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Cited by 10Diabetes Management and EducationHealth, psychology, and well-beingBehavioral Health and Interventions

Development of a salutogenic intervention for healthy eating among Dutch type 2 diabetes mellitus patients

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Polhuis, Kristel C M M, Vaandrager, Lenneke, Soedamah-Muthu, Sabita S, Koelen, Maria A·2021·Health Promotion International
DOI 10.1093/heapro/daab020PMC PMC8827024
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Abstract

Lay Summary: Healthy eating can be challenging for type 2 diabetes mellitus (T2DM) patients. The theory of salutogenesis, which focuses on the resources required to organize behavioural changes in everyday life, was used to develop an intervention for healthy eating. The aim was to describe the development, structure and content of this salutogenic intervention. The development consisted of two phases that were based on the operationalization of important key principles of salutogenesis. In Phase 1 (Exploration and synthesis), a systematic review and three qualitative studies were performed to explore important characteristics to enable healthy eating in everyday life. The results were used to develop the draft intervention. In Phase 2 (Validation and adjustment), interviews and workshops were conducted with T2DM patients, healthcare providers and scientists. Based on this, the draft intervention was modified into its final form. The developmental process resulted in a 12-week, group-based intervention that aimed to enable important resources for healthy eating via self-examination, reflection, setting goals and sharing experiences. Attention was also paid to disease information, disease acceptance, food literacy, stress management, self-identity and social support. The group sessions began following an individual intake session, with a booster session held 3 months after the intervention. The researcher’s translation of the stakeholders’ priorities into an intervention was corrected for and approved by the stakeholders concerned. This comprehensive salutogenic intervention was developed based on practical and scientific evidence. Providing transparency in developmental processes and content is important because it determines the scientific integrity and credibility of an intervention.

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  • Family involvement contributes to adherence and self-management of type 2 diabetes mellitus, especially outside supervised settings.

    “Mendes et al. 20 and Polhuis et al. 8 also addressed family participation, showing that family involvement contributes to adherence and self-management of type 2 diabetes mellitus, especially outside supervised settings.”

    From Healthy eating among people with type 2 diabetes in the Brazilian Amazon: a qualitative study in primary health care (2026) · cites this paper as [8]

    The Discussion links social support to adherence to self-management, and the Results (Phase 2: validation and adjustment) describe plans to invite partners to intervention sessions. The paper does not show that family involvement improves adherence or self-management, nor does it establish a particular benefit outside supervised settings; it describes an intervention being developed, not an observed effect. (LLM, conf=0.86)

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Research works printed but not linked: 41

