Comparison of the Effectiveness of Family-centered Empowerment Model, Collaborative Care Model and Motivational Interviewing on Blood Glucose Control and Nutritional Behaviors Based on BASNEF Model in Patients Attended to Rural Health Centers

Comparison of the Effectiveness of Family-centered Empowerment Model, Collaborative Care Model and Motivational Interviewing on Blood Glucose Control and Nutritional Behaviors Based on BASNEF Model in Patients Attended to Rural Health Centers | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Comparison of the Effectiveness of Family-centered Empowerment Model, Collaborative Care Model and Motivational Interviewing on Blood Glucose Control and Nutritional Behaviors Based on BASNEF Model in Patients Attended to Rural Health Centers Kamal Mirkarimi This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4639811/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Type 2 diabetes mellitus has imposed increasingly burden on health systems worldwide. Self-care behaviors improve and enhance by receiving support from family of diabetic patients. The present study aims to compare the effectiveness of the family-centered empowerment model, collaborative care model and motivational interviewing on blood glucose control and nutritional behaviors based on the BASNEF model. Methods A single blind randomized clinical trial survey was run among patients with T2DM who were referred to the Rural Health Centers located in Gorgan city of Iran. In total, 120 patients were classified randomly into four groups of interventions (family-centered empowerment model n = 30, collaborative care model n = 30, and motivational interviewing n = 30 and control (n = 30). Blood glucose control, nutritional behaviors and constructs of the model were measured in pre-intervention, 2,6 and 12 months’ follow-ups. P-value < 0.05 was considered significant. Results The mean age of participants was 57.19 ± 5.79 year. Constructs of the model and nutrition variables (except for carbohydrates) did not present statistically significant difference in the pre-intervention, while in six and twelve months showed statistically significant differences (p = 0.001). In addition, FBS (p = 0.001) and HbA 1 C (p = 0.008), decreased significantly in 12-month follow-up.​ Conclusion Given the present findings, FCEM, CCM and MI techniques might be likely applicable and useful to improve nutritional behavior and control chronic diseases such as diabetes which is a serious threat to people's health. Trial registration: The study protocol was approved by the Iranian Registry of Clinical Trials (trial ID 34852 in 2018-12-05). Blood Glucose Diabetes Mellitus Type 2 Motivational Interviewing Single-Blind Method Figures Figure 1 Figure 2 Figure 3 1. Introduction Type 2 diabetes mellitus (T2DM) has imposed increasingly burden on health systems worldwide. [ 1 ] The prevalence of T2DM is rapidly augmenting 3–4% every year in global. [ 2 ] Middle East will likely be exposed with a remarkable increase in diabetes burden in the coming years. Moreover, the vast majority of increase will happen among individuals aged 45 to 64 that are known active population of the country, economically. [ 3 ] The prevalence of T2DM has constantly extended in past years in Iran caused by aging, obesity, urbanization, population growth, and sedentary life style. [ 3 ] According to the studies, 11.4% of Iranian people experienced diabetes, [ 4 ] even 40 percent of them, approximately, have not been diagnosed yet. [ 3 ] T2DM is presently a main reason of death and reduced lifetime. [ 1 ] The chronic hyperglycemia resulted by T2DM leads to macro and microvascular problems. [ 2 ] Despite numerous complications including cardiac diseases, diabetic retinopathy, stroke, organ amputation, these serious disabilities could be prevented using suitable control and care. [ 5 ] self-care behaviors improve and enhance by receiving support from family of diabetic patients. The family-centered empowerment model (FCEM) enhances the quality of life, accountability, greater relationship with health care providers, improved commitment to treatment, satisfaction, prevention of complications, controlling and reducing therapeutic costs, and a favorable attitude toward problem. [ 5 ] The Collaborative Care Model (CCM) consists of health care providers that work together in interaction with patients, their families, health care providers, and communities to provide appropriate care. Also, the positive effects of CCM are well-documented in improving patients and health outcomes. [ 6 ] Numerous studies have shown that CCM meets the quadruple goal of healthcare, such as healthcare costs, health-related consequences, experience of health care provider and approaches. [ 7 ] Motivational interviewing technique (MIT) is a patient-centered counselling model that has been used to develop healthy behavior changes via self-reflection. It has been implemented by people to prevent unhealthy behaviors and improve recommended behaviors. Systematic reviews have reported the significant effects of MIT on weight loss among adults with overweight or obesity, as well as the remarkable changes in health conditions in other metabolic risks, including waist circumference, triglyceride levels, and hypertension. [ 8 ] The BASNEF model is known as an applicable model in health education and promotion that combines with a behavioral intention model and precedes one. The BASNEF model notices the effect of knowledge and attitude on a special practice and also other factors, including enabling factors and subjective norms on a behavior. [ 9 ] The findings of Kabodi et al. study reported that more than 50 percent of patients with T2DM act on self‑medication behaviors. Also, attitude, enabling factors, and subjective norms are the main constructs predicting patients’ self‑medication behaviors. [ 10 ] What is not yet known why current training methods are not effective in the Iranian Health System. Therefore, the present study aims to compare the effectiveness of the family-centered empowerment model, collaborative care model and motivational interviewing on blood glucose control and nutritional behaviors based on the BASNEF model in patients attended to rural health centers. 2. Materials and Methods 2.1. Study design A single blind randomized clinical trial survey was run. Patients with type 2 diabetes were considered as study samples who attended in the Rural Health Centers located in Gorgan city. At present, multistage sampling technique was used to collect data. There are 80 Health Houses in Gorgan city that four of them were included in the study, randomly. Then, 30 patients were selected in each group from a separate Health Houses (family-centered empowerment model n = 30, collaborative care model n = 30, motivational interviewing n = 30, and control group n = 30) that included 120 samples, totally. Arms were evaluated at baseline, 2, 6 and 12 months. To control selection bias, participants of the study in the intervention and control groups were enrolled from different Health Centers. The study protocol was approved by the Iranian Registry of Clinical Trials (trial ID 34852 in 2018-12-05). Moreover, the study protocol was also approved by the Ethics Committee of the Golestan University of Medical Sciences. 2.2. Control group Education was provided in four sessions in the two weeks, two sessions per week, 60 minutes for each session that instructed either by a health education specialist or by a Health worker under supervision of a specialist. At the end of the sessions, the participants could ask their questions to the researchers. 2.3. Motivational Interviewing group (MI group) The five sessions of MI were conducted by a psychologist for 7 to 10 subjects for each session in terms of nutritional behaviors. MI intervention comprised four stages including; a) The therapist asked the patients to introduce themselves and provide explanations about the marital status, work history, education, age, etc. which led to group solidarity and breaking the passive mode of the session (took 5–10 minutes). b) participant's feelings about having diabetes and its control was explored and discussed using open-ended questions, and also their feelings of ambivalence and discussion of change was studied. The techniques used in this stage were open questions, active and reflective listening, and acknowledgment and empathy (took 5–10 minutes). c) to stimulate the doubt and hesitancy of diabetic patients, the positive and negative aspects of the existing situation and change were examined using open questions and brainstorming. During this process, active and reflective listening technique was used (took 10–15 minutes). d) The goals and values of the patients were discussed and the degree of conformity of their behaviors with their goals and values was evaluated by using of open questions, raising inconsistencies and reflective listening of the group members with each other and the therapist as a facilitator, also obstacles to achieve the goals and the methods for solving them were examined (took 10–15 minutes). The activities that they wanted to achieve the goals were listed for each person by the therapist, and also a list of goals supporters was created (took 5 minutes). 2.4. Collaborative Care Model This model consists of four stages: 1) motivation, 2) preparation, 3) engagement, and 4) evaluation. 1) In order to motivate patients, after the implementation of the pre-test stage (examining the structures of the BASNEF model and biochemical parameters), the findings were discussed by the researchers and physicians in the presence of patients. 2, 3) The preparation and engagement stages were executed based on the collaborative educational visits and collaborative follow-up visits. Collaborative educational visits consisted of three visits. In the first visit, two steps were done. a) Motivating patients by familiarizing clients with care problems, current conditions, threats, and future risks. b) Empowering the patients to understand and explain diabetes, its causes, complications and risks. This stage was formed with the presence of 30 patients in the presence of a doctor. Educational materials were presented by lecture and picture presentation techniques. In this session, each patient received information and guidance about medication and treatment. On the second visit, preparation of clients to participate in the care and treatment process was done in two weeks. The goals of this stage include familiarization with the methods of preventing high blood sugar and correcting behavioral patterns, the diet pattern with appropriate sugar, the importance of a proper diet rich in fruits and vegetables. On the third visit, patients were familiar with a regular daily exercise program, useful and harmful exercises, and finally, prevention and drug treatment, the importance of correct and timely consumption, the effects and side effects of drugs. All three visits were implemented for two groups of 15 participants (30 people in total) independently (the duration of each session was 45–60 minutes). Collaborative follow-up visits were done with the aim of continuing the care program and involvement of patients. The number of these visits was two sessions with an interval of 2 weeks for each patient. The number of collaborative follow-up visits for each group was twice and one month apart. 4) Evaluation was performed at the end of all visits. 2.5. Family-centered Empowerment Model The implementation of this model includes four stages of 1) perceived threat, 2) self-efficacy, 3) self-esteem and 4) evaluation. 1) The first step was to increase the perceived threat of the diabetic patient and her/his family. This stage was done in two training sessions (each session 30–45 minutes; 15 patients in each group). 2) Group discussion sessions were held in four sessions of 30–45 minutes with 15 clients and their families that were faced by problems and the process of solving them. 3) The materials related to group discussion sessions were transferred to other family members by diabetic patients through two sessions of 30–45 minutes, and in addition, educational pamphlets were provided to them. 4) The knowledge and self-efficacy of patients and their families were evaluated after the intervention in two sessions of 30–45 minutes. 