SummaryPurposeThis study systematically reviewed research on behavioral interventions based on the information-motivation-behavioral skills (IMB) model to investigate specific intervention strategies that focus on information, motivation, and behavioral skills and to evaluate their effectiveness for people with chronic diseases.MethodsA systematic review was conducted in accordance with the guidelines of both the National Evidence-based Healthcare Collaborating Agency and Im and Chang. A literature search was conducted using electronic databases. Randomized controlled trials that tested behavioral interventions based on the IMB model for promoting health behaviors among people with chronic diseases were included. Four investigators independently reviewed the studies and assessed the quality of each study. A narrative synthesis was used.ResultsA total of 12 studies were included in the review. Nine studies investigated patients with HIV/AIDS. The most frequently used intervention strategies were instructional pamphlets for the information construct, motivational interviewing techniques for the motivation construct, and instruction or role playing for the behavioral skills construct. Ten studies reported significant behavior changes at the first post-intervention assessment.ConclusionThis review indicates the potential strength of the IMB model as a theoretical framework to develop behavioral interventions. The specific integration strategies delineated for each construct of the model can be utilized to design model-based interventions

Purpose: To describe strategies for enhancing information, motivation, and skills related to changes in diabetes self-management behavior among community-dwelling older adults in Korea. Patients and methods: A total of five focus group interviews (three separate focus groups) were conducted with 12 older adults with type 2 diabetes and five diabetes educators. Qualitative content analysis was used. Results: “One’s own willingness and ability” emerged as a fundamental belief about the strategies for diabetes self-management. Six major themes under three categories were identified. Under the information category, the recurrent themes were: 1) repeatedly offering detailed knowledge regarding self-management, 2) providing information about current health status, and 3) identifying experiential knowledge of blood glucose control. The recurrent themes in the motivation category were: 1) ensuring a positive attitude regarding self-management, and 2) encouragement or feedback from significant others. Furthermore, in the skills category, we found that the following theme emerged: hands-on skills training with numerical standards. Conclusion: This study identified six tailored strategies for enhancing information, motivation, and skills for diabetes self-management behavior changes. These strategies can be used in the development of a culturally sensitive diabetes self-management program for older adults.

Development of behavior theory–based health promotion programs is encouraged with the paradigm shift from contents to behavior outcomes. This article describes the development process of the diabetes self-management program for older Koreans (DSME-OK) using intervention mapping (IM) protocol. The IM protocol includes needs assessment, defining goals and objectives, identifying theory and determinants, developing a matrix to form change objectives, selecting strategies and methods, structuring the program, and planning for evaluation and pilot testing. The DSME-OK adopted seven behavior objectives developed by the American Association of Diabetes Educators as behavioral outcomes. The program applied an information-motivation-behavioral skills model, and interventions were targeted to 3 determinants to change health behaviors. Specific methods were selected to achieve each objective guided by IM protocol. As the final step, program evaluation was planned including a pilot test. The DSME-OK was structured as the 3 determinants of the IMB model were intervened to achieve behavior objectives in each session. The program has 12 weekly 90-min sessions tailored for older adults. Using the IM protocol in developing a theory-based self-management program was beneficial in terms of providing a systematic guide to developing theory-based and behavior outcome–focused health education programs.

This study examined the effect of a combined program of exercise training and self-management education on risk factors for diabetes complications and adherence behavior. A two-group, quasi-experimental study design was used to test the 12-week intervention program with community-dwelling older adults in Korea. Change scores (from baseline to Week 13) of outcome variables were compared between the intervention group ( n = 21) and the control group ( n = 16). The change scores in triglyceride levels, body weight, body mass index, and diabetes self-management behavior showed significant differences between groups. However, no significant differences were found in A1C and blood pressure change scores between the groups in this sample, in which these characteristics were relatively well controlled at baseline. The results of this study showed some promising synergistic effects of lowering cardiovascular risk factors from combining the two interventions.