Feasibility of the Diabetes Self-Management Coaching Program Among Individuals with Uncontrolled Type 2 Diabetes in Primary Care in Ethiopia: A Concurrent Mixed-Method Feasibility Randomized Controlled Trial
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Authors
Yehualashet, Fikadu
Date
2025-07-22
Type
thesis
Language
eng
Keyword
Diabetes Mellitus , Self-management , Coaching , Feasibility RCT , Primary care , Ethiopia , Rehabilitation Science
Alternative Title
Abstract
Background. Diabetes mellitus is a global public health problem affecting over half a billion people. Over 80% of individuals with diabetes live in low- and middle-income countries where the health system is not well-positioned to mitigate the impact of diabetes. Diabetes self-management is a cornerstone in supporting individuals to acquire the necessary knowledge, skills, and experience of self-management. Health coaching is a client-centered collaborative self-management support to enhance the development of autonomy, competence, self-efficacy, and positive relationships. Health coaching has shown a promising effect in changing the clinical and behavioral outcomes of individuals with diabetes.
Methods. This dissertation employed a concurrent mixed-method feasibility randomized controlled trial to examine the feasibility and acceptability of the Diabetes Self-Management Coaching program in primary care and evaluate the potential effectiveness of the program on glycosylated hemoglobin, diabetes self-efficacy, diabetes self-care activity, and health-related quality of life among individuals with uncontrolled diabetes in Ethiopia.
Results. The study found remarkable recruitment, adherence, retention, and acceptability rates despite a low eligibility rate. The findings revealed that the 12-week self-management coaching program was feasible in primary care settings and acceptable by individuals with type 2 diabetes. The preliminary effectiveness findings of the Diabetes Self-Management Coaching program indicates a potentially meaningful clinical benefit, particularly in glycemic control. In addition, favorable differences in diabetes self-efficacy and diabetes self-care activities were observed at follow-up, suggesting that the coaching program may strengthen participants’ confidence and engagement in diabetes self-management behaviors. However, the absence of notable changes in body mass index, blood pressure, and health-related quality of life points to areas where the intervention may need revisions in duration or intervention delivery.
Conclusion. The 12-week Diabetes Self-Management Coaching program was feasible in primary care in Ethiopia, acceptable by individuals with type 2 diabetes, and showed a promising improvement in the clinical and behavioral outcomes in primary care. Therefore, this mixed-method feasibility RCT provides a foundation for a multi-center, a large-scale, definitive randomized controlled trial to assess the clinical, behavioral, social, and emotional outcomes in primary care settings.
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This publication is made available by the authority of the copyright owner solely for the purpose of private study and research and may not be copied or reproduced except as permitted by the copyright laws without written authority from the copyright owner.