The effectiveness of a self-efficacy-focused structured education programme on adults with type 2 diabetes: A multicentre randomised controlled trial

Aims and objectives To evaluate the effectiveness of a self-efficacy-focused structured education programme on outcomes in adults with type 2 diabetes (T2DM) without insulin therapy. Background Structured education regarding metabolic control in T2DM adults without insulin therapy has not always been effective, and this lack of effectiveness might be due to overlooking self-efficacy. Whether a self-efficacy-focused structured education programme could improve metabolic and psychosocial outcomes for T2DM adults more effectively remains unknown. Design A multicentre parallel randomised controlled concealed label trial. Methods The study conducted in outpatients of four hospitals in China. A total of 265 T2DM adults without insulin therapy were randomly assigned to an intervention group of a self-efficacy-focused structured education programme (n = 133), or to a control group of routine education (n = 132). The differences in metabolic and psychosocial outcomes were investigated at baseline, three- and 6-month follow-ups. Results The primary outcome of A1C and the secondary outcomes of weight, body mass index, waist circumference, diastolic pressure, self-efficacy, self-management behaviours and knowledge improved significantly in the intervention group compared with the control group at 6-month follow-up. The differences in A1C between groups for patients with a low educational background at 6-month follow-up were significant. No significant differences were found in other secondary outcomes of systolic pressure, the blood lipid profile and diabetes distress between groups at 6-month follow-up. Conclusions This programme can improve glycaemic control, weight control, diastolic pressure, self-efficacy, self-management behaviours and diabetes knowledge for T2DM adults. Relevance to clinical practice This self-efficacy-focused structured education programme is effective and can be incorporated into regular clinical care and led by trained staff (e.g. nurses), and it can be implemented in patients with low educational backgrounds.