The efficacy of PRECEDE-PROCEED model-based interventions on HbA1c and self-management in type 2 diabetes patients: a systematic review and meta-analysis
Abstract Background Type 2 diabetes is a global public health challenge characterized by high prevalence and poor self-management outcomes. The PRECEDE-PROCEED model is a well-known conceptual widely used to promote health in chronic diseases. This meta-analysis evaluated the efficacy of interventio...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-05-01
|
| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12889-025-23073-9 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850231373955072000 |
|---|---|
| author | Yan Tang Kim Lam Soh Wan Ying Gan Junjun Zhou Kim Geok Soh |
| author_facet | Yan Tang Kim Lam Soh Wan Ying Gan Junjun Zhou Kim Geok Soh |
| author_sort | Yan Tang |
| collection | DOAJ |
| description | Abstract Background Type 2 diabetes is a global public health challenge characterized by high prevalence and poor self-management outcomes. The PRECEDE-PROCEED model is a well-known conceptual widely used to promote health in chronic diseases. This meta-analysis evaluated the efficacy of interventions based on PRECEDE-PROCEED model in reducing Glycated Hemoglobin A1c (HbA1c) and enhancing self-management in patients with type 2 diabetes. Methods Nine online databases—PubMed, Cochrane Library, Embase, PsycINFO, Scopus, CINAHL, Web of Science, CNKI, and WANFANG—were searched from inception to June 2024. Randomized controlled trials (RCTs) and quasi-experimental studies (QESs) were identified using keywords related to the PRECEDE-PROCEED model, type 2 diabetes, and self-management. Review Manager 5.4 was used for meta-analysis and the 95% confidence intervals (CIs) was calculated for standardized mean differences (SMDs) or weighted mean differences (WMDs). Results Fourteen studies (11 RCTs and 3 QESs) involving 2,478 patients met the eligibility criteria. Interventions significantly reduced HbA1c, with progressive improvements over time: WMD = -0.41 (95% CI: -0.58 to -0.24) at 1 month, -0.50 (95% CI: -0.67 to -0.33) at 3 months, and -0.63 (95% CI: -0.93 to -0.33) at 6 months. Significant improvements were also observed in total self-management scores (SMD = 2.53; 95% CI: 1.14to 3.91) and in key PRECEDE-PROCEED model variables, including knowledge, attitudes, self-efficacy, reinforcing, and enabling factors, though high heterogeneity was noted. Conclusions The PRECEDE-PROCEED model is an effective framework for reducing HbA1c and enhancing self-management among patients with type 2 diabetes. Future research should focus on standardizing intervention protocols and developing unified outcome measures to improve reproducibility and cross-study comparability. Trial registration The PROSPERO registration ID is CRD42024600814. |
| format | Article |
| id | doaj-art-ac020b703c5443efb4585a8bbcad37fc |
| institution | OA Journals |
| issn | 1471-2458 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj-art-ac020b703c5443efb4585a8bbcad37fc2025-08-20T02:03:34ZengBMCBMC Public Health1471-24582025-05-0125111610.1186/s12889-025-23073-9The efficacy of PRECEDE-PROCEED model-based interventions on HbA1c and self-management in type 2 diabetes patients: a systematic review and meta-analysisYan Tang0Kim Lam Soh1Wan Ying Gan2Junjun Zhou3Kim Geok Soh4Department of Nursing, University Putra MalaysiaDepartment of Nursing, University Putra MalaysiaDepartment of Nutrition, University Putra MalaysiaDepartment of Endocrinology, Yancheng No.1 People’s Hospital, Affiliated Hospital of Medical School, Nanjing UniversityDepartment of Sports Studies, University Putra MalaysiaAbstract Background Type 2 diabetes is a global public health challenge characterized by high prevalence and poor self-management outcomes. The PRECEDE-PROCEED model is a well-known conceptual widely used to promote health in chronic diseases. This meta-analysis evaluated the efficacy of interventions based on PRECEDE-PROCEED model in reducing Glycated Hemoglobin A1c (HbA1c) and enhancing self-management in patients with type 2 diabetes. Methods Nine online databases—PubMed, Cochrane Library, Embase, PsycINFO, Scopus, CINAHL, Web of Science, CNKI, and WANFANG—were searched from inception to June 2024. Randomized controlled trials (RCTs) and