A community-based home intelligent blood glucose management for older adults with type 2 diabetes based on the Health Belief Model — a randomized controlled trial (Preprint)

BACKGROUND The number of older patients with type 2 diabetes has been on the rise, and effective self-management is key to controlling disease progression and its complications. OBJECTIVE A home telemedicine intervention combining telemedicine and health education based on the Health Belief Model was designed, and the effectiveness on self-management in older patients with type 2 diabetes was evaluated. METHODS A randomized controlled trial including 198 community-dwelling patients aged 65 years or older with type 2 diabetes was conducted. Patients were randomly assigned to a control group (conventional diabetes management program), or intervention group (home telemedicine intervention with a health education program based on the Health Belief Model). The intervention lasted for 6 months. The primary outcome was glycosylated hemoglobin; secondary outcomes were diabetes self-management capacity, self-efficacy, and health beliefs. Baseline, 3-month, and 6-month outcome metrics were collected. Generalized estimating equations were used to compare changes in outcomes. The study is registered with the China Clinical Trial Registry (ChiCTR2200057428). RESULTS 96.5% (191/198) of patients completed the study. From baseline to 6 months, HbA1c decreased by -0.99 (95% CI, -1.60% to -0.60%) in the intervention group and -0.42 (95% CI, -0.90% to 0.90%) in the control group. The intervention group had a greater reduction, of 0.42, compared to the control group (95% CI, 0.12% to 0.73%). Compared to the control group, the intervention group showed significant improvements in diabetes self-management skills, self-efficacy, and health beliefs at 3 and 6 months. CONCLUSIONS Home telemedicine interventions with health education based on the Health Belief Model may result in greater benefits for community-dwelling older patients with type 2 diabetes, potentially offering new options for chronic disease prevention and management. However, future large-scale studies are needed to assess effectiveness and feasibility. CLINICALTRIAL China Clinical Trial Registry (ChiCTR2200057428); https://www.chictr.org.cn/showproj.html?proj=152850