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Beyond good intentions: The role of proactive coping in achieving sustained behavioural change in the context of diabetes management
Open accessAbstract
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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“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]
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Metadata
- 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
- 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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