Journal of School of Public Health and

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Background and Aim: Based on WHO reports, there are about 100-150 million people with asthma around the world and the number is increasing. Asthma is a prevalent disease and permanent self-management is needed in order to control the symptoms and maintain the normal action of the lungs and a normal level of activity. The Green's Model of Health Education Planning provides a systematic process for planning, implementation and evaluation of population health promotion programs and is used in a broad range of issues in health promotion, including self-management in asthma. This study was carried out with the aim of determining predictors of self-management behaviors in patients with asthma in Yazd, Iran, based on the above-mentioned model.

Methods and Materials: In this cross-sectional study convenience sampling was employed to recruit 94 outpatients with asthma from among those referring to Shaheed-Sadooghi Clinic in Yazd, Iran. Data were collected using a questionnaire based on the Green's Model constructs, consisting of predisposing, reinforcing, and enabling factors and self-management behaviors. Reliability and validity of the questionnaire were assessed prior to data collection.

Results: The subjects acquired 49.5%, 68.6%, 67.3%, and 61.2 % of the earnable scores for self-management behavior, predisposing factors, reinforcing factors, and enabling factors, respectively. Predisposing, reinforcing, and enabling variables had positive correlations with self-management behaviors (p<0.01) and accounted for 34.6% of the self-management variance. Predisposing factors were the strongest predictor (β = 0.480).

Conclusion: It is concluded that the Green's Model of Health Education Planning can be used in developing countries, such as Iran, as a framework for planning intervention programs in an attempt to improve the self-management behaviors of patients with asthma. Designing and implementing educational programs aiming at promoting self-management behaviors in asthmatic patients with emphasis on predisposing factor enhancement is recommended.

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Background and Aim: Diabetes mellitus is a widespread disease. Diabetes patients should be fully familiar with the different dimensions of this chronic disease and possess the skills required for self-management and self-care. They should realize that each patient is a different case. It is to be noted that promoting self-management behavior is an essential component of case management in type-2 diabetes mellitus. The objective of this study was to assess self-management behavior of type-2 diabetes patients in Isfahan, Iran and determine factors influencing it.  

Materials and Methods: This was a 6-month cross-sectional study conducted in 2011. The study population was type-2 diabetes patients consulting an outpatient diabetes center in Isfahan, Iran. The sample included a group of 350 patients selected by the continuous sampling method. The self-management behavior of the patients was assessed using a diabetes self-management instrument (DSMI), containing questions on 5 domains. The responses were rated on a 5-point Likert scale and SPSS software, version 11.5 was used for analyzing the collected data.

Results: The response rate was 88%. The majority of the patients were 50-60 years (55.52 ± 8.42) old and 54.3% of them demonstrated borderline metabolic control according to the World Health Organization criteria. Mean scores of self-integration, self-regulation, interaction with health professionals and other influential persons, self-monitoring blood glucose, and adherence to recommended regime were 33.67±6.36, 29.09±5.9, 27.08±4.81, 11.71±3.91 and 11.46±2.9, respectively. On the whole, the global diabetes self-management behavior seemed to be not quite desirable (the score was at an intermediate level). Further analysis of the data revealed that self-management behaviors (at 3 levels, namely, desirable, intermediate, and undesirable) had significant associations (p<0.001) with demographic (age, gender, marital status, education level) and health-related (duration of diabetes, diabetes-related diseases, diabetes complications, general health, type of treatment, family income, and serum HbA₁C level) variables. Self-management behavior had no association with disease history 

Conclusion: Empowerment of patients afflicted with diabetes and, more generally, non-communicable diseases, which are quite prevalent and on the increase, in the area of self-management at the individual and community level will be a vital step towards promotion of health of the population.

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Background and Aim: Patients with diabetes need continous support for sustainable self-care behaviors. The use of supportive forces to improve the level of self-management of diabetes is felt. The aim of this study was to compare the effectiveness of direct and indirect virtual educational interventions on the promotion of self-management behaviors and diabetes control in women with type 2 diabetes. The study was conducted in 2019.
Materials and Methods: This clinical trial study included 100 females with type 2 diabetes under the coverage of three health centers affiliated to Tehran University of Medical Sciences, randomly divided into two groups of direct and indirect education (50 subjects in either group). A questionnaire was used as the standard tool of diabetes self-management. The education imparted to the subjects was based on the latest version of Diabetes Self-Management Education (DSME), and the educational sessions were based on the Stanford University's self-management model, including six 90-minute sessions during three weeks. Data were analyzed using SPSS-16 statistical software, the statistical tests being covariance analysis, etc.        
Results: There were no statistically significant differences between the direct and indirect educational groups as regards the self-management scores and HbA1c levels in the first and second pre-tests (p<0.05). However, both the self-management scores and HbA1c levels of the two groups, determined at 3- and 6-month follow-ups, were found to be statistically significantly different (p<0.05).               
Conclusion: The findings of this study indicate the feasibility of using volunteers, after empowering them properly, to implement diabetes self-management educational interventions.