  1. Antonovsky A. (1979) Health, Stress, and Coping, 4th edition. Jossey-Bass Publishers, San Fransisco.
  2. Bisogni C. A., Jastran M., Seligson M., Thompson A. (2012) How people interpret healthy eating: contributions of qualitative research. Journal of Nutrition Education and Behavior, 44, 282– 301. 22732708
  3. Boutron I., Moher D., Altman D. G., Schulz K. F., Ravaud P; for the CONSORT Group (2008) Extending the CONSORT statement to randomized trials of nonpharmacologic treatment: explanation and elaboration. Annals of Internal Medicine, 148, 295– 309. 18283207
  4. Calder P. C., Feskens E. J. M., Kraneveld A. D., Plat J., Van ’T Veer P., De Vries J. (2020) Towards “improved Standards in the Science of Nutrition” through the Establishment of Federation of European Nutrition Societies Working Groups. Annals of Nutrition and Metabolism, 76, 2– 5. 32074598
  5. Caro-Bautista J., Kaknani-Uttumchandani S., García-Mayor S., Villa-Estrada F., Morilla-Herrera J. C., León-Campos A. et al (2020) Impact of self-care programmes in type 2 diabetes mellitus population in primary health care: systematic review and meta-analysis. Journal of Clinical Nursing, 29, 1– 20. 31944439
  6. Coster S., Norman I. (2009) Cochrane reviews of educational and self-management interventions to guide nursing practice: a review. International Journal of Nursing Studies, 46, 508– 528. 19012889
  7. Evert A. B., Boucher J. L., Cypress M., Dunbar S. A., Franz M. J., Mayer-Davis E. J. et al (2014) Nutrition therapy recommendations for the management of adults with diabetes. Diabetes Care, 37, S120– S143. 24357208
  8. Franz M. J., Boucher J. L., Rutten-Ramos S., Vanwormer J. J. (2015) Lifestyle weight-loss intervention outcomes in overweight and obese adults with type 2 diabetes: a systematic review and meta-analysis of randomized clinical trials. Journal of the Academy of Nutrition and Dietetics, 115, 1447– 1463. 25935570
  9. Franz M. J., Vanwormer J. J., Crain L., Boucher A., Histon J. L., Caplan T. et al (2007) Weight-loss outcomes: a systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up. Journal of the American Dietetic Association, 107, 1755– 1767. 17904936
  10. Ganiyu A. B., Mabuza L. H., Malete N. H., Govender I., Ogunbanjo G. A. (2013) Non-adherence to diet and exercise recommendations amongst patients with type 2 diabetes mellitus attending extension II clinic in Botswana. African Journal of Primary Health Care and Family Medicine, 5, 2– 7.
  11. Green L. W., Glasgow R. E., Atkins D., Stange K. (2009) Making evidence from research more relevant, useful, and actionable in policy, program planning, and practice slips “Twixt Cup and Lip”. American Journal of Preventive Medicine, 37, S187– S191. 19896017
  12. Gregg E., Chen H., Wagenknecht L., Clark J., Delahanty L., Bantle J. et al (2012) Association of an intensive lifestyle intervention with remission of type 2 diabetes. JAMA, 308, 2489– 2496. 23288372 PMC4771522
  13. Hart A. (2003) What is the research question? A case study in the early stages of design of a randomised controlled trial for a complementary therapy. Complementary Therapies in Medicine, 11, 42– 45. 12667975
  14. Hartmann-Boyce J., Nourse R., Boylan A.-M., Jebb S., Aveyard P. (2018) Experiences of reframing during self-directed weight loss and weight loss maintenance: systematic review of qualitative studies. Applied Psychology: Health and Well-Being, 10, 309– 329. 29856139 PMC6055795
  15. Higgs S. (2015) Social norms and their influence on eating behaviours. Appetite, 86, 38– 44. 25451578
  16. Kelly S., Martin S., Kuhn I., Cowan A., Brayne C., Lafortune L. (2016) Barriers and facilitators to the uptake and maintenance of healthy behaviours by people at mid-life: a rapid systematic review. PLoS One, 11, e0145074. 26815199 PMC4731386
  17. Lawton J., Ahmad N., Peel E., Hallowell N. (2007) Contextualising accounts of illness: notions of responsibility and blame in white and South Asian respondents’ accounts of diabetes causation. Sociology of Health & Illness, 29, 891– 906. 17986021
  18. Lundkvist P., Fjellström C., Sidenvall B., Lumbers M., Raats M. (2010) Management of healthy eating in everyday life among senior Europeans. Appetite, 55, 616– 622. 20869999
  19. McClain A. D., Chappuis C., Nguyen-Rodriguez S. T., Yaroch A. L., Spruijt-Metz D. (2009) Psychosocial correlates of eating behavior in children and adolescents: a review. International Journal of Behavioral Nutrition and Physical Activity, 6, 54– 20. PMC3224918 19674467
  20. Minary L., Trompette J., Kivits J., Cambon L., Tarquinio C., Alla F. (2019) Which design to evaluate complex interventions? Toward a methodological framework through a systematic review. BMC Medical Research Methodology, 19, 9. 31064323 PMC6505260
  21. Mittelmark M. B., Kickbusch I., Rootman I., Scriven A., Tones K. (2017) Health promotion. In Stella R. Q. (Ed.), International Encyclopedia of Public Health, 2nd edition, Vol. 3. Elsevier, Oxford, UK, pp. 450– 462.
  22. Mohammed M. A., Sharew N. T. (2019) Adherence to dietary recommendation and associated factors among diabetic patients in Ethiopian teaching hospitals. Pan African Medical Journal, 33, 1– 11. PMC6814932 31692826
  23. Moher D., Hopewell S., Schulz K. F., Montori V., Gøtzsche P. C., Devereaux P. J. (2010) CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. British Medical Journal, 340, 1– 28. PMC2844943 20332511
  24. Neuenschwander M., Hoffmann G., Schwingshackl L., Schlesinger S. (2019) Impact of different dietary approaches on blood lipid control in patients with type 2 diabetes mellitus: a systematic review and network meta-analysis. European Journal of Epidemiology, 34, 837– 852. 31201670
  25. Norris S., Zhang X., Avenell A., Gregg E., Brown T. J., Schmid C. H. et al (2005) Long-term non-pharmacologic weight loss interventions for adults with type 2 diabetes (review). Cochrane Database of Systematic Reviews, 2, 1– 67. PMC8407357 15846698
  26. Pan B., Wu Y., Yang Q., Ge L., Gao C., Xun Y. et al (2019) The impact of major dietary patterns on glycemic control, cardiovascular risk factors, and weight loss in patients with type 2 diabetes: a network meta-analysis. Journal of Evidence-Based Medicine, 12, 29– 39. 30070019
  27. Polhuis C. M. M., Bouwman L. I., Vaandrager L., Soedamah-Muthu S. S., Koelen M. A. (2020a) Systematic review of salutogenic-oriented lifestyle randomised controlled trials for adults with type 2 diabetes mellitus. Patient Education and Counseling, 103, 764– 776. 31711677
  28. Polhuis C. M. M., Vaandrager L., Soedamah-Muthu S. S., Koelen M. A. (2020b) Salutogenic model of health to identify turning points and coping styles for eating practices in type 2 diabetes mellitus. International Journal for Equity in Health, 19, 20. 32487086 PMC7266427
  29. Prestwich A., Kellar I., Parker R., MacRae S., Learmonth M., Sykes B. et al (2014) How can self-efficacy be increased? Meta-analysis of dietary interventions. Health Psychology Review, 8, 270– 285. 25053214
  30. Schwingshackl L., Chaimani A., Hoffmann G., Schwedhelm C., Boeing H. (2018) A network meta-analysis on the comparative efficacy of different dietary approaches on glycaemic control in patients with type 2 diabetes mellitus. European Journal of Epidemiology, 33, 157– 170. 29302846 PMC5871653
  31. Seib C., Parkinson J., McDonald N., Fujihira H., Zietek S., Anderson D. (2018) Lifestyle interventions for improving health and health behaviours in women with type 2 diabetes: a systematic review of the literature 2011–2017. Maturitas, 111, 1– 14. 29673826
  32. Shao Y., Liang L., Shi L., Wan C., Yu S. (2017) The effect of social support on glycemic control in patients with type 2 diabetes mellitus: the mediating roles of self-efficacy and adherence. Journal of Diabetes Research, 2017, 1– 8. PMC5463190 28626769
  33. Song Y., Nam S., Park S., Shin I. S., Ku B. J. (2017) The impact of social support on self-care of patients with diabetes: what is the effect of diabetes type? Systematic review and meta-analysis. The Diabetes Educator, 43, 396– 412. 28578632
  34. Stopford R., Winkley K., Ismail K. (2013) Social support and glycemic control in type 2 diabetes: A systematic review of observational studies. Patient Education and Counseling, 93, 549– 558. 24021417
  35. Strachan S. M., Brawley L. R. (2009) Healthy-eater identity and self-efficacy predict healthy eating behavior: a prospective view. Journal of Health Psychology, 14, 684– 695. 19515684
  36. Strychar I., Elisha B., Schmitz N. (2012) Type 2 diabetes self-management: role of diet self-efficacy. Canadian Journal of Diabetes, 36, 337– 344.
  37. Super S., Wagemakers M. A. E., Picavet H. S. J., Verkooijen K. T., Koelen M. A. (2016) Strengthening sense of coherence: opportunities for theory building in health promotion. Health Promotion International, 31, 869– 878. 26208654
  38. Swan E., Bouwman L., Hiddink G. J., Aarts N., Koelen M. (2015) Applying the salutogenic framework to nutrition research and practice. American Journal of Health Promotion, 30, 71– 73. 26517585
  39. Turk M. W., Yang K., Hravnak M., Sereika S. M., Ewing L. J., Burke L. E. (2009) Randomized clinical trials of weight loss maintenance. Journal of Cardiovascular Nursing, 24, 58– 80. PMC2676575 19114803
  40. Van Hoek E., Bouwman L. I., Koelen M. A., Lutt M. A. J., Feskens E. J. M., Janse A. J. (2017) Development of a Dutch intervention for obese young children. Health Promotion International, 32, 624– 635. 26755807
  41. Van Woerkum C., Bouwman L. (2014) “Getting things done”: an everyday-life perspective towards bridging the gap between intentions and practices in health-related behavior. Health Promotion International, 29, 278– 286. 23135834

