Beyond good intentions: The role of proactive coping in achieving sustained behavioural change in the context of diabetes management

Thoolen, Bart Johan; Ridder, Denise de; Bensing, Jozien; Gorter, Kees; Rutten, Guy

doi:10.1080/08870440701864504

Cited by 127Diabetes Management and EducationBehavioral Health and InterventionsHealth and Wellbeing Research

Beyond good intentions: The role of proactive coping in achieving sustained behavioural change in the context of diabetes management

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Thoolen, Bart Johan, Ridder, Denise de, Bensing, Jozien, Gorter, Kees, Rutten, Guy·2009·Psychology & Health

DOI 10.1080/08870440701864504

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Abstract

This study examines the effectiveness of a brief self-management intervention to support patients recently diagnosed with type-2 diabetes to achieve sustained improvements in their self-care behaviours. Based on proactive coping, the intervention emphasizes the crucial role of anticipation and planning in maintaining self-care behaviours. In a randomised controlled trial among recent screen-detected patients, participants who received the intervention were compared with usual-care controls, examining changes in proximal outcomes (intentions, self-efficacy and proactive coping), self-care behaviour (diet, physical activity and medication) and weight over time (0, 3 and 12 months). Subsequently, the contribution of proactive coping in predicting maintenance of behavioural change was analysed using stepwise hierarchical regression analyses, controlling for baseline self-care behaviour, patient characteristics, and intentions and self-efficacy as measured after the course. The intervention was effective in improving proximal outcomes and behaviour with regard to diet and physical activity, resulting in significant weight loss at 12 months. Furthermore, proactive coping was a better predictor of long-term self-management than either intentions or self-efficacy. Proactive coping thus offers new insights into behavioural maintenance theory and can be used to develop effective self-management interventions.

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Daily self-management imposes a significant burden on patients with T2DM, often leading to increased emotional distress and feelings of being overwhelmed.
“However, the demanding character of daily self-management imposes a significant burden on patients with T2DM. Adopting new healthier habits, along with the need for constant blood glucose monitoring and medication adherence, often leads to increased emotional distress and feelings of being overwhelmed [6,11-13].”
From Evaluation of the Impact of Mobile Health App Vitadio in Patients With Type 2 Diabetes: Randomized Controlled Trial (2025) · cites this paper as [13]
The Introduction (p. 2) describes daily self-management in type-2 diabetes as a difficult, potentially daunting task that can affect family, work and social life. The Notes (p. 10) report distress in some patient groups, but do not establish that adopting healthier habits, monitoring glucose and taking medication often lead to increased emotional distress or feelings of being overwhelmed. (LLM, conf=0.86)
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The effectiveness of a proactive coping intervention targeting self-management in diabetes patients
Kroese, F. M., Adriaanse, M. A., Vinkers, C. D. W., van de Schoot, R., & de Ridder, D. T. D. (2013) · Psychology and Health · doi:10.1080/08870446.2013.841911 · Cited by 32 · see citing works
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Beyond Good Intentions: The effectiveness of a proactive self-management intervention in patients with screen-detected type 2 diabetes
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Beyond Good Intentions: the development and evaluation of a proactive self-management course for patients recently diagnosed with Type 2 diabetes
Thoolen, B., de Ridder, D. T. D., Bensing, J. M., Gorter, K. J., & Rutten, G. E. H. M. (2007) · Health Education Research · doi:10.1093/her/cyl160 · Cited by 82 · see citing works
Self-citation
Beyond good intentions: the development and evaluation of a proactive self-management course for patients recently diagnosed with type 2 diabetes. Health Educ Res. Epub ahead of print February 7,2007
Thoolen, B., de Ridder, D. T. D., Bensing, J. M., Gorter, K. J., & Rutten, G. E. H. M. (2015)
Self-citation
Efficacy of a self-management intervention for weight control in overweight and obese adults: a randomized controlled trial
Vinkers, C. D. W., Adriaanse, M. A., Kroese, F. M., & de Ridder, D. T. D. (2013) · Journal of Behavioral Medicine · doi:10.1007/s10865-013-9530-9 · Cited by 18 · see citing works
Self-citation

Authors: Thoolen, B. J., Ridder, D. D., Bensing, J., Gorter, K., & Rutten, G.
Affiliations: Utrecht University (NL)
Netherlands Institute for Health Services Research (NL)
Corresponding author: Thoolen, Bart Johan
ORCID: Rutten, Guy
Venue: Psychology & Health
Publisher: Informa UK Limited
Published: 2009-03
Volume: 24
Issue: 3
Pages: 237-254
ISSN: 0887-0446 (ISSN-L)
1476-8321
DOI: 10.1080/08870440701864504
OpenAlex: W1973255064
Cited by: 127
References: 45
Citations by year: 2026: 3 · 2025: 4 · 2024: 5 · 2023: 2 · 2022: 7 · 2021: 6 · 2020: 4 · 2019: 4 · 2018: 6 · 2017: 7 · 2016: 11 · 2015: 12 · 2014: 13 · 2013: 22 · 2012: 14
FWCI: 1.69
Type: journal article
Language: en
Open access: green
www.nivel.nl
Licence: other-oa
Locations: Psychology and Health (publishedVersion)
PubMed (publishedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
Health Sciences › Health Professions › General Health Professions › Health and Wellbeing Research
Keywords: proactive coping, type 2 diabetes, diabetes self-management, self-care behavior, self-efficacy, behavioral intention, screen-detected diabetes, diet, physical activity, medication adherence, weight loss, anticipatory planning
MeSH terms: Adaptation, Psychological, Aged, Behavioral Medicine, Diabetes Mellitus, Type 2, Female, Humans, Male, Middle Aged, Netherlands, Prospective Studies, Surveys and Questionnaires, Self Care, Intention, Risk Reduction Behavior

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Beyond good intentions: The role of proactive coping in achieving sustained behavioural change in the context of diabetes management

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