2.4. Participants Patients with type 2 diabetes as FG ≥ 126mg/dl or HbA 1 c ≥ 6.5%, [ 11 ] having active records in Health House, being able to read and write¸ and willingness to participate in the study were eligibility criteria of the study. Exclusion criteria were also considered as; absence more than two sessions in the FCEM, CCM, MIT and control arms, consumption of drugs may likely interfere with type 2 diabetes. In the two-month follow-up, no patients were excluded from the study. Prior to the study, written informed consent was obtained from all patients. In the six-month follow-up, one patient was not inclined to participate in the study in the control and FCEM. Two people in the MI group were also excluded from the study due to migration to another city. In final, in each of the control and CCM groups, two patients were lost, while in the MI and FCEM groups one patient was excluded from the study. 2.5. Sample size According to Kashfi and et al. study [ 12 ] entitled the effect of nutrition education and walking behavior on blood glucose control among patients with type 2 diabetes, with the estimation of mean and standard deviation of 4.9 ± 0.45 and 1.7 ± 0.63 in the intervention and control group, respectively, also % 90 test power, and % 5 error 30 samples in each group were computed. 2.6. Measures MI education was provided by a psychologist. The CCM, FCEM and control groups were educated by a health education specialist. Although, all patients (four groups) received routine education (such as lecture, questions and answer sessions with pamphlet) that monthly provided by the health workers in the Iranian active care program for diabetics. 2.7. Blood samples All samples were taken in the same laboratory located in a governmental hospital by a trained person under the same condition. Prior to test FBS or HbA 1 C, patients were fasted for 6–8 hours for solids and clear liquids (traditional protocol). [ 13 ] 2.8. Questionnaire To collect data, a standard questionnaire applied in Najimi et al. study with reliability of 0.76 was used. [ 14 ] The current questionnaire comprised of demographic characteristics (14 questions), knowledge (15 questions, true scored 2 and false scored 1), attitude (11 questions, disagree 4, agree 3, no comment 2, and disagree 1), enabling factors (5 questions, answered always, most of time, sometimes, rarely and never) and subjective norms (5 questions, answered always, most of the time, sometimes, rarely and never). A three-day diet record was used to measure the nutritional behavior of participants. Also, to calculate the portion mean of dietary groups, a dietary guide pyramid was run. Finally, for investigating Fasting Blood Sugar (FBS) and HbA 1 c, all blood indices tests were measured in the same laboratory. 2.9. Ethical considerations All subjects received written information regarding study protocol, could ask their questions, and filled informed written consent. All procedures were implemented in relevance with the recommended guidelines and regulations. 2.9. Data analysis In order to report descriptive results, methods of mean and standard deviation were used. To compare groups before intervention, statistical methods such as Chi-square and Independent t-test were also applied. Kolmogorov–Smirnov run to test normal distribution of data. In final, to analyze, One-way ANOVA test was run to study difference between groups. Also, ANOVA repeated measure was used to investigate difference of the variables during times of the study. Prior to run repeated-measures ANOVA, Mauchly's Test was used to assess the statistical assumption of sphericity. 3. Results The participants of the control and intervention groups were homogeny in terms of demographic characteristics. The mean age of participants was 57.19 ± 5.79 ranged 45 to 72 year. Subjects were overwhelmingly female (n= 89, % 74.2). Furthermore, regarding education status, 30 (% 25) were secondary school versus 5 (% 4.2) participants had university education. According to the family history of diabetes, 73.3, 80, 90, and 70 percent in the MI, CCM, FCEM and control groups declared that one of their family members is affected, respectively. Time of diabetes were approximately stated 6 years in all groups. (table 1) Constructs of the model did not present statistically significant difference in the pre-intervention, while in six and twelve months showed statistically notable differences (p=0.001). Although, two variables of knowledge and attitude were not differed in two-month follow-up. Repeated-measure ANOVA also indicated the meaningful difference for all constructs of the model in all follow-up times. (p=0.001) (table 2) One-way ANOVA statistical test indicated that, except for the carbohydrate variable, all the variables did not have a statistically significant difference before the intervention. Whereas, all variables (fat, protein, cholesterol, etc.) changed significantly in two, six and twelve follow-ups (p=0.001). Repeated-measure ANOVA reported the meaningful difference for all variables in all follow-ups. (p=0.001) (table 3). Despite all aforementioned significant relationships, FBS (p=0.001) and HbA 1 C (p=0.008) showed only a significant change in 12-month follow-up. According to Repeated-measure ANOVA, meaningful differences found for FBS and HbA 1 C during times of the study. (p=0.001) (table 4) Figure 1 reports calories consumed in groups of the study during different times. Also, figure 2 indicated HbA 1 C levels in participants during follow-ups of the study. Figure 3 shows the flow of subjects participated throughout the trial. A total of 135 participants were assessed for eligibility that 120 of them enrolled at baseline; 30 samples allocated to each groups, randomly. 4. Discussion 4.1. The intervention based on the BASNEF model The present study indicates that a BASNEF-based intervention may improve patient lifestyle by increasing knowledge, changing patient beliefs and attitudes in a healthy way, and altering social norms using the engagement of family of patients. In line with our study, Villarino et al. [ 15 ] Baghiani moghadam et al. [ 16 ] and Arani et al. [ 17 ] indicates that the lifestyle intervention program based on the BASNEF model has significant privileges regarding meaningful commitment to treatment in patients with hypertension. In a study conducted by Khani Jeihooni et al. [ 9 ] knowledge, attitude and subjective norms of participants increased three months after intervention. 4.1.1. Knowledge Present findings reported that knowledge was significantly improved after interventions in all intervention groups compared to control group except for two-month follow-up. Askari et al. [ 18 ] study showed that the mean score of awareness of subjects in the experimental group increased meaningfully. Other studies in line with the present showed that educational intervention improved patients’ knowledge. [ 9 , 19 , 20 ] According to the numerous studies, the effectiveness of educational interventions to improve awareness might be likely beneficial in disease control. 4.1.2. Attitude Attitude toward a behavior means people's willingness to perform desired behavior, and it is accordance with the judgment of a person about the consequences of that behavior on his/her life. [ 9 ] At present, attitude of participants improved in post intervention in all groups of the study except for two-month follow-up. In Afshary et al. [ 21 ] study, educational intervention resulted in improvement of attitude toward diabetes. In addition, Zhong et al. [ 22 ] and Khattab et al. [ 23 ] cited positive attitude of patients about treatment. 4.1.3. Subjective norms Subjective norms are known as effective social pressures for doing or not doing a behavior. Due to increasing social pressures and supports from family members, health care providers, and friends for doing healthy behaviors, patient’s sentiment for conducting healthy behaviors increases. [ 24 ] We found that all intervention groups influenced the subjective norms compared to the control group. Rothschild et al. [ 25 ] revealed that more participation of health center providers results in the improvement of glycemic control in patients with diabetes. Relationship with health center officials has a great effect on health promotion of patients suffering from chronic diseases. In a study conducted by Movahed et al. [ 26 ] general physicians, families, and friends were the most vital guides of patients for implementing self‑medication behaviors. 4.1.4. Enabling factors A condition in which a person wants to perform a behavior but cannot do it due to some deficiencies such as time, money, resources, skills, and accessible health care that are named enabling factors. [ 18 ] Given the present results, enabling factors improved significantly after intervention. In Askari et al. [ 18 ] study to control diabetes, the factors such as providing information through training sessions and booklets supported elderly patients with type II diabetes. The current findings are relevance with those of Khani Jeihooni et al. [ 9 ] Zendehtalab et al. [ 27 ] The BASNEF model identifies numerous factors, including understanding, attitudes, cultural merits, and social influences. According to this model, families, friends, and other important individuals, can affect the perception of psychological and social well-being of people. [ 15 ] At present, lifestyle interventions to control or change nutritional behavior must involve the patients and health care providers, family, and also the other essential people with significant effects on the behavior of individuals. 4.2. Comparison of the mean scores of BAZNEF model constructs between investigation groups At present, mean scores of BAZNEF model increased in all intervention groups in all three follow-ups, while no changes were seen in the control group. 4.2.1. The Collaborative Care Model findings Our findings also presented the beneficial effect of CCM for patients with type 2 diabetes. The important issue in diabetic patients is the continuation of treatment and regular use of drugs, which was still present after 12 months. For further description, the mean score of all constructs of the model (knowledge, attitude, subjective norms and enabling factors) were improved remarkably in all three follow-ups. The useful impact of CCM on improving health outcomes and reducing medical errors is well-documented. [ 28 , 29 ] CCM resulted in an increase in patient’s quality of life and improvement of patient health status. [ 30 ] 4.2.2. The Motivational Interviewing Technique According to the present, MI results were meaningfully improved in all three follow-ups for all constructs of the model, as well. MI has become an intervention applied for physical health, to encourage behavior change among people diagnosed with chronic conditions. For instance, it has been used in efforts to improve outcomes correlated with the management of type II diabetes and obesity. [ 8 ] In a systematic review implemented by Macnamara et al. [ 31 ] the positive impacts of the MI technique were widely introduced in aspects of oral health. In addition, systematic reviews have cited the lucrative effects of MI in terms of overweight and obesity, [ 32 ] and other metabolic risks, and blood pressure. [ 8 ] 4.2.3. The Family Centered Empowerment Model Family support makes patients motivated to do self-care behaviors in terms of diabetes. FCEM was developed to enhance the care and subsequence of patients with chronic conditions. [ 33 ] According to present findings, FCEM results were meaningfully refined in two, six and twelve follow-ups for all constructs of the model. In a study conducted by Shahabi et al. [ 5 ] FCEM resulted in a notable increase in compliance with a diet regimen and its aspects among patients with type 2 diabetes. Agarwal et al. [ 34 ] showed that in the lack of family support, adherence to treatment regimen decreases after discharge from the hospital. Conclusion Given the effectiveness of the intervention found at present to improve blood glucose control and nutritional behaviors, implementing the FCEM, MI and CCM for controlling chronic conditions is applicable and possible. Therefore, it is recommended that the existing interventions be made known to the health decision makers to improve the health status of patients and even healthy people. Declarations Ethics approval and consent to participate: The study protocol was approved by the Iranian Registry of Clinical Trials (trial ID 34852 in 2018-12-05). Also, an informed consent form was obtained from all subjects prior to the study. Consent for publication: Dr Kamal Mirkarimi declares his consent to publish the article. Availability of data and materials: All the data of the study will be provided to the authorities of the journal if necessary. Competing interests: There is no competing of interest. 