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Comparison of the Effectiveness of Family-centered Empowerment Model, Collaborative Care Model and Motivational
1Health Education and Promotion, Nursing Research Center, Golestan University of Medical Sciences, Gorgan, Iran. ak.mirkarimi@gmail.com.
Background:
Given the global burden of type 2 diabetes mellitus (T2DM), the present study aims to compare the effectiveness of the family-centered empowerment model, collaborative care model, and motivational interviewing on blood glucose control and nutritional behaviors based on the BASNEF model.
Methods:
A single-blind randomized clinical trial was conducted among patients with T2DM referred to the Rural Health Centers in Gorgan city, Iran. A total of 120 patients were allocated into one of four groups: family-centered empowerment model (n = 30), collaborative care model (n = 30), motivational interviewing (n = 30), and control group (n = 30) using a computer-generated randomization sequence. Participants were blinded to group assignment, while outcome assessors (laboratory technicians) and the data analyst were blinded to the group codes. The primary outcome was the change in HbA1c and FBS levels from baseline to 12 months. Blood glucose control, nutritional behaviors, and constructs of the model were measured pre-intervention and at 2, 6, and 12 months' follow-up.
Results:
Regarding the primary behavioral and nutritional outcomes, the Collaborative Care Model (CCM) demonstrated superior effectiveness. It produced the highest scores in patient attitude (40.17, p < 0.01) and enabling factors (12.07, p < 0.01), and led to the most substantial reduction in saturated fat intake (65% decrease, p < 0.01) over the 12-month period. For biochemical outcomes, all three intervention groups demonstrated statistically significant reductions in FBS and HbA1c compared to the control group at the 12-month follow-up, with the MI group exhibiting the most substantial improvement (p = < 0.001).
Conclusions:
These findings suggest that optimal diabetes care may benefit from selecting interventions based on individual patient profiles: CCM for structured continuity, MI for motivational challenges, and FCEM where family support is available. The present findings, may be applicable and useful to improve nutritional behavior and control chronic diseases such as diabetes which is a serious threat to people's health.