quasi-experimental studies (QESs) were identified using keywords related to the PRECEDE-PROCEED model, type 2 diabetes, and self-management. Review Manager 5.4 was used for meta-analysis and the 95% confidence intervals (CIs) was calculated for standardized mean differences (SMDs) or weighted mean differences (WMDs). Results Fourteen studies (11 RCTs and 3 QESs) involving 2,478 patients met the eligibility criteria. Interventions significantly reduced HbA1c, with progressive improvements over time: WMD = -0.41 (95% CI: -0.58 to -0.24) at 1 month, -0.50 (95% CI: -0.67 to -0.33) at 3 months, and -0.63 (95% CI: -0.93 to -0.33) at 6 months. Significant improvements were also observed in total self-management scores (SMD = 2.53; 95% CI: 1.14to 3.91) and in key PRECEDE-PROCEED model variables, including knowledge, attitudes, self-efficacy, reinforcing, and enabling factors, though high heterogeneity was noted. Conclusions The PRECEDE-PROCEED model is an effective framework for reducing HbA1c and enhancing self-management among patients with type 2 diabetes. Future research should focus on standardizing intervention protocols and developing unified outcome measures to improve reproducibility and cross-study comparability. Trial registration The PROSPERO registration ID is CRD42024600814.https://doi.org/10.1186/s12889-025-23073-9PRECEDE-PROCEED modelType 2 diabetesSelf-managementMeta-analysis |
| spellingShingle | Yan Tang Kim Lam Soh Wan Ying Gan Junjun Zhou Kim Geok Soh The efficacy of PRECEDE-PROCEED model-based interventions on HbA1c and self-management in type 2 diabetes patients: a systematic review and meta-analysis BMC Public Health PRECEDE-PROCEED model Type 2 diabetes Self-management Meta-analysis |
| title | The efficacy of PRECEDE-PROCEED model-based interventions on HbA1c and self-management in type 2 diabetes patients: a systematic review and meta-analysis |
| title_full | The efficacy of PRECEDE-PROCEED model-based interventions on HbA1c and self-management in type 2 diabetes patients: a systematic review and meta-analysis |
| title_fullStr | The efficacy of PRECEDE-PROCEED model-based interventions on HbA1c and self-management in type 2 diabetes patients: a systematic review and meta-analysis |
| title_full_unstemmed | The efficacy of PRECEDE-PROCEED model-based interventions on HbA1c and self-management in type 2 diabetes patients: a systematic review and meta-analysis |
| title_short | The efficacy of PRECEDE-PROCEED model-based interventions on HbA1c and self-management in type 2 diabetes patients: a systematic review and meta-analysis |
| title_sort | efficacy of precede proceed model based interventions on hba1c and self management in type 2 diabetes patients a systematic review and meta analysis |
| topic | PRECEDE-PROCEED model Type 2 diabetes Self-management Meta-analysis |
| url | https://doi.org/10.1186/s12889-025-23073-9 |
| work_keys_str_mv | AT yantang theefficacyofprecedeproceedmodelbasedinterventionsonhba1candselfmanagementintype2diabetespatientsasystematicreviewandmetaanalysis AT kimlamsoh theefficacyofprecedeproceedmodelbasedinterventionsonhba1candselfmanagementintype2diabetespatientsasystematicreviewandmetaanalysis AT wanyinggan theefficacyofprecedeproceedmodelbasedinterventionsonhba1candselfmanagementintype2diabetespatientsasystematicreviewandmetaanalysis AT junjunzhou theefficacyofprecedeproceedmodelbasedinterventionsonhba1candselfmanagementintype2diabetespatientsasystematicreviewandmetaanalysis AT kimgeoksoh theefficacyofprecedeproceedmodelbasedinterventionsonhba1candselfmanagementintype2diabetespatientsasystematicreviewandmetaanalysis AT yantang efficacyofprecedeproceedmodelbasedinterventionsonhba1candselfmanagementintype2diabetespatientsasystematicreviewandmetaanalysis AT kimlamsoh efficacyofprecedeproceedmodelbasedinterventionsonhba1candselfmanagementintype2diabetespatientsasystematicreviewandmetaanalysis AT wanyinggan efficacyofprecedeproceedmodelbasedinterventionsonhba1candselfmanagementintype2diabetespatientsasystematicreviewandmetaanalysis AT junjunzhou efficacyofprecedeproceedmodelbasedinterventionsonhba1candselfmanagementintype2diabetespatientsasystematicreviewandmetaanalysis AT kimgeoksoh efficacyofprecedeproceedmodelbasedinterventionsonhba1candselfmanagementintype2diabetespatientsasystematicreviewandmetaanalysis |