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Estimated cost-effectiveness, cost benefit, and risk reduction associated with an endocrinologist-pharmacist diabetes intense medical management “tune-up” clinic. 2017;23(3):318-26. Schepman S, Hansen J, De Putter ID, Batenburg RS, De Bakker DHJIjoic. The common characteristics and outcomes of multidisciplinary collaboration in primary health care: a systematic literature review. 2015;15. Macnamara A, Mishu MP, Faisal MR, Islam M, Peckham EJPo. Improving oral health in people with severe mental illness (SMI): A systematic review. 2021;16(12):e0260766. Armstrong M, Mottershead T, Ronksley P, Sigal R, Campbell T, Hemmelgarn BJOr. Motivational interviewing to improve weight loss in overweight and/or obese patients: a systematic review and meta‐analysis of randomized controlled trials. 2011;12(9):709-23. Rahimi-Bashar F, Salesi M, Gohari-Moghadam K, Jouzdani AF, Pourhoseingholi MA, Vahedian-Azimi AJSR. Assessment of 5-year outcomes of life satisfaction in survivors after rehabilitation programs: a multicenter clinical trial. 2022;12(1):1497. Aggarwal B, Liao M, Allegrante JP, Mosca LJJone, behavior. Low social support level is associated with non-adherence to diet at 1 year in the Family Intervention Trial for Heart Health (FIT Heart). 2010;42(6):380-8. Tables Table 1. Socio-demographic characteristics and medical history of patients participating in the study Variables MI group (n=30) Frequency (percent) CCM (n=30) Frequency (percent) FCEM (n=30) Frequency (percent) Control (n=30) Frequency (percent) P- value Gender Male 8 (26.7) 6 (20) 7 (23.3) 10 (33.3) N.S Female 22 (23.3) 24 (80) 23 (76.7) 20 (66.7) Total 30 (100) 30 (100) 30 (100) 30 (100) Education Illiterate 4 (13.3) 4 (13.3) 3 (10) 5 (16.7) N.S Elementary school 6 (20) 5 (16.7) 6 (20) 5 (16.7) Secondary school 7 (23.3) 7 (23.3) 8 (26.7) 8 (26.7) High school 7 (23.3) 6 (20) 6 (20) 6 (20) Diploma 5 (16.7) 6 (20) 6 (20) 5 (16.7) Academic 1 (3.3) 2 (6.7) 1 (3.3) 1 (3.3) Total 30 (100) 30 (100) 30 (100) 30 (100) Marital status Single --- 1 (3.3) 2 (6.7) 3 (10) N.S Married 26 (86.7) 25 (83.3) 23 (76.7) 22 (73.3) Widow for death 3 (10) 3 (10) 3 (10) 4 (13.3) Widow for divorce 1 (3.3) 1 (3.3) 2 (6.7) 1 (3.3) Total 30 (100) 30 (100) 30 (100) 30 (100) Family history of diabetes Yes 22 (73.3) 24 (80) 27 (90) 21 (70) N.S No 8 (26.7) 6 (20) 3 (10) 9 (30) Total 30 (100) 30 (100) 30 (100) 30 (100) Affected members of the family Father 3 (10) 2 (6.7) 3 (10) 3 (10) N.S Mother 15 (50) 16 (53.3) 18 (60) 12 (40) Brother 3 (10) 3 (10) 3 (10) 3 (10) Sister 3 (10) 3 (10) --- 6 (20) Two or more 6 (20) 6 (20) 6 (20) 6 (20) Total 30 (100) 30 (100) 30 (100) 30 (100) Age Mean (SD) 57.03 (5.33) 56.90 (6.11) 56.47 (5.92) 58.37 (5.91) N.S Number of child Mean (SD) 3.23 (1.25) 2.90 (1.21) 2.97 (1.27) 3.07 (1.61) N.S Time of diabetes Mean (SD) 6 (2.84) 6.07 (2.40) 6.13 (2.64) 6.40 (3.09) N.S SD = Standard deviation N.S = Not significant Table 2. Comparison of the mean scores of BAZNEF model constructs between investigation groups at the pre-intervention, two, six and twelve months’ follow-ups Groups Constructs MI group Mean (SD) CCM Mean (SD) FCEM Mean (SD) Control Mean (SD) * P- value variables ** P- value Pre-intervention Knowledge 20.97 (3.46) 20.96 (3.53) 21.20 (3.44) 21.36 (3.38) 0.962 Knowledge 0.001 Attitude 33.63 (3.54) 34 (3.52) 35.70 (4.12) 34.96 (3.24) 0.117 Enabling factor 6.46 (1.19) 7.73 (0.78) 7.16 (1.05) 6.23 (0.62) 0.102 Subjective norms 12.66 (2.24) 14.50 (2.20) 13 (2.63) 14.56 (1.77) 0.247 Two months follow-up Knowledge 22 (3.36) 22.03 (3.36) 22.13 (3.38) 21.70 (3.19) 0.962 Attitude 0.001 Attitude 35.37 (3.89) 36.70 (2.81) 37.07 (4.03) 35.50 (3.12) 0.156 Enabling factor 7.33 (1.64) 8.70 (1.23) 7.77 (1.35) 6.67 (0.95) 0.001 Subjective norms 17.87 (3.85) 18.30 (3.31) 16.33 (3.67) 15.73 (2.19) 0.009 Six months follow-up Knowledge 24.10 (2.24) 24 (3.24) 24.17 (3.17) 21.97 (3.24) 0.013 Enabling factor 0.001 Attitude 37.03 (4.24) 38.8 (2.10) 38.90 (3.06) 35.73 (3.20) 0.001 Enabling factor 10.30 (3.97) 10.67 (2.98) 9.27 (2.27) 7.10 (1.18) 0.001 Subjective norms 19.23 (3.62) 20.03 (3.58) 17.60 (2.83) 15.93 (2.22) 0.001 Twelve months follow-up Knowledge 25.03 (2.39) 24.63 (2.65) 25.23 (2.97) 21.83 (3.28) 0.001 Subjective norms 0.001 Attitude 38.23 (4) 40.17 (2.30) 39.70 (2.90) 35.27 (3.14) 0.001 Enabling factor 11.60 (3.99) 12.07 (3.16) 10.17 (2.81) 6.97 (1.29) 0.001 Subjective norms 20.83 (3.35) 21.23 (3.29) 19.17 (3.52) 14.43 (2.07) 0.001 SD= Standard deviation * P-value: Between groups ** P-value: ANOVA Repeated Measure Table 3. Comparison of the mean scores of dietary components between investigation groups at the pre-intervention, two, six and twelve months’ follow-ups Groups Constructs MI group Mean (SD) CCM Mean (SD) FCEM Mean (SD) Control Mean (SD) * P- value Variables ** P- value Pre-intervention Carbohydrates Mean (SD) 319.26 (53.59) 337.65 (34.27) 296.49 (60.91) 332.59 (46.99) 0.009 Carbohydrates 0.001 Fat Mean (SD) 88.52 (20.97) 89.22 (24.03) 90.81 (45.56) 81.37 (23.11) 0.630 Saturated fat Mean (SD) 31.66 (8.12) 33.03 (9.29) 33.43 (11.35) 30.62 (9.34) 0.655 Protein Mean (SD) 113.53 (26.78) 115.62 (21.71) 113.51 (24.63) 104.79 (25.98) 0.342 Cholesterol Mean (SD) 470.17 (217.04) 398.22 (199.62) 466.81 (231.13) 389.29 (222.56) 0.318 Fat 0.001 Energy Mean (SD) 2532.46(443.91) 2617.01(340.14) 2464.59(676.75) 2467.87(384.63) 0.573 Two months follow-up Carbohydrates Mean (SD) 317.49 (43.20) 306.65 (38.39) 295.83 (46.57) 344.24 (37.23) 0.001 Fat Mean (SD) 67.74 (16.16) 41.20 (8.95) 52.97 (16.06) 71.54 (18.21) 0.001 Saturated fat Mean (SD) 24.78 (7.13) 14.94 (3.61) 17.45 (4.32) 25.58 (7.03) 0.001 Saturated fat 0.001 Protein Mean (SD) 103.53 (15.59) 104.32 (19.08) 113.66 (16.45) 106.32 (18.28) 0.103 Cholesterol Mean (SD) 406.46 (117.22) 266.08 (118.40) 430.73 (204.81) 392.88 (211.92) 0.001 Energy Mean (SD) 2276.01(322.73) 2000.55(217.94) 2084.71(239.33) 2427.36(330.77) 0.001 Six months follow-up Carbohydrates Mean (SD) 263.66 (37.38) 237.45 (39.99) 254.30 (44.32) 278.93 (37.01) 0.001 Protein 0.001 Fat Mean (SD) 68.98 (21.16) 39.27 (10.34) 38.55 (9.89) 84.99 (12) 0.001 Saturated fat Mean (SD) 24.57 (9.33) 13.60 (2.87) 12.36 (2.69) 35.22 (5) 0.001 Protein Mean (SD) 95.89 (17.80) 89.49 (11.90) 88.31 (13.81) 112.93 (15.17) 0.001 Cholesterol Mean (SD) 401.99 (208.59) 257.46 (154.08) 262 (178.64) 578.19 (260.37) 0.001 Cholesterol 0.001 Energy Mean (SD) 2266.36(316.76) 1995.71(215.33) 2075.91(233.22) 2417.08(317.12) 0.001 Twelve months follow-up Carbohydrates Mean (SD) 255.93 (38.13) 232.43 (39.21) 246.71 (43.83) 283.81 (38.64) 0.001 Fat Mean (SD) 68.50 (20.98) 38.45 (10.14) 37.92 (9.51) 85.55 (12.08) 0.001 Saturated fat Mean (SD) 23.90 (8.82) 12.81 (2.55) 12.10 (2.51) 35.49 (4.89) 0.001 Energy 0.001 Protein Mean (SD) 93.86 (17.04) 87.37 (9.94) 86.96 (12.73) 116.44 (15.39) 0.001 Cholesterol Mean (SD) 391.87 (201.96) 250.53 (144.60) 254.55 (174.19) 587.02 (262.85) 0.001 Energy Mean (SD) 2185.93(301.17) 1971.33(199.68) 2052.59(231.56) 2449.14(313.80) 0.001 SD= Standard deviation * P-value: Between groups ** P-value: ANOVA Repeated Measure Table 4. Comparison of the mean scores of FBS and HbA 1 C between investigation groups at the pre-intervention, two, six and twelve months’ follow-ups Group Pre-intervention Two follow-up Six follow-up Twelve follow-up FBS HbA 1 C FBS HbA 1 C FBS HbA 1 C FBS HbA 1 C FCEM Mean (SD) 8.22 (2.20) 162.43 (21.71) 159.53 (17.86) 7.90 (2.01) 157 (16.65) 7.45 (1.36) 154.73 (16.32) 7.04 (1.17) CCM Mean (SD) 8.41 (2.14) 163.80 (23.90) 160.97 (22.04) 7.86 (1.58) 157.37 (20.44) 7.48 (1.27) 150.87 (15.96) 6.89 (1.07) MI Mean (SD) 9.02 (2.32) 165.63 (27.48) 157.63 (28.55) 8.80 (2.07) 152.47 (23.93) 8.10 (1.62) 144.03 (21.30) 7.49 (1.47) Control Mean (SD) 8.74 (2.59) 168.57 (33.35) 167.37 (32.70) 8.50 (2.37) 167.40 (32.50) 8.32 (2.23) 168.33 (32.42) 8.18 (2.22) * P-value 0.833 0.552 0.207 0.499 0.105 0.111 0.001 0.008 ** P-value FBS 0.001 HbA 1 C 0.001 SD= Standard deviation * P-value: Between groups ** P-value: ANOVA Repeated Measure Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4639811","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":326239070,"identity":"00f52341-dce4-4ef6-a455-cff90369e6bf","order_by":0,"name":"Kamal Mirkarimi","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA40lEQVRIiWNgGAWjYDACHiBOAEIGZgaGAx+AHDZ2UrQcnAHSwkyMFpAmEGAGcwhp4e85wLrh4Z40efN27sTDNr+2yfMxMzB++JiDW4vE2Qa2GwnPcgznHObdcDi377ZhGzMDs+TMbXisOc8A1HKggnEGM0hLz21GoBY2Zl48WuShWuzBWix7btsT1GIAdtiBnESwFoYftxMJajE8c7ANqCUtGaTlYG/D7eQ2ZsZmvH6RO5N87OaPA8m2M/jPbv7w489t2/ntzQc/fMTnfQbGBiR2G7oIYfCHFMWjYBSMglEwUgAAtjdU+d6zAZUAAAAASUVORK5CYII=","orcid":"","institution":"Golestan University of Medical Sciences","correspondingAuthor":true,"prefix":"","firstName":"Kamal","middleName":"","lastName":"Mirkarimi","suffix":""}],"badges":[],"createdAt":"2024-06-26 04:21:46","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4639811/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4639811/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":61198038,"identity":"acf50296-b1ee-41bd-b63d-ad85d4df59a3","added_by":"auto","created_at":"2024-07-27 00:36:46","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":122578,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eComparison of calories consumed between groups during the follow-ups\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-4639811/v1/8f0324e559f8f279c37c9480.png"},{"id":61198467,"identity":"c5e05d61-bb64-46dc-b5b2-8fa0fc1deb6c","added_by":"auto","created_at":"2024-07-27 00:44:45","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":116699,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eComparison of HbA\u003c/strong\u003e\u003csub\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/sub\u003e\u003cstrong\u003eC level between groups during the follow-ups\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-4639811/v1/475bc3fafa47397b12bdf61e.png"},{"id":61198037,"identity":"70d03c15-8aa0-4b62-9cd3-12d8661741cb","added_by":"auto","created_at":"2024-07-27 00:36:46","extension":"jpeg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":1193049,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eParticipation details of the trial\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage3.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-4639811/v1/c058a63fe590b847f6e7bff3.jpeg"},{"id":86223976,"identity":"a59b0dca-c93d-4bc4-ac79-c390e4e49d01","added_by":"auto","created_at":"2025-07-08 07:39:08","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":3445784,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4639811/v1/43e3a7d7-1173-49b7-8820-a5fa9131b480.pdf"},{"id":61198035,"identity":"b2cbb63e-6638-475c-b2d2-b34bca9ea12c","added_by":"auto","created_at":"2024-07-27 00:36:45","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":12330,"visible":true,"origin":"","legend":"","description":"","filename":"Thenoveltyofthework.docx","url":"https://assets-eu.researchsquare.com/files/rs-4639811/v1/5c30b85ba7e5a23900ac762e.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Comparison of the Effectiveness of Family-centered Empowerment Model, Collaborative Care Model and Motivational Interviewing on Blood Glucose Control and Nutritional Behaviors Based on BASNEF Model in Patients Attended to Rural Health Centers","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eType 2 diabetes mellitus (T2DM) has imposed increasingly burden on health systems worldwide.