Document Type : Original Article


1 Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj

2 Departments of Health Education and Promotion

3 Departments of Epidemiology, Iran University of Medical Science, Tehran, Iran


Introduction: Diabetes is a chronic disease; it can cause serious complications. Diabetes
self-management is essential for prevention of disease complications. This study was
conducted to evaluate self-management promotion educational program intervention
efficiency among diabetic patients in Iran and health belief model (HBM) was applied as a
theoretical framework. Materials and Methods: Overall, 120 Type 2 diabetic patients referred
to rural health centers in Gachsaran, Iran participated in this study as randomly divided into
intervention and control group. This was a longitudinal randomized pre- and post-test series
control group design panel study to implement a behavior modification based intervention to
promotion self-management among diabetic patients. Cross-tabulation and t-test by using
SPSS statistical package, version 16 was used for the statistical analysis. Results: Mean age
was 55.07 years (SD = 9.94, range: 30-70). Our result shows significant improvements in
average response for susceptibility, severity, benefit and self-management among intervention
group. Additionally, after intervention, average response of the barrier to self-management was
decreased among intervention group. Conclusion: Our result showed education program
based on HBM was improve of self-management and seems implementing these programs
can be effective in the and prevention of diabetes complications.


1. Yekta Z, Pourali R, Aghassi MR, Ashragh N, Ravanyar L,
Rahim Pour MY. Assessment of self-care practice and its associated
factors among diabetic patients in Urban Area of Urmia, Northwest
of Iran. J Res Health Sci 2011;11:33-82. Lawton J, Ahmad N, Hanna L, Douglas M, Hallowell N. ‘I can’t do
any serious exercise’: Barriers to physical activity amongst people
of Pakistani and Indian origin with Type 2 diabetes. Health Educ
Res 2006;21:43-54.
3. Gagliardino JJ, Etchegoyen G, PENDID-LA Research Group. A model
educational program for people with type 2 diabetes: A cooperative
Latin American implementation study (PEDNID-LA). Diabetes Care
4. Baptiste-Roberts K, Gary TL, Beckles GL, Gregg EW, Owens M,
Porterfield D, et al. Family history of diabetes, awareness of risk
factors, and health behaviors among African Americans. Am J
Public Health 2007;97:907-12.
5. Hazavehei SM, Sharifirad G, Mohebi S. The effect of educational
program based on health belief model on diabetic foot care. Int J
Diabetes Dev Ctries 2007;27:18-23.
6. Ratanasuwan T, Indharapakdi S, Promrerk R, Komolviphat T,
Thanamai Y. Health belief model about diabetes mellitus in Thailand:
The culture consensus analysis. J Med Assoc Thai 2005; 88:623-31.
7. Esscot-Stump S, Mahan LK. Medical nutrition for diabetes mellitus
and hypoglycaemia of nondiabetic origin. Krause’s Food, Nutrition
and Diet Therapy. 9th ed. Philadelphia: W.B. Saunders Company
Publisher; 1996. p. 69-82.
8. van Dam HA, van der Horst FG, Knoops L, Ryckman RM,
Crebolder HF, van den Borne BH. Social support in diabetes:
A systematic review of controlled intervention studies. Patient Educ
Couns 2005;59:1-12.
9. Sarkar U, Fisher L, Schillinger D. Is self-efficacy associated with
diabetes self-management across race/ethnicity and health literacy?
Diabetes Care 2006;29:823-9.
10. Pinto SL, Lively BT, Siganga W, Holiday-Goodman M, Kamm G.
Using the Health Belief Model to test factors affecting patient
retention in diabetes-related pharmaceutical care services. Res
Social Adm Pharm 2006;2:38-58.
11. Wens J, Vermeire E, Royen PV, Sabbe B, Denekens J. GPs’
perspectives of type 2 diabetes patients’ adherence to treatment:
A qualitative analysis of barriers and solutions. BMC Fam Pract
12. Wai CT, Wong ML, Ng S, Cheok A, Tan MH, Chua W, et al. Utility
of the Health Belief Model in predicting compliance of screening
in patients with chronic hepatitis B. Aliment Pharmacol Ther
13. Chapman KM, Ham JO, Liesen P, Winter L. Applying behavioral
models to dietary education of elderly diabetic patients. J Nutr Educ
14. Becker MH, Janz NK. The health belief model applied to
understanding diabetes regimen compliance. Diabetes Educ
15. Philis-Tsimikas A, Walker C, Rivard L, Talavera G, Reimann JO,
Salmon M, et al. Improvement in diabetes care of underinsured
patients enrolled in project dulce: A community-based, culturally
appropriate, nurse case management and peer education diabetes
care model. Diabetes Care 2004;27:110-5.
16. Molaei TA, Eftekhar H, Mohammad K. Application of health
belief model to behavior change of diabetic patients. Payesh
17. Kartal A, Ozsoy SA. Validity and reliability study of the Turkish
version of Health Belief Model Scale in diabetic patients. Int J Nurs
Stud 2007;44:1447-58.
18. Daniel M, Messer LC. Perceptions of disease severity and barriers to
self-care predict glycemic control in Aboriginal persons with type 2
diabetes mellitus. Chronic Dis Can 2002;23:130-8.
19. Tan MY. The relationship of health beliefs and complication
prevention behaviors of Chinese individuals with Type 2 Diabetes
Mellitus. Diabetes Res Clin Pract 2004;66:71-7.
20. Aljasem LI, Peyrot M, Wissow L, Rubin RR. The impact of barriers
and self-efficacy on self-care behaviors in type 2 diabetes. Diabetes
Educ 2001;27:393-404.
21. Aalto AM, Uutela A. Glycemic control, self-care behaviors, and
psychosocial factors among insulin treat ed diabetics: A test of an
extended health belief model. Int J Behav Med 1997;4:191-214.
22. Bernal H, Woolley S, Schensul JJ, Dickinson JK. Correlates of
self-efficacy in diabetes self-care among Hispanic adults with
diabetes. Diabetes Educ 2000;26:673-80.