Effects of Messaging Framing on the Self-Management Activities and Self-Efficacies of Patients with Type 2 Diabetes Mellitus
Abstract
Background: Message framing is a low-cost and effective intervention method to improve diabetics’ health behaviors. The study aimed to investigate the impacts of positive and negative message framing interventions on the self-management activities and self-efficacy of patients with type 2 diabetes mellitus (T2DM).
Method: Overall, 102 T2DM patients from Jinhua People’s Hospital of China were recruited and divided into three groups: positive and negative message framing intervention groups and a control group. A 12-week experiment was implemented on the first two groups. Then, the differences of the patients’ self-management activities and self-efficacies were analyzed between the experimental and control groups. Finally, the mediating effect of self-efficacy between two types of message framing interventions and patients’ self-management activities was investigated.
Results: Both positive and negative message framing interventions could significantly improve the T2DM patients’ self-management activities in diet, blood glucose testing, foot care, and medication taking (P<0.05), meanwhile significantly improving their self-efficacies along the nutrition, physical exercise and weight, medical treatment, blood sugar, and feet check (P<0.05). Results of the difference analysis for both within-group and inter-group showed that, compared with the positive messaging framing intervention, the negative one had more significant effects on enhancing the patients’ self-management activities and self-efficacy. Self-efficacy had only a mediating effect between negative messaging framing intervention and self-management activities (β = 0.94, 95% CI: 0.0934 – 0.456).
Conclusion: Negative messaging framing intervention could better enrich T2DM patients’ diabetes knowledge through offering threatening information, thereby enhancing their self-efficacies, and ultimately improve their self-management activities.
2. Yang W, Dall T, Beronjia K, et al. (2018). Economic costs of diabetes in the U.S. in 2017. Diabetes Care, 41(5): 917-28.
3. Laxy M, Mielck A, Hunger M, et al. (2014). The association between patient-reported self-management behavior, intermediate clinical outcomes, and mortality in patients with type 2 diabetes: Results from the KORA-A Study. Diabetes Care, 37(6): 1604-12.
4. Dedov I, Kontsevaya A, Shestakova M, et al. (2017). Economic evaluation of type 2 diabetes mellitus burden and its main cardiovascular complications in the Russian Federation. Diabetes Mellit, 19(6): 518-27.
5. Bao H (2021). Relationship among family support, mental resilience and diabetic distress in patients with type 2 diabetic mellitus during COVID-19. Iran J Public Health, 51(3): 606-14.
6. Hu C, Jia W (2018). Diabetes in China: Epidemiology and genetic risk factors and their clinical utility in personalized medication. Diabetes, 67: 3-11.
7. Kirk J, Arcury T, Ip E, et al. (2014). Diabetes symptoms and self-management behaviors in rural older adults. Diabetes Res Clin Pract, 107(1): 54-60.
8. Leal S, Johnson E, Shubrook J, et al. (2018). Standards of medical care in diabetes—2018 abridged for primary care providers. Clin Diabetes, 36(1): 14-37.
9. O'Keefe D, Jensen J (2007). The relative persuasiveness of gain-framed loss-framed messages for encouraging disease prevention behaviors: A meta-analytic review. J Health Commun, 12(7): 623-44.
10. Yang W, Zhang X, Chen J, et al. (2022). Effects of internet-based interventions on improvement of glycemic control and self-management in older adults with diabetes: Systematic review and meta-analysis. Prim Care Diabetes, 16(4): 475-83.
11. Rothman A, Salovey P (1997). Shaping perceptions to motivate healthy behavior: The role of message framing. Psychol Bull, 121(1): 3-19.
12. Ledford C (2012). Exploring the interaction of patient activation and message design variables: Message frame and presentation mode influence on the walking behavior of patients with type 2 diabetes. J Health Psychol, 17(7): 989-1000.
13. Grady JL, Entin EB, Entin EE, et al. (2011). Using message framing to achieve long-term behavioral changes in persons with diabetes. Appl Nurs Res, 24(1): 22-8.
14. Li K-K, Ng L, Cheng S-T, et al. (2017). Reverse message-framing effects on accelerometer-assessed physical activity among older outpatients with type 2 diabetes. J Sport Exercise Psy, 39(3): 1-6.
15. Al-Amer R, Ramjan L, Glew P, et al. (2016). Self-efficacy, depression, and self-care activities in adult Jordanians with type 2 diabetes: The role of illness perception. Issues Ment Health N, 37: 1-11.
16. Bhandari P, Kim M (2016). Self-care behaviors of Nepalese adults with type 2 diabetes: A mixed methods analysis. Nurs Res, 65(3): 202-14.
17. Chrvala CA, Sherr D, Lipman RD (2016). Diabetes self-management education for adults with type 2 diabetes mellitus: A systematic review of the effect on glycemic control. Patient Educ Couns, 99(6): 926-43.
18. Cosansu G, Semra E (2013). Influence of psychosocial factors on self-care behaviors and glycemic control in Turkish patients with type 2 diabetes mellitus. J Transcult Nurs, 25(1): 51-9.
19. Xie Z, Liu K, Or CK, et al. (2020). An examination of the socio-demographic correlates of patient adherence to self-management behaviors and the mediating roles of health attitudes and self-efficacy among patients with coexisting type 2 diabetes and hypertension. BMC Public Health, 20: 1227.
20. van 't Riet J, Ruiter R, Werrij M, et al. (2008). Self-efficacy moderates message-framing effects: The case of skin-cancer detection. Psychol Health, 25(3): 339-49.
21. Park J, Kim S, Kim J (2020). Effects of message framing and health literacy on intention to perform diabetes self-care: A randomized controlled trial. Diabetes Res Clin Pract, 161(4481): 108043.
22. Gallagher K, Updegraff J (2012). Health message framing effects on attitudes, intentions, and behavior: A meta-analytic review. Ann Behav Med, 43: 101-16.
23. Toobert D, Hampson S, Glasgow R (2000). The summary of diabetes self-care activities measure: results from 7 studies and a revised scale. Diabetes Care, 23(7): 943-50.
24. Vivienne Wu S-F, Courtney M, Edwards H, et al. (2008). dDevelopment and validation of the Chinese version of the diabetes management self-efficacy scale. Int J Nurs Stud, 45(4): 534-42.
25. Li Y, Wang D, Ley S, et al. (2017). Time trends of dietary and lifestyle factors and their potential impact on diabetes burden in China. Diabetes Care, 40: 1685-94.
26. Churchill S, Pavey L (2012). Promoting fruit and vegetable consumption: The role of message framing and autonomy. Br J Health Psychol, 18: 610-22.
27. Paragas Jr ED, Barcelo TI (2019). Effects of message-framed informational videos on diabetes management knowledge and self-efficacy. Int J Nurs Pract, 25(4): e12737.
28. Lee A, Aaker J (2004). Bringing the Frame Into Focus: The Influence of Regulatory Fit on Processing Fluency and Persuasion. J Pers Soc Psychol, 86(2): 205-18.
| Files | ||
| Issue | Vol 52 No 6 (2023) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v52i6.12991 | |
| Keywords | ||
| Message framing intervention Positive and negative information Type 2 diabetes mellitus Self-management activity Self-efficacy | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