\u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/sup\u003e The prevalence of T2DM is rapidly augmenting 3\u0026ndash;4% every year in global.\u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e Middle East will likely be exposed with a remarkable increase in diabetes burden in the coming years. Moreover, the vast majority of increase will happen among individuals aged 45 to 64 that are known active population of the country, economically.\u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e The prevalence of T2DM has constantly extended in past years in Iran caused by aging, obesity, urbanization, population growth, and sedentary life style.\u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e According to the studies, 11.4% of Iranian people experienced diabetes,\u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e even 40 percent of them, approximately, have not been diagnosed yet.\u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e T2DM is presently a main reason of death and reduced lifetime.\u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/sup\u003e The chronic hyperglycemia resulted by T2DM leads to macro and microvascular problems.\u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e Despite numerous complications including cardiac diseases, diabetic retinopathy, stroke, organ amputation, these serious disabilities could be prevented using suitable control and care.\u003csup\u003e[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eself-care behaviors improve and enhance by receiving support from family of diabetic patients. The family-centered empowerment model (FCEM) enhances the quality of life, accountability, greater relationship with health care providers, improved commitment to treatment, satisfaction, prevention of complications, controlling and reducing therapeutic costs, and a favorable attitude toward problem.\u003csup\u003e[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThe Collaborative Care Model (CCM) consists of health care providers that work together in interaction with patients, their families, health care providers, and communities to provide appropriate care. Also, the positive effects of CCM are well-documented in improving patients and health outcomes.\u003csup\u003e[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/sup\u003e Numerous studies have shown that CCM meets the quadruple goal of healthcare, such as healthcare costs, health-related consequences, experience of health care provider and approaches.\u003csup\u003e[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eMotivational interviewing technique (MIT) is a patient-centered counselling model that has been used to develop healthy behavior changes via self-reflection. It has been implemented by people to prevent unhealthy behaviors and improve recommended behaviors. Systematic reviews have reported the significant effects of MIT on weight loss among adults with overweight or obesity, as well as the remarkable changes in health conditions in other metabolic risks, including waist circumference, triglyceride levels, and hypertension.\u003csup\u003e[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThe BASNEF model is known as an applicable model in health education and promotion that combines with a behavioral intention model and precedes one. The BASNEF model notices the effect of knowledge and attitude on a special practice and also other factors, including enabling factors and subjective norms on a behavior.\u003csup\u003e[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/sup\u003e The findings of Kabodi et al. study reported that more than 50 percent of patients with T2DM act on self‑medication behaviors. Also, attitude, enabling factors, and subjective norms are the main constructs predicting patients\u0026rsquo; self‑medication behaviors.\u003csup\u003e[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/sup\u003e What is not yet known why current training methods are not effective in the Iranian Health System. Therefore, the present study aims to compare the effectiveness of the family-centered empowerment model, collaborative care model and motivational interviewing on blood glucose control and nutritional behaviors based on the BASNEF model in patients attended to rural health centers.\u003c/p\u003e"},{"header":"2. Materials and Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1. Study design\u003c/h2\u003e \u003cp\u003eA single blind randomized clinical trial survey was run. Patients with type 2 diabetes were considered as study samples who attended in the Rural Health Centers located in Gorgan city. At present, multistage sampling technique was used to collect data. There are 80 Health Houses in Gorgan city that four of them were included in the study, randomly. Then, 30 patients were selected in each group from a separate Health Houses (family-centered empowerment model n\u0026thinsp;=\u0026thinsp;30, collaborative care model n\u0026thinsp;=\u0026thinsp;30, motivational interviewing n\u0026thinsp;=\u0026thinsp;30, and control group n\u0026thinsp;=\u0026thinsp;30) that included 120 samples, totally. Arms were evaluated at baseline, 2, 6 and 12 months. To control selection bias, participants of the study in the intervention and control groups were enrolled from different Health Centers. The study protocol was approved by the Iranian Registry of Clinical Trials (trial ID 34852 in 2018-12-05). Moreover, the study protocol was also approved by the Ethics Committee of the Golestan University of Medical Sciences.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2. Control group\u003c/h2\u003e \u003cp\u003eEducation was provided in four sessions in the two weeks, two sessions per week, 60 minutes for each session that instructed either by a health education specialist or by a Health worker under supervision of a specialist. At the end of the sessions, the participants could ask their questions to the researchers.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3. Motivational Interviewing group (MI group)\u003c/h2\u003e \u003cp\u003eThe five sessions of MI were conducted by a psychologist for 7 to 10 subjects for each session in terms of nutritional behaviors. MI intervention comprised four stages including; a) The therapist asked the patients to introduce themselves and provide explanations about the marital status, work history, education, age, etc. which led to group solidarity and breaking the passive mode of the session (took 5\u0026ndash;10 minutes). b) participant's feelings about having diabetes and its control was explored and discussed using open-ended questions, and also their feelings of ambivalence and discussion of change was studied. The techniques used in this stage were open questions, active and reflective listening, and acknowledgment and empathy (took 5\u0026ndash;10 minutes). c) to stimulate the doubt and hesitancy of diabetic patients, the positive and negative aspects of the existing situation and change were examined using open questions and brainstorming. During this process, active and reflective listening technique was used (took 10\u0026ndash;15 minutes). d) The goals and values of the patients were discussed and the degree of conformity of their behaviors with their goals and values was evaluated by using of open questions, raising inconsistencies and reflective listening of the group members with each other and the therapist as a facilitator, also obstacles to achieve the goals and the methods for solving them were examined (took 10\u0026ndash;15 minutes). The activities that they wanted to achieve the goals were listed for each person by the therapist, and also a list of goals supporters was created (took 5 minutes).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e2.4. \u003cem\u003eCollaborative Care Model\u003c/em\u003e\u003c/h2\u003e \u003cp\u003eThis model consists of four stages: 1) motivation, 2) preparation, 3) engagement, and 4) evaluation. 1) In order to motivate patients, after the implementation of the pre-test stage (examining the structures of the BASNEF model and biochemical parameters), the findings were discussed by the researchers and physicians in the presence of patients. 2, 3) The preparation and engagement stages were executed based on the collaborative educational visits and collaborative follow-up visits. Collaborative educational visits consisted of three visits. In the first visit, two steps were done. a) Motivating patients by familiarizing clients with care problems, current conditions, threats, and future risks. b) Empowering the patients to understand and explain diabetes, its causes, complications and risks. This stage was formed with the presence of 30 patients in the presence of a doctor. Educational materials were presented by lecture and picture presentation techniques. In this session, each patient received information and guidance about medication and treatment. On the second visit, preparation of clients to participate in the care and treatment process was done in two weeks. The goals of this stage include familiarization with the methods of preventing high blood sugar and correcting behavioral patterns, the diet pattern with appropriate sugar, the importance of a proper diet rich in fruits and vegetables. On the third visit, patients were familiar with a regular daily exercise program, useful and harmful exercises, and finally, prevention and drug treatment, the importance of correct and timely consumption, the effects and side effects of drugs. All three visits were implemented for two groups of 15 participants (30 people in total) independently (the duration of each session was 45\u0026ndash;60 minutes). Collaborative follow-up visits were done with the aim of continuing the care program and involvement of patients. The number of these visits was two sessions with an interval of 2 weeks for each patient. The number of collaborative follow-up visits for each group was twice and one month apart. 4) Evaluation was performed at the end of all visits.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e2.5. Family-centered Empowerment Model\u003c/h2\u003e \u003cp\u003eThe implementation of this model includes four stages of 1) perceived threat, 2) self-efficacy, 3) self-esteem and 4) evaluation. 1) The first step was to increase the perceived threat of the diabetic patient and her/his family. This stage was done in two training sessions (each session 30\u0026ndash;45 minutes; 15 patients in each group). 2) Group discussion sessions were held in four sessions of 30\u0026ndash;45 minutes with 15 clients and their families that were faced by problems and the process of solving them. 3) The materials related to group discussion sessions were transferred to other family members by diabetic patients through two sessions of 30\u0026ndash;45 minutes, and in addition, educational pamphlets were provided to them. 4) The knowledge and self-efficacy of patients and their families were evaluated after the intervention in two sessions of 30\u0026ndash;45 minutes.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e2.4. Participants\u003c/h2\u003e \u003cp\u003ePatients with type 2 diabetes as FG\u0026thinsp;\u0026ge;\u0026thinsp;126mg/dl or HbA\u003csub\u003e1\u003c/sub\u003ec\u0026thinsp;\u0026ge;\u0026thinsp;6.5%,\u003csup\u003e[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]\u003c/sup\u003e having active records in Health House, being able to read and write\u0026cedil; and willingness to participate in the study were eligibility criteria of the study. Exclusion criteria were also considered as; absence more than two sessions in the FCEM, CCM, MIT and control arms, consumption of drugs may likely interfere with type 2 diabetes.\u003c/p\u003e \u003cp\u003eIn the two-month follow-up, no patients were excluded from the study. Prior to the study, written informed consent was obtained from all patients. In the six-month follow-up, one patient was not inclined to participate in the study in the control and FCEM. Two people in the MI group were also excluded from the study due to migration to another city. In final, in each of the control and CCM groups, two patients were lost, while in the MI and FCEM groups one patient was excluded from the study.