Effectiveness of the Mindfulness-Based Diabetes Self-and Family Management Support Program among Adults with Uncontrolled Diabetes: A Randomized Controlled Trial

Adults with type 2 diabetes need to master illness self-management to meaningfully sustain behavior change and mindfulness practice may facilitate this process. This study investigated the effectiveness of the Mindfulness-Based Diabetes Self-and Family Management Support Program to improve glycated hemoglobin among Thai adults with uncontrolled diabetes. This program was developed from a literature review, and in-depth interviews with 15 participants who had poorly controlled diabetes and their family members. The Information-Motivation-Behavioral Skills Model and mindfulness approach was used as a framework to develop study intervention. We conducted a randomized controlled trial from September 2018 to March 2019. Eighty adults with uncontrolled type 2 diabetes were randomized to 12 weeks of either the control group who received only usual care (n = 40) or the experimental group (n = 40) who received an intervention in addition to usual care. Glycated hemoglobin, fasting blood glucose, mindful-eating, self-efficacy, dietary consumption, physical activity, and medication adherence were assessed at baseline, week 12 and week 16. Data were analyzed using descriptive statistics, ANCOVA, Repeated Measures ANOVA, and Independent t-test. The findings showed that participants receiving the intervention improved more between baseline and both weeks 12 and 16 in fasting blood glucose and HbA_1c, appropriate dietary consumption, amount of physical activity, medication adherence, mindful eating, and self-efficacy than those in the control group. Nurses can be trained to implement this intervention program in adults with uncontrolled diabetes. However, more studies with a larger number of community participants are recommended with the application of advanced technology such as mobile health.