The Effect of Educational Program Based on Belief, Attitude, Subjective Norm, and Enabling Factors Model on Changing the Metabolic Indices in Elderly Patients with Type II Diabetes

Abstract

Background: Diabetes is the most common disease related to metabolism disorders. Today, diabetes in the elderly is one of the major epidemics of the century. This study aimed to investigate the effect of nutrition and jogging‑based Belief, Attitude, Subjective Norm, and Enabling Factors (BASNEF) model in changes in metabolic parameters that performed in elderly patients with type II diabetes in Fasa city.

Methods: This study was a randomized clinical trial on 108 elderly patients with type II diabetes (54 patients in the experimental group and 54 in control group) referred to the diabetes center in Fasa City, Fars Province, Iran, in 2016. Data were collected using a valid self‑reported questionnaire including demographic variables and BASNEF Model (knowledge, attitudes, subjective norms, and enabling factors), checklist for patient’s practices nutrition and jogging based on self‑reporting patients, assess the level of fasting blood sugar (FBS), low‑density lipoprotein (LDL), high‑density lipoprotein (HDL), triglycerides (TG), and HbAlc patients which was completed by both groups before and 3 months after the intervention. The experimental group received the training in eight sessions; each session lasted for 70 min. Then, the data were entered into the SPSS 22 software (SPSS Inc., IBM, Chicago, IL, USA) and were analyzed using descriptive statistics, Chi‑square test, independent t‑test, and paired t‑test. P <0.05 was considered as statistically signifcant.

Results: The results showed that the mean scores of the BASNEF components (knowledge, attitudes, subjective norms, and enabling factors) in two experimental and control groups after intervention were a signifcant difference. After training program, nutritional and jogging performance in the experimental group was better than the control group. Furthermore, FBS (P < 0.001), LDL (P < 0.001), HDL (P < 0.001), TG (P < 0.001), and HbAlc (P < 0.001) improved signifcantly in the experimental group compared to the control group.

Conclusions: Plan and implement nutrition and jogging education using the BASNEF model to improve metabolic parameters in diabetic patients are very effective and benefcial. Moreover, in the implementation of these programs, control, monitoring, and follow‑up educational are recommended.

Keywords: Belief, Attitude, Subjective Norm and Enabling Factors model, elderly, jogging, metabolic parameters, nutrition education, type II diabetes