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e2.5. Sample size\u003c/h2\u003e \u003cp\u003eAccording to Kashfi and et al. study\u003csup\u003e[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/sup\u003e entitled the effect of nutrition education and walking behavior on blood glucose control among patients with type 2 diabetes, with the estimation of mean and standard deviation of 4.9\u0026thinsp;\u0026plusmn;\u0026thinsp;0.45 and 1.7\u0026thinsp;\u0026plusmn;\u0026thinsp;0.63 in the intervention and control group, respectively, also % 90 test power, and % 5 error 30 samples in each group were computed.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003e2.6. Measures\u003c/h2\u003e \u003cp\u003eMI education was provided by a psychologist. The CCM, FCEM and control groups were educated by a health education specialist. Although, all patients (four groups) received routine education (such as lecture, questions and answer sessions with pamphlet) that monthly provided by the health workers in the Iranian active care program for diabetics.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e2.7. Blood samples\u003c/h2\u003e \u003cp\u003eAll samples were taken in the same laboratory located in a governmental hospital by a trained person under the same condition. Prior to test FBS or HbA\u003csub\u003e1\u003c/sub\u003eC, patients were fasted for 6\u0026ndash;8 hours for solids and clear liquids (traditional protocol).\u003csup\u003e[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/sup\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003e2.8. Questionnaire\u003c/h2\u003e \u003cp\u003eTo collect data, a standard questionnaire applied in Najimi et al. study with reliability of 0.76 was used.\u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e The current questionnaire comprised of demographic characteristics (14 questions), knowledge (15 questions, true scored 2 and false scored 1), attitude (11 questions, disagree 4, agree 3, no comment 2, and disagree 1), enabling factors (5 questions, answered always, most of time, sometimes, rarely and never) and subjective norms (5 questions, answered always, most of the time, sometimes, rarely and never). A three-day diet record was used to measure the nutritional behavior of participants. Also, to calculate the portion mean of dietary groups, a dietary guide pyramid was run. Finally, for investigating Fasting Blood Sugar (FBS) and HbA\u003csub\u003e1\u003c/sub\u003ec, all blood indices tests were measured in the same laboratory.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003e2.9. \u003cem\u003eEthical considerations\u003c/em\u003e\u003c/h2\u003e \u003cp\u003e All subjects received written information regarding study protocol, could ask their questions, and filled informed written consent. All procedures were implemented in relevance with the recommended guidelines and regulations.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003e2.9. Data analysis\u003c/h2\u003e \u003cp\u003eIn order to report descriptive results, methods of mean and standard deviation were used. To compare groups before intervention, statistical methods such as Chi-square and Independent t-test were also applied. Kolmogorov\u0026ndash;Smirnov run to test normal distribution of data. In final, to analyze, One-way ANOVA test was run to study difference between groups. Also, ANOVA repeated measure was used to investigate difference of the variables during times of the study. Prior to run repeated-measures ANOVA, Mauchly's Test was used to assess the statistical assumption of sphericity.\u003c/p\u003e \u003c/div\u003e"},{"header":"3. Results","content":"\u003cp\u003eThe participants of the control and intervention groups were homogeny in terms of demographic characteristics. The mean age of participants was 57.19 \u0026plusmn; 5.79 ranged 45 to 72 year. Subjects were overwhelmingly female (n= 89, % 74.2). Furthermore, regarding education status, 30 (% 25) were secondary school versus 5 (% 4.2) participants had university education. According to the family history of diabetes, 73.3, 80, 90, and 70 percent in the MI, CCM, FCEM and control groups declared that one of their family members is affected, respectively. Time of diabetes were approximately stated 6 years in all groups. (table 1)\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConstructs of the model did not present statistically significant difference in the pre-intervention, while in six and twelve months showed statistically notable differences (p=0.001). Although, two variables of knowledge and attitude were not differed in two-month follow-up. Repeated-measure ANOVA also indicated the meaningful difference for all constructs of the model in all follow-up times. (p=0.001) (table 2)\u003c/p\u003e\n\u003cp\u003eOne-way ANOVA statistical test indicated that, except for the carbohydrate variable, all the variables did not have a statistically significant difference before the intervention. Whereas, all variables (fat, protein, cholesterol, etc.) changed significantly in two, six and twelve follow-ups (p=0.001). Repeated-measure ANOVA reported the meaningful difference for all variables in all follow-ups. (p=0.001) (table 3).\u003c/p\u003e\n\u003cp\u003eDespite all aforementioned significant relationships, FBS (p=0.001) and HbA\u003csub\u003e1\u003c/sub\u003eC (p=0.008) showed only a significant change in 12-month follow-up. According to Repeated-measure ANOVA, meaningful differences found for FBS and HbA\u003csub\u003e1\u003c/sub\u003eC during times of the study. (p=0.001) (table 4)\u003c/p\u003e\n\u003cp\u003eFigure 1 reports calories consumed in groups of the study during different times. Also, figure 2 indicated HbA\u003csub\u003e1\u003c/sub\u003eC levels in participants during follow-ups of the study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFigure 3 shows the flow of subjects participated throughout the trial. A total of 135 participants were assessed for eligibility that 120 of them enrolled at baseline; 30 samples allocated to each groups, randomly.\u003c/p\u003e"},{"header":"4. Discussion","content":"\u003cp\u003e\u003cstrong\u003e4.1. \u003cem\u003eThe intervention based on the BASNEF model\u003c/em\u003e \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe present study indicates that a BASNEF-based intervention may improve patient lifestyle by increasing knowledge, changing patient beliefs and attitudes in a healthy way, and altering social norms using the engagement of family of patients. In line with our study, Villarino et al.\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e15\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e Baghiani moghadam et al.\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e16\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e and Arani et al.\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e17\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e indicates that the lifestyle intervention program based on the BASNEF model has significant privileges regarding meaningful commitment to treatment in patients with hypertension. In a study conducted by Khani Jeihooni et al.\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e9\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e knowledge, attitude and subjective norms of participants increased three months after intervention. \u003c/p\u003e\n\u003cp\u003e\u003cem\u003e4.1.1. Knowledge\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003ePresent findings reported that knowledge was significantly improved after interventions in all intervention groups compared to control group except for two-month follow-up. Askari et al.\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e18\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e study showed that the mean score of awareness of subjects in the experimental group increased meaningfully. Other studies in line with the present showed that educational intervention improved patients\u0026rsquo; knowledge.\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e9\u003c/sup\u003e\u003csup\u003e, \u003c/sup\u003e\u003csup\u003e19\u003c/sup\u003e\u003csup\u003e, \u003c/sup\u003e\u003csup\u003e20\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e According to the numerous studies, the effectiveness of educational interventions to improve awareness might be likely beneficial in disease control. \u003c/p\u003e\n\u003cp\u003e\u003cem\u003e4.1.2. Attitude\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAttitude toward a behavior means people\u0026apos;s willingness to perform desired behavior, and it is accordance with the judgment of a person about the consequences of that behavior on his/her life.\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e9\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e At present, attitude of participants improved in post intervention in all groups of the study except for two-month follow-up. In Afshary et al.\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e21\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e study, educational intervention resulted in improvement of attitude toward diabetes. In addition, Zhong et al.\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e22\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e and Khattab et al.\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e23\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e cited positive attitude of patients about treatment. \u003c/p\u003e\n\u003cp\u003e\u003cem\u003e4.1.3. Subjective norms\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eSubjective norms are known as effective social pressures for doing or not doing a behavior. Due to increasing social pressures and supports from family members, health care providers, and friends for doing healthy behaviors, patient\u0026rsquo;s sentiment for conducting healthy behaviors increases.\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e24\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e\u003csup\u003e \u003c/sup\u003e We found that all intervention groups influenced the subjective norms compared to the control group. Rothschild et al.\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e25\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e revealed that more participation of health center providers results in the improvement of glycemic control in patients with diabetes. Relationship with health center officials has a great effect on health promotion of patients suffering from chronic diseases. In a study conducted by Movahed et al.\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e26\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e general physicians, families, and friends were the most vital guides of patients for implementing self‑medication behaviors.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e4.1.4. Enabling factors\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eA condition in which a person wants to perform a behavior but cannot do it due to some deficiencies such as time, money, resources, skills, and accessible health care that are named enabling factors.\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e18\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e Given the present results, enabling factors improved significantly after intervention. In Askari et al.\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e18\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e study to control diabetes, the factors such as providing information through training sessions and booklets supported elderly patients with type II diabetes. The current findings are relevance with those of Khani Jeihooni et al.\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e9\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e Zendehtalab et al.