Table 1 Educational content based on constructs of SCT
Constructs | Education details |
|---|---|
Knowledge | The interactive lecture techniques used included presentations, video clips, booklets, and a replica of the gastrointestinal tract to improve knowledge of diabetes |
Self-efficacy | Four methods recommended by Bandura [19] were used to improve patients’ self-efficacy for doing self-management behaviors. For example, to promote physical activity, simple and short activities, such as walking, were started [mastery experiences], and physically active people were used as role models [observational learning]. Besides, relaxation exercises, such as yoga, were used to improve the participants’ emotional states. The exercise instructor and one of the researchers attended the training sessions [verbal persuasion and reducing stress [19, 22] |
Goal setting and self-monitoring | The participants were asked to evaluate their performance concerning each self-management component individually and then in small groups to improve their self-regulatory skills [self-monitoring]. Appropriate goals and step-by-step plans were set to improve their performance through partnerships with group members [goal-setting]; they monitored their performance and gave feedback to themselves and each other. The feedback was also given through face-to-face conversations and telephone or WhatsApp calls. In addition, the patients’ progress was rewarded [self-reward]. The participants were advised to refer to the introduced booklets and resources [self-instruction] to promote their learning [20] |
Outcome expectations | The benefits and barriers of self-care behaviors were identified using small group techniques such as snowballs and buzzing [33]. Discussion and question–answer methods were used to improve outcome expectations. Additionally, evidence supporting the positive outcomes of self-management behaviors was presented through mini-lectures. Moreover, the individuals who successfully controlled their type 2 diabetes were asked to share their experiences with group members |
Environmental factors | During the project, efforts were made to provide social support from multiple sources, including family, health care providers, and peers [19]. During home visits, family members were briefly trained and encouraged to support their patients as needed. A nutritionist provided nutrition counseling in some training sessions. In addition, a member of the research team [second author] and a trained health worker accompanied the patients during the exercise sessions and were on-call to respond to patients by phone and WhatsApp |