Bao Huilan
The Endocrinology Department, the People's Hospital, Jinhua, 321000, China.
Iran J Public Health. 2023 Jun;52(6):1248-1258. doi: 10.18502/ijph.v52i6.12991.
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).
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.
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 (<0.05), meanwhile significantly improving their self-efficacies along the nutrition, physical exercise and weight, medical treatment, blood sugar, and feet check (<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 ( = 0.94, 95% CI: 0.0934 - 0.456).
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.
信息框架是一种低成本且有效的干预方法，可改善糖尿病患者的健康行为。本研究旨在探讨积极和消极信息框架干预对2型糖尿病（T2DM）患者自我管理活动和自我效能的影响。
总共招募了来自中国金华人民医院的102名T2DM患者，并将其分为三组：积极和消极信息框架干预组以及对照组。对前两组实施了为期12周的实验。然后，分析实验组和对照组之间患者自我管理活动和自我效能的差异。最后，研究自我效能在两种信息框架干预与患者自我管理活动之间的中介作用。
积极和消极信息框架干预均可显著改善T2DM患者在饮食、血糖检测、足部护理和服药方面的自我管理活动（<0.05），同时在营养、体育锻炼和体重、医疗、血糖及足部检查方面显著提高其自我效能（<0.05）。组内和组间差异分析结果显示，与积极信息框架干预相比，消极信息框架干预在增强患者自我管理活动和自我效能方面具有更显著的效果。自我效能仅在消极信息框架干预与自我管理活动之间起中介作用（ = 0.94，95% CI：0.0934 - 0.456）。
消极信息框架干预可通过提供威胁性信息更好地丰富T2DM患者的糖尿病知识，从而增强其自我效能，并最终改善其自我管理活动。