\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e27\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003eThe BASNEF model identifies numerous factors, including understanding, attitudes, cultural merits, and social influences. According to this model, families, friends, and other important individuals, can affect the perception of psychological and social well-being of people.\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e15\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e At present, lifestyle interventions to control or change nutritional behavior must involve the patients and health care providers, family, and also the other essential people with significant effects on the behavior of individuals.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003e4.2.\u003c/em\u003e\u003c/strong\u003e\u003cem\u003e \u003c/em\u003e\u003cstrong\u003e\u003cem\u003eComparison of the mean scores of BAZNEF model constructs between investigation groups\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAt present, mean scores of BAZNEF model increased in all intervention groups in all three follow-ups, while no changes were seen in the control group.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e4.2.1. The Collaborative Care Model findings \u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eOur findings also presented the beneficial effect of CCM for patients with type 2 diabetes. The important issue in diabetic patients is the continuation of treatment and regular use of drugs, which was still present after 12 months. For further description, the mean score of all constructs of the model (knowledge, attitude, subjective norms and enabling factors) were improved remarkably in all three follow-ups. The useful impact of CCM on improving health outcomes and reducing medical errors is well-documented.\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e28\u003c/sup\u003e\u003csup\u003e, \u003c/sup\u003e\u003csup\u003e29\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e\u003csup\u003e \u003c/sup\u003eCCM resulted in an increase in patient\u0026rsquo;s quality of life and improvement of patient health status.\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e30\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e \u003c/p\u003e\n\u003cp\u003e\u003cem\u003e4.2.2. The Motivational Interviewing Technique \u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAccording to the present, MI results were meaningfully improved in all three follow-ups for all constructs of the model, as well. MI has become an intervention applied for physical health, to encourage behavior change among people diagnosed with chronic conditions. For instance, it has been used in efforts to improve outcomes correlated with the management of type II diabetes and obesity.\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e8\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e In a systematic review implemented by Macnamara et al.\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e31\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e the positive impacts of the MI technique were widely introduced in aspects of oral health. In addition, systematic reviews have cited the lucrative effects of MI in terms of overweight and obesity, \u003csup\u003e[\u003c/sup\u003e\u003csup\u003e32\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e and other metabolic risks, and blood pressure.\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e8\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e \u003c/p\u003e\n\u003cp\u003e\u003cem\u003e4.2.3. The Family Centered Empowerment Model\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eFamily support makes patients motivated to do self-care behaviors in terms of diabetes. FCEM was developed to enhance the care and subsequence of patients with chronic conditions. \u003csup\u003e[\u003c/sup\u003e\u003csup\u003e33\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e According to present findings, FCEM results were meaningfully refined in two, six and twelve follow-ups for all constructs of the model. In a study conducted by Shahabi et al.\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e5\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e FCEM resulted in a notable increase in compliance with a diet regimen and its aspects among patients with type 2 diabetes. Agarwal et al.\u003csup\u003e[\u003c/sup\u003e\u003csup\u003e34\u003c/sup\u003e\u003csup\u003e]\u003c/sup\u003e showed that in the lack of family support, adherence to treatment regimen decreases after discharge from the hospital.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eGiven the effectiveness of the intervention found at present to improve blood glucose control and nutritional behaviors, implementing the FCEM, MI and CCM for controlling chronic conditions is applicable and possible. Therefore, it is recommended that the existing interventions be made known to the health decision makers to improve the health status of patients and even healthy people.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate:\u003c/strong\u003e The study protocol was approved by the Iranian Registry of Clinical Trials (trial ID 34852 in 2018-12-05). Also, an informed consent form was obtained from all subjects prior to the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication: \u003c/strong\u003eDr Kamal Mirkarimi declares his consent to publish the article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials: \u003c/strong\u003eAll the data of the study will be provided to the authorities of the journal if necessary.\u003c/p\u003e\n\u003cp dir=\"\"\u003e\u003cstrong\u003e\u003cspan dir=\"\"\u003eCompeting interests: \u003c/span\u003e\u003c/strong\u003e\u003cspan dir=\"\"\u003eThere is no competing of interest. \u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding: \u003c/strong\u003eThe study protocol was financially supported by the Golestan University of Medical Sciences.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions: \u003c/strong\u003eAll the works of the manuscript was done by Dr Mirkarimi. \u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements: \u003c/strong\u003eWe sincerely appreciate all the participants in the study and their participation in the intervention and follow-up process. \u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eYahaya TO, Oladele EO, Mshelia MB, Sifau MO, Fashola OD, Bunza M, et al. 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The effect of telenursing training based on family-centered empowerment pattern on compliance with diet regimen in patients with diabetes mellitus type 2: a randomized clinical trial. 2022;22(1):1-8.\u003c/li\u003e\n\u003cli\u003eAbdulrhim S, Sankaralingam S, Ibrahim MIM, Diab MI, Hussain MAM, Al Raey H, et al. Collaborative care model for diabetes in primary care settings in Qatar: a qualitative exploration among healthcare professionals and patients who experienced the service. 2021;21(1):1-12.\u003c/li\u003e\n\u003cli\u003eO\u0026rsquo;Reilly P, Lee SH, O\u0026rsquo;Sullivan M, Cullen W, Kennedy C, MacFarlane AJPo. Assessing the facilitators and barriers of interdisciplinary team working in primary care using normalisation process theory: an integrative review. 2017;12(5):e0177026.\u003c/li\u003e\n\u003cli\u003eSawyer AT, McManus KJIjoqsoh, well-being. Understanding patient experiences in a motivational interviewing intervention to improve whole-person lifestyle among individuals with hypertension or type 2 diabetes: a qualitative focus group study. 2021;16(1):1978373.\u003c/li\u003e\n\u003cli\u003eJeihooni AK, Barati M, Kouhpayeh A, Kashfi SM, Harsini PA, Rahbar MJIJoE, et al. The effect of educational intervention based on BASNEF model on self-medication behavior of type 2 diabetic patients. 2019;23(6):616.\u003c/li\u003e\n\u003cli\u003eKabodi S, Hazavehei MM, Rahimi M, Roshanaei GJJoE, Health C. Application of BASNEF model in analyzing self-treatment behavior among type 2 diabetic patients in 2014. 2015;2(1):38-49.\u003c/li\u003e\n\u003cli\u003eLoehr LR, Meyer ML, Poon AK, Selvin E, Palta P, Tanaka H, et al. Prediabetes and diabetes are associated with arterial stiffness in older adults: the ARIC study. 2016;29(9):1038-45.\u003c/li\u003e\n\u003cli\u003eKashfi S, KHANI JA, BAHADORI KR, HATAMI M. Evaluation of the effects of educating about nutrition and jogging on the blood sugar of type II diabetic patients of a clinic in Shiraz, Iran. 2009.\u003c/li\u003e\n\u003cli\u003ede Aguilar-Nascimento JE, de Almeida Dias AL, Dock-Nascimento DB, Correia MIT, Campos AC, Portari-Filho PE, et al. Actual preoperative fasting time in Brazilian hospitals: the BIGFAST multicenter study. 2014;10:107.\u003c/li\u003e\n\u003cli\u003eNajimi A, Sharifirad G, Hasanzadeh A, Azadbakht LJJoIMS. Effect of Nutrition Education on Nutritional Behaviors and Glycemic Control Indices Based on BASNEF Model among Elderly with Type 2 Diabetes. 2011;29(155).\u003c/li\u003e\n\u003cli\u003eVillarino RT, Arcay CA, Temblor MC, Villarino ML, Bagsit R, Ocampo L, et al. The effects of lifestyle intervention using the modified beliefs, attitude, subjective norms, enabling factors model in hypertension management: Quasi-experimental study. 2021;5(2):e20297.\u003c/li\u003e\n\u003cli\u003eBaghianimoghadam MH, Rahaee Z, Morowatisharifabad MA, Sharifirad G, Andishmand A, Azadbakht LJJorimstojoIUoMS. Effects of education on self-monitoring of blood pressure based on BASNEF model in hypertensive patients. 2010;15(2):70.\u003c/li\u003e\n\u003cli\u003eArani MD, Taghadosi M, Gilasi HRJIRCMJ. The Effect of Education Based on BASNEF Model on Lifestyle in Patients with Hypertension. 2017;19(11).\u003c/li\u003e\n\u003cli\u003eAskari A, Jeihooni AK, Kashfi SM, Marzban A, Khiyali ZJIjopm. The effect of educational program based on belief, attitude, subjective norm, and enabling factors model on changing the metabolic indices in elderly patients with type II diabetes. 2018;9.\u003c/li\u003e\n\u003cli\u003eOmran D, Guirguis LM, Simpson SHJCJoD. Systematic review of pharmacist interventions to improve adherence to oral antidiabetic medications in people with type 2 diabetes. 2012;36(5):292-9.\u003c/li\u003e\n\u003cli\u003eChubbs DO. Primary Care Provider Adherence to the Canadian Diabetes Association Clinical Practice Guideline for Chronic Kidney Disease. 2017.\u003c/li\u003e\n\u003cli\u003eAfshari M. The effect of BASNEF-based blended educational program on on diabetes control among type 2 diabetic patients referred to diabetes clinic of Samirom city. 2015.\u003c/li\u003e\n\u003cli\u003eZhong X, Tanasugarn C, Fisher EB, Krudsood S, Nityasuddhi DJSAJoTM, Health P. Awareness and practices of self-management and influence factors among individuals with type 2 diabetes in urban community settings in Anhui Province, China. 2011;42(1):184.\u003c/li\u003e\n\u003cli\u003eKhattab M, Khader YS, Al-Khawaldeh A, Ajlouni KJJoD, Complications i. Factors associated with poor glycemic control among patients with type 2 diabetes. 2010;24(2):84-9.\u003c/li\u003e\n\u003cli\u003eDydarlu AJTTUoMS. Effect of educational intervention based on the theory of developed reasoned action to promote of selfmanagement in women with type 2 diabetes. 2011.\u003c/li\u003e\n\u003cli\u003eRothschild SK, Martin MA, Swider SM, Tumial\u0026aacute;n Lynas CM, Janssen I, Avery EF, et al. Mexican American trial of community health workers: a randomized controlled trial of a community health worker intervention for Mexican Americans with type 2 diabetes mellitus. 2014;104(8):1540-8.\u003c/li\u003e\n\u003cli\u003eMovahed E, Arefi Z, Ameri MJIjohe, promotion h. The effect of health belief model-based training (HBM) on self-medication among the male high school students. 2014;2(1):65-72.\u003c/li\u003e\n\u003cli\u003eZendehtalab H, Vaghei S, Emamimoghadam ZJEbc. Effect of intervention based on BASNEF model on quality of life in patients with type 2 diabetes. 2013;3(1):7-16.\u003c/li\u003e\n\u003cli\u003eAbdulrhim S, Sankaralingam S, Ibrahim MIM, Diab MI, Hussain MAM, Al Raey H, et al. Collaborative care model for diabetes in primary care settings in Qatar: a qualitative exploration among healthcare professionals and patients who experienced the service. 2021;21:1-12.