention (THRIVE) in Australian General Practice: Protocol for a Mixed Methods Feasibility Study (ePREVENT-360)
Singleton, G., Halcomb, E., Bonney, A. D., & Hosseinzadeh, H. (2025) · JMIR Research Protocols · doi:10.2196/83105 · Cited by 1 · see citing works
“Despite its potential, the role of activation in the primary prevention of chronic conditions remains underexplored [21,22,25,29].”
Self-citation
Relationship between patient activation, experienced stigma, and internalised weight stigma in people with type 2 diabetes
Sims, T. J., Kapoor, R., Chinthammit, C., & Spaepen, E. (2025) · Diabetic Medicine · doi:10.1111/dme.70190 · Cited by 1 · see citing works
Patient Activation and Diabetes Outcomes Among Jordanian Patients With Type 2 Diabetes: Longitudinal Evidence on Adherence and Glycemic Control With Linear Mixed Model Analysis
Alosta, M. R., Atiyeh, H., Hani, S. B., Hamdan‐Mansour, A. M., Al‐yyan, A. A., Afaneh, T., Sarhan, R., Al‐Momani, M., & Othman, E. H. (2026) · Research in Nursing & Health · doi:10.1002/nur.70080 · Cited by 1 · see citing works
Exploring Self-Care Interventions to Improve Glycemic Control in Type 2 Diabetes Mellitus: A Scoping Review
Haeruddin, H., Amiruddin, R., Yusuf, S., Naiem, M. F., Sidin, A. I., Wahiduddin, W., Wahyu, A., Kada, M. K. R., Ma'ge, A., & Harbaeni, H. (2026) · F1000Research · doi:10.12688/f1000research.177355.2 · Cited by 1 · see citing works

Patient activation and Type 2 diabetes mellitus self-management: a systematic review and meta-analysis
Hosseinzadeh, H., Verma, I., & Gopaldasani, V. (2020) · Australian Journal of Primary Health · doi:10.1071/py19204 · Cited by 44 · see citing works
Self-citation
Relationship Between Patient Activation and Type 2 Diabetes Mellitus Self-management and Clinical Outcomes in Saudi Arabian Primary Care Setting
Almutairi, N., Gopaldasani, V., & Hosseinzadeh, H. (2023) · American Journal of Health Promotion · doi:10.1177/08901171231224889 · Cited by 14 · see citing works
Self-citation
Promoting glycemic control through diabetes self-management: evaluating a patient activation intervention
Williams, G. C., McGregor, H. A., Zeldman, A., Freedman, Z. R., Deci, E. L., & Elder, D. (2004) · Patient Education and Counseling · doi:10.1016/j.pec.2003.11.008 · Cited by 114 · see citing works
The Effect of a Patient Activation Tailored Intervention on Type 2 Diabetes Self-Management and Clinical Outcomes: A Study from Saudi Arabian Primary Care Settings
Almutairi, N., Gopaldasani, V., & Hosseinzadeh, H. (2023) · Journal of Diabetes Research · doi:10.1155/2023/2074560 · Cited by 17 · see citing works
Self-citation
The Associations of Patient Activation and Self-Management with Diabetes Clinical Control in Diverse Primary Care Patients
Bravin, J. I. (2021) · eScholarship (California Digital Library)

Authors: Almutairi, N., Hosseinzadeh, H., & Gopaldasani, V.
Affiliations: University of Wollongong (AU)
Corresponding author: Hosseinzadeh, Hassan
ORCID: Almutairi, Nasser
Hosseinzadeh, Hassan
Gopaldasani, Vinod
Venue: Primary Care Diabetes
Publisher: Elsevier BV
Published: 2020-02
Volume: 14
Issue: 1
Pages: 12-20
ISSN: 1751-9918 (ISSN-L)
DOI: 10.1016/j.pcd.2019.08.009
OpenAlex: W2974640377
Cited by: 144
References: 50
Citations by year: 2026: 17 · 2025: 22 · 2024: 23 · 2023: 28 · 2022: 23 · 2021: 20 · 2020: 10 · 2019: 1
FWCI: 2.08
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Primary care diabetes (publishedVersion)
PubMed (publishedVersion)
Research Online (University of Wollongong) (submittedVersion)
Funders: ministry of health
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Keywords: patient activation, type 2 diabetes, glycemic control, HbA1c, self-management behavior, physical activity, healthy eating, foot care, self-monitoring of blood glucose, medication adherence, culturally tailored interventions, telephone follow-up
MeSH terms: Healthy Lifestyle, Diet, Healthy, Glycemic Control, Blood Glucose, Diabetes Mellitus, Type 2, Female, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Patient Education as Topic, Patient Participation, Self Care, Biomarkers, Exercise, Randomized Controlled Trials as Topic, Treatment Outcome, Risk Reduction Behavior, Medication Adherence

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

The effectiveness of patient activation intervention on type 2 diabetes mellitus glycemic control and self-management behaviors: A systematic review of RCTs

Abstract

Integrity signals

Claims the paper makes

Claims other papers make about this one

Cites

Cited by

Related

Record

About these checks