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Cited by 45Diabetes Management and EducationHealth Education and ValidationHealth Policy Implementation Science

Complex intervention development for diabetes self‐management

Sturt, Jackie, Whitlock, Sandra, Hearnshaw, Hilary·2006·Journal of Advanced Nursing
DOI 10.1111/j.1365-2648.2006.03819.x
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Abstract

Aim. The aim of this paper is to present the development and evaluation of the Self‐Efficacy Goal Achievement nursing intervention for type 2 diabetes. Background. Systematic reviews support the clinical effectiveness of diabetes self‐management programmes that are collaborative, involve biomedical feedback and are goal focussed. Method. The self‐efficacy goal achievement intervention comprises patient goal‐setting consultations with practice nurses using the Diabetes Management Self‐Efficacy Scale. The United Kingdom Medical Research Council framework for the evaluation of complex interventions by randomized controlled trial was used to develop and evaluate the intervention. The ‘preclinical’ study included literature analysis and findings from parallel studies. The ‘phase I’ study, carried out in spring 2003, was a small trial of the intervention, evaluation of its feasibility, identification of appropriate outcome measures for future trials and improvement of the components, with two nurses and eight patients. Findings. The ‘preclinical’ study supported continued intervention development. The ‘phase I’ intervention resulted in a mean reduction in participants’ glycosylated haemoglobin of 0·93% between baseline and 3‐months postintervention. It showed an increase in patient self‐efficacy and some decline in patient diabetes treatment satisfaction. Qualitative data recorded therapeutically desirable behavioural changes in all participants. Follow‐up consultations and goal evaluation were found to be important to patients. Nurses reported (i) reservations about the repeated use of components of the intervention, which were felt to be repetitive and restrictive; and (ii) the time commitment required to deliver the educational sessions. Conclusions. Most phase I components were effective in delivering a feasible nursing intervention. The intervention has been adjusted to remove the less effective components and enhance the more effective. The outcome measures were appropriate for the intervention. A phase II trial is being developed to further test both the intervention and research protocol for comparing the intervention to an alternative.

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  • Six included studies evaluated more than one element; they explored the acceptability to different stakeholders together with either the intervention's effectiveness or cost-effectiveness.

    “Six studies evaluated more than one element; in particular, they explored the acceptability to different stakeholders together with either the intervention’s effectiveness [25, 26, 28, 35, 38] or cost-effectiveness [33].”

    From Optimisation of complex health interventions prior to a randomised controlled trial: a scoping review of strategies used (2016) · cites this paper as [38]

  • A number of included studies adopted quantitative methods such as fractional factorial experiments, economic modelling, small uncontrolled pilot studies (with no control group), experimental 2×2 randomised controlled trials, probability models and evaluation questionnaires.

    “A number of studies adopted quantitative methods such as fractional factorial experiments [10, 44], economic modelling [33], small uncontrolled pilot studies (with no control group) [25, 29, 38], experimental 2 × 2 randomised controlled trials [45, 46], probability models [49, 50] and evaluation questionnaires [43].”

    From Optimisation of complex health interventions prior to a randomised controlled trial: a scoping review of strategies used (2016) · cites this paper as [38]

  • Factorial experiments, uncontrolled pilot studies and probability models tended to be used to test specific components and to identify an intervention's potential effect.

    “For example, factorial experiments, uncontrolled pilot studies and probability models tended to be used to test specific components and to identify an intervention’s potential effect [10, 25, 29, 38, 44, 49, 50].”

    From Optimisation of complex health interventions prior to a randomised controlled trial: a scoping review of strategies used (2016) · cites this paper as [38]

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Authors
Sturt, J., Whitlock, S., & Hearnshaw, H.
Affiliations
University of Warwick (GB)
ORCID
Sturt, Jackie
Venue
Journal of Advanced Nursing
Publisher
Wiley
Published
2006-04-21
Volume
54
Issue
3
Pages
293-303
ISSN
  • 0309-2402 (ISSN-L)
  • 1365-2648
DOI
10.1111/j.1365-2648.2006.03819.x
OpenAlex
W2041352919
Cited by
45
References
38
Citations by year
2021: 7 · 2019: 4 · 2017: 1 · 2016: 2 · 2015: 2 · 2014: 5 · 2013: 5 · 2012: 3
FWCI
2.26
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Journal of Advanced Nursing (publishedVersion)
  • PubMed (publishedVersion)
  • Research Portal (King's College London) (submittedVersion)
Funders
  • University of Warwick
  • Nederlandse Organisatie voor Wetenschappelijk Onderzoek
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
  • Social Sciences › Education › Health Education and Validation
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Keywords
type 2 diabetes, diabetes self-management, complex intervention development, self-efficacy, goal setting, nursing interventions, practice nurses, glycosylated haemoglobin, treatment satisfaction, intervention feasibility, patient behavior change
MeSH terms
Aged, Attitude to Health, Diabetes Mellitus, Type 2, Goals, Glycated Hemoglobin, Humans, Self Care, Randomized Controlled Trials as Topic, Patient Satisfaction, Self Efficacy

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