应用信息-动机-行为技能模型提高2型糖尿病老年人的药物依从性：伊朗克尔曼沙赫一项准实验研究的结果
Application of the information-motivation-behavioral skills model to improve medication adherence among older adults with type 2 diabetes: findings from a quasi-experimental study in Kermanshah, Iran.
作者信息
Mirzaei-Alavijeh Mehdi, Yarmoradi Saba, Khashij Shima, Jalilian Farzad
机构信息
Social Development and Health Promotion Research Center, Health Policy and Promotion Research Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Department of Health Education and Promotion, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
出版信息
BMC Geriatr. 2025 May 13;25(1):328. doi: 10.1186/s12877-025-06000-w.
INTRODUCTION
Medication adherence is crucial for effective blood sugar control in diabetes patients. However, older adults face a higher risk of non-adherence. This study aims to evaluate the effectiveness of a theory-based program designed to enhance medication adherence among older adults with type 2 diabetes.
METHODS
This quasi-experimental study involved 100 elderly individuals with type 2 diabetes in Kermanshah, Iran, in 2024. Participants were randomly assigned to an intervention (50) or control group (50). The intervention group attended six 40-minute sessions over six weeks, based on the Information-Motivation-Behavioral Skills (IMB) model. Data were collected via a questionnaire assessing demographics, IMB model components, and medication adherence. Data were analyzed using SPSS version 16, employing chi-square tests and t-tests for comparisons, moreover, effect sizes were determined using Cohen's d.
RESULTS
The intervention group showed significant improvements, especially in "Information," with a very large effect size of 1.3 and an average change of 3.84 (p < 0.001). In contrast, the control group had minimal changes. Other components like "Attitude" and "Self-efficacy" also had large effect sizes (0.65 and 0.67). However, "Subjective Norms" showed a small effect size (0.11) with no significant changes. Additionally, the intervention group showed a significant improvement in medication adherence (effect size 1.15), increasing scores from 16.92 to 19.76, (p < 0.001) while the control group had minimal changes.
CONCLUSION
The program based on the IMB model significantly improved medication adherence among elderly individuals with type 2 diabetes. We also identified the key theoretical methods of behavior change for each determinant of the IMB model and recommend utilizing them in the development of similar future interventions.
引言
药物依从性对于糖尿病患者有效控制血糖至关重要。然而，老年人面临更高的不依从风险。本研究旨在评估一项基于理论的项目的有效性，该项目旨在提高2型糖尿病老年人的药物依从性。
方法
这项准实验研究于2024年在伊朗克尔曼沙赫涉及100名2型糖尿病老年人。参与者被随机分配到干预组（50人）或对照组（50人）。干预组在六周内参加了六次每次40分钟的课程，课程基于信息 - 动机 - 行为技能（IMB）模型。通过问卷收集数据，评估人口统计学、IMB模型组成部分和药物依从性。使用SPSS 16版进行数据分析，采用卡方检验和t检验进行比较，此外，使用科恩d值确定效应大小。
结果
干预组有显著改善，特别是在“信息”方面，效应大小非常大，为1.3，平均变化为3.84（p < 0.001）。相比之下，对照组变化极小。其他组成部分如“态度”和“自我效能感”也有较大的效应大小（分别为0.65和0.67）。然而，“主观规范”的效应大小较小（0.11），没有显著变化。此外，干预组在药物依从性方面有显著改善（效应大小为1.15），得分从16.92提高到19.76，（p < 0.001），而对照组变化极小。
结论
基于IMB模型的项目显著提高了2型糖尿病老年人的药物依从性。我们还确定了IMB模型每个决定因素行为改变的关键理论方法，并建议在未来类似干预措施的开发中加以利用。
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