\u003c/li\u003e\n\u003cli\u003eHirsch JD, Bounthavong M, Arjmand A, Ha DR, Cadiz CL, Zimmerman A, et al. Estimated cost-effectiveness, cost benefit, and risk reduction associated with an endocrinologist-pharmacist diabetes intense medical management \u0026ldquo;tune-up\u0026rdquo; clinic. 2017;23(3):318-26.\u003c/li\u003e\n\u003cli\u003eSchepman S, Hansen J, De Putter ID, Batenburg RS, De Bakker DHJIjoic. The common characteristics and outcomes of multidisciplinary collaboration in primary health care: a systematic literature review. 2015;15.\u003c/li\u003e\n\u003cli\u003eMacnamara A, Mishu MP, Faisal MR, Islam M, Peckham EJPo. Improving oral health in people with severe mental illness (SMI): A systematic review. 2021;16(12):e0260766.\u003c/li\u003e\n\u003cli\u003eArmstrong M, Mottershead T, Ronksley P, Sigal R, Campbell T, Hemmelgarn BJOr. Motivational interviewing to improve weight loss in overweight and/or obese patients: a systematic review and meta‐analysis of randomized controlled trials. 2011;12(9):709-23.\u003c/li\u003e\n\u003cli\u003eRahimi-Bashar F, Salesi M, Gohari-Moghadam K, Jouzdani AF, Pourhoseingholi MA, Vahedian-Azimi AJSR. Assessment of 5-year outcomes of life satisfaction in survivors after rehabilitation programs: a multicenter clinical trial. 2022;12(1):1497.\u003c/li\u003e\n\u003cli\u003eAggarwal B, Liao M, Allegrante JP, Mosca LJJone, behavior. Low social support level is associated with non-adherence to diet at 1 year in the Family Intervention Trial for Heart Health (FIT Heart). 2010;42(6):380-8.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cdiv dir=\"RTL\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eTable 1. Socio-demographic characteristics and medical history of patients participating in the study\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cdiv align=\"\" dir=\"ltr\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"728\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.46217331499312%\" colspan=\"2\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.91884456671252%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eMI group (n=30)\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eFrequency (percent)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.89270976616231%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eCCM (n=30)\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eFrequency (percent)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.342503438789546%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eFCEM (n=30)\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eFrequency (percent)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.442916093535075%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eControl (n=30)\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eFrequency (percent)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.940852819807429%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eP- value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"15.543328748280604%\" rowspan=\"3\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eGender\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.91884456671252%\"\u003e\n \u003cp dir=\"LTR\"\u003eMale\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.91884456671252%\"\u003e\n \u003cp dir=\"LTR\"\u003e8 (26.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.89270976616231%\"\u003e\n \u003cp dir=\"LTR\"\u003e6 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.342503438789546%\"\u003e\n \u003cp dir=\"LTR\"\u003e7 (23.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.442916093535075%\"\u003e\n \u003cp dir=\"LTR\"\u003e10 (33.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.940852819807429%\" rowspan=\"3\"\u003e\n \u003cp dir=\"LTR\"\u003eN.S\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"LTR\"\u003eFemale\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"LTR\"\u003e22 (23.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.397085610200364%\"\u003e\n \u003cp dir=\"LTR\"\u003e24 (80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.66848816029144%\"\u003e\n \u003cp dir=\"LTR\"\u003e23 (76.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.12568306010929%\"\u003e\n \u003cp dir=\"LTR\"\u003e20 (66.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eTotal\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e30 (100)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.397085610200364%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e30 (100)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.66848816029144%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e30 (100)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.12568306010929%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e30 (100)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"15.543328748280604%\" rowspan=\"7\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eEducation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.91884456671252%\"\u003e\n \u003cp dir=\"LTR\"\u003eIlliterate\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.91884456671252%\"\u003e\n \u003cp dir=\"LTR\"\u003e4 (13.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.89270976616231%\"\u003e\n \u003cp dir=\"LTR\"\u003e4 (13.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.342503438789546%\"\u003e\n \u003cp dir=\"LTR\"\u003e3 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.442916093535075%\"\u003e\n \u003cp dir=\"LTR\"\u003e5 (16.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.940852819807429%\" rowspan=\"7\"\u003e\n \u003cp dir=\"LTR\"\u003eN.S\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"LTR\"\u003eElementary school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"LTR\"\u003e6 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.397085610200364%\"\u003e\n \u003cp dir=\"LTR\"\u003e5 (16.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.66848816029144%\"\u003e\n \u003cp dir=\"LTR\"\u003e6 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.12568306010929%\"\u003e\n \u003cp dir=\"LTR\"\u003e5 (16.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"LTR\"\u003eSecondary school\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"LTR\"\u003e7 (23.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.397085610200364%\"\u003e\n \u003cp dir=\"LTR\"\u003e7 (23.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.66848816029144%\"\u003e\n \u003cp dir=\"LTR\"\u003e8 (26.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.12568306010929%\"\u003e\n \u003cp dir=\"LTR\"\u003e8 (26.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"LTR\"\u003eHigh school\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"LTR\"\u003e7 (23.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.397085610200364%\"\u003e\n \u003cp dir=\"LTR\"\u003e6 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.66848816029144%\"\u003e\n \u003cp dir=\"LTR\"\u003e6 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.12568306010929%\"\u003e\n \u003cp dir=\"LTR\"\u003e6 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"LTR\"\u003eDiploma\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"LTR\"\u003e5 (16.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.397085610200364%\"\u003e\n \u003cp dir=\"LTR\"\u003e6 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.66848816029144%\"\u003e\n \u003cp dir=\"LTR\"\u003e6 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.12568306010929%\"\u003e\n \u003cp dir=\"LTR\"\u003e5 (16.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"LTR\"\u003eAcademic\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"LTR\"\u003e1 (3.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.397085610200364%\"\u003e\n \u003cp dir=\"LTR\"\u003e2 (6.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.66848816029144%\"\u003e\n \u003cp dir=\"LTR\"\u003e1 (3.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.12568306010929%\"\u003e\n \u003cp dir=\"LTR\"\u003e1 (3.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e30 (100)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.397085610200364%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e30 (100)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.66848816029144%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e30 (100)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.12568306010929%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e30 (100)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"15.543328748280604%\" rowspan=\"5\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eMarital status\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.91884456671252%\"\u003e\n \u003cp dir=\"LTR\"\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.91884456671252%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e---\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.89270976616231%\"\u003e\n \u003cp dir=\"LTR\"\u003e1 (3.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.342503438789546%\"\u003e\n \u003cp dir=\"LTR\"\u003e2 (6.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.442916093535075%\"\u003e\n \u003cp dir=\"LTR\"\u003e3 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.940852819807429%\" rowspan=\"5\"\u003e\n \u003cp dir=\"LTR\"\u003eN.S\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"LTR\"\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"LTR\"\u003e26 (86.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.397085610200364%\"\u003e\n \u003cp dir=\"LTR\"\u003e25 (83.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.66848816029144%\"\u003e\n \u003cp dir=\"LTR\"\u003e23 (76.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.12568306010929%\"\u003e\n \u003cp dir=\"LTR\"\u003e22 (73.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"LTR\"\u003eWidow for death\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"LTR\"\u003e3 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.397085610200364%\"\u003e\n \u003cp dir=\"LTR\"\u003e3 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.66848816029144%\"\u003e\n \u003cp dir=\"LTR\"\u003e3 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.12568306010929%\"\u003e\n \u003cp dir=\"LTR\"\u003e4 (13.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"LTR\"\u003eWidow for divorce\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"LTR\"\u003e1 (3.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.397085610200364%\"\u003e\n \u003cp dir=\"LTR\"\u003e1 (3.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.66848816029144%\"\u003e\n \u003cp dir=\"LTR\"\u003e2 (6.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.12568306010929%\"\u003e\n \u003cp dir=\"LTR\"\u003e1 (3.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e30 (100)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.397085610200364%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e30 (100)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.66848816029144%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e30 (100)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.12568306010929%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e30 (100)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"15.543328748280604%\" rowspan=\"3\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eFamily history of diabetes\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.91884456671252%\"\u003e\n \u003cp dir=\"LTR\"\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.91884456671252%\"\u003e\n \u003cp dir=\"LTR\"\u003e22 (73.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.89270976616231%\"\u003e\n \u003cp dir=\"LTR\"\u003e24 (80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.342503438789546%\"\u003e\n \u003cp dir=\"LTR\"\u003e27 (90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.442916093535075%\"\u003e\n \u003cp dir=\"LTR\"\u003e21 (70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.940852819807429%\" rowspan=\"3\"\u003e\n \u003cp dir=\"LTR\"\u003eN.S\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"LTR\"\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"LTR\"\u003e8 (26.