Cited by

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Authors
Polhuis, K. C. M. M., Vaandrager, L., Soedamah-Muthu, S. S., & Koelen, M. A.
Affiliations
  • Wageningen University & Research (NL)
  • Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic disorders (CORPS), Tilburg University, Warandelaan 2, 5037 AB, Tilburg, The Netherlands
Corresponding author
Polhuis, Kristel C M M
ORCID
Venue
Health Promotion International
Publisher
Oxford University Press (OUP)
Published
2021-03-01
Volume
36
Issue
6
Pages
1694-1704
ISSN
  • 0957-4824 (ISSN-L)
  • 1460-2245
DOI
10.1093/heapro/daab020
PMC
PMC8827024
OpenAlex
W3133549039
Cited by
10
References
5
Citations by year
2026: 2 · 2025: 2 · 2023: 6
FWCI
0.23
Type
journal article
Language
en
Open access
Licence
Locations
  • Health Promotion International (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • Research portal (Tilburg University) (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Socio-Environmental Systems Modeling (acceptedVersion, cc-by-nc)
  • Data Archiving and Networked Services (DANS) (submittedVersion, cc-by-nc)
Funders
Edema-Steernberg Foundation (Wageningen, The Netherlands
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
  • Health Sciences › Health Professions › General Health Professions › Health, psychology, and well-being
  • Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
Keywords
salutogenesis, type 2 diabetes, healthy eating, intervention development, group intervention, self-examination, goal setting, food literacy, stress management, acceptance of illness, social support, self-identity, stakeholder engagement, booster sessions
MeSH terms
Diet, Healthy, Diabetes Mellitus, Type 2, Ethnicity, Humans, Social Support, Sense of Coherence

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