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.397085610200364%\"\u003e\n \u003cp dir=\"LTR\"\u003e6 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.66848816029144%\"\u003e\n \u003cp dir=\"LTR\"\u003e3 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.12568306010929%\"\u003e\n \u003cp dir=\"LTR\"\u003e9 (30)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e30 (100)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.397085610200364%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e30 (100)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.66848816029144%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e30 (100)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.12568306010929%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e30 (100)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"15.543328748280604%\" rowspan=\"6\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eAffected members of the family\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.91884456671252%\"\u003e\n \u003cp dir=\"LTR\"\u003eFather\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.91884456671252%\"\u003e\n \u003cp dir=\"LTR\"\u003e3 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.89270976616231%\"\u003e\n \u003cp dir=\"LTR\"\u003e2 (6.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.342503438789546%\"\u003e\n \u003cp dir=\"LTR\"\u003e3 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.442916093535075%\"\u003e\n \u003cp dir=\"LTR\"\u003e3 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.940852819807429%\" rowspan=\"6\"\u003e\n \u003cp dir=\"LTR\"\u003eN.S\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"LTR\"\u003eMother\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"LTR\"\u003e15 (50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.397085610200364%\"\u003e\n \u003cp dir=\"LTR\"\u003e16 (53.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.66848816029144%\"\u003e\n \u003cp dir=\"LTR\"\u003e18 (60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.12568306010929%\"\u003e\n \u003cp dir=\"LTR\"\u003e12 (40)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"LTR\"\u003eBrother\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003e3 (10)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.397085610200364%\"\u003e\n \u003cp dir=\"LTR\"\u003e3 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.66848816029144%\"\u003e\n \u003cp dir=\"LTR\"\u003e3 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.12568306010929%\"\u003e\n \u003cp dir=\"LTR\"\u003e3 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"LTR\"\u003eSister\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003e3 (10)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.397085610200364%\"\u003e\n \u003cp dir=\"LTR\"\u003e3 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.66848816029144%\"\u003e\n \u003cp dir=\"LTR\"\u003e---\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.12568306010929%\"\u003e\n \u003cp dir=\"LTR\"\u003e6 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"LTR\"\u003eTwo or more\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"LTR\"\u003e6 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.397085610200364%\"\u003e\n \u003cp dir=\"LTR\"\u003e6 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.66848816029144%\"\u003e\n \u003cp dir=\"LTR\"\u003e6 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.12568306010929%\"\u003e\n \u003cp dir=\"LTR\"\u003e6 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.404371584699454%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e30 (100)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.397085610200364%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e30 (100)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.66848816029144%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e30 (100)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.12568306010929%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e30 (100)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"15.543328748280604%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eAge\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.91884456671252%\"\u003e\n \u003cp dir=\"LTR\"\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.91884456671252%\"\u003e\n \u003cp dir=\"LTR\"\u003e57.03 (5.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.89270976616231%\"\u003e\n \u003cp dir=\"LTR\"\u003e56.90 (6.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.342503438789546%\"\u003e\n \u003cp dir=\"LTR\"\u003e56.47 (5.92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.442916093535075%\"\u003e\n \u003cp dir=\"LTR\"\u003e58.37 (5.91)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.940852819807429%\"\u003e\n \u003cp dir=\"LTR\"\u003eN.S\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"15.543328748280604%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eNumber of child\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.91884456671252%\"\u003e\n \u003cp dir=\"LTR\"\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.91884456671252%\"\u003e\n \u003cp dir=\"LTR\"\u003e3.23 (1.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.89270976616231%\"\u003e\n \u003cp dir=\"LTR\"\u003e2.90 (1.21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.342503438789546%\"\u003e\n \u003cp dir=\"LTR\"\u003e2.97 (1.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.442916093535075%\"\u003e\n \u003cp dir=\"LTR\"\u003e3.07 (1.61)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.940852819807429%\"\u003e\n \u003cp dir=\"LTR\"\u003eN.S\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"15.543328748280604%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eTime of diabetes\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.91884456671252%\"\u003e\n \u003cp dir=\"LTR\"\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.91884456671252%\"\u003e\n \u003cp dir=\"LTR\"\u003e6 (2.84)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.89270976616231%\"\u003e\n \u003cp dir=\"LTR\"\u003e6.07 (2.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.342503438789546%\"\u003e\n \u003cp dir=\"LTR\"\u003e6.13 (2.64)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.442916093535075%\"\u003e\n \u003cp dir=\"LTR\"\u003e6.40 (3.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.940852819807429%\"\u003e\n \u003cp dir=\"LTR\"\u003eN.S\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eSD = Standard deviation\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eN.S = Not significant\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv dir=\"RTL\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eTable 2. Comparison of the mean scores of BAZNEF model constructs between investigation groups at the pre-intervention, two, six and twelve months\u0026rsquo; follow-ups\u003c/strong\u003e\u003c/p\u003e\n \u003cdiv align=\"\" dir=\"ltr\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"924\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.324675324675326%\" colspan=\"2\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Groups\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eConstructs\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.281385281385282%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eMI group\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eMean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.255411255411255%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eCCM\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eMean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.255411255411255%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eFCEM\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eMean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.255411255411255%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eControl\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eMean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.173160173160174%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u003csup\u003e*\u003c/sup\u003e\u003c/strong\u003e\u003cstrong\u003eP- value\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.281385281385282%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003evariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.173160173160174%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u003csup\u003e**\u003c/sup\u003e\u003c/strong\u003e\u003cstrong\u003eP- value\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"7.034632034632034%\" rowspan=\"4\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003ePre-intervention\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.29004329004329%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eKnowledge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.281385281385282%\"\u003e\n \u003cp dir=\"LTR\"\u003e20.97 (3.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.255411255411255%\"\u003e\n \u003cp dir=\"LTR\"\u003e20.96 (3.53)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.255411255411255%\"\u003e\n \u003cp dir=\"LTR\"\u003e21.20 (3.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.255411255411255%\"\u003e\n \u003cp dir=\"LTR\"\u003e21.36 (3.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.173160173160174%\"\u003e\n \u003cp dir=\"LTR\"\u003e0.962\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.281385281385282%\" rowspan=\"4\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eKnowledge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.173160173160174%\" rowspan=\"4\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.223880597014926%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eAttitude\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.17910447761194%\"\u003e\n \u003cp dir=\"LTR\"\u003e33.63 (3.54)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.522388059701493%\"\u003e\n \u003cp dir=\"LTR\"\u003e34 (3.52)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.522388059701493%\"\u003e\n \u003cp dir=\"LTR\"\u003e35.70 (4.12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.522388059701493%\"\u003e\n \u003cp dir=\"LTR\"\u003e34.96 (3.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.029850746268657%\"\u003e\n \u003cp dir=\"LTR\"\u003e0.117\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.223880597014926%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eEnabling factor\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.17910447761194%\"\u003e\n \u003cp dir=\"LTR\"\u003e6.46 (1.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.522388059701493%\"\u003e\n \u003cp dir=\"LTR\"\u003e7.73 (0.78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.522388059701493%\"\u003e\n \u003cp dir=\"LTR\"\u003e7.16 (1.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.522388059701493%\"\u003e\n \u003cp dir=\"LTR\"\u003e6.23 (0.62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.029850746268657%\"\u003e\n \u003cp dir=\"LTR\"\u003e0.102\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.223880597014926%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eSubjective norms\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.17910447761194%\"\u003e\n \u003cp dir=\"LTR\"\u003e12.66 (2.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.522388059701493%\"\u003e\n \u003cp dir=\"LTR\"\u003e14.50 (2.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.522388059701493%\"\u003e\n \u003cp dir=\"LTR\"\u003e13 (2.63)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.522388059701493%\"\u003e\n \u003cp dir=\"LTR\"\u003e14.56 (1.77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.029850746268657%\"\u003e\n \u003cp dir=\"LTR\"\u003e0.247\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"7.034632034632034%\" rowspan=\"4\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eTwo months follow-up\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.29004329004329%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eKnowledge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.281385281385282%\"\u003e\n \u003cp dir=\"LTR\"\u003e22 (3.36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.255411255411255%\"\u003e\n \u003cp dir=\"LTR\"\u003e22.03 (3.36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.255411255411255%\"\u003e\n \u003cp dir=\"LTR\"\u003e22.13 (3.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.255411255411255%\"\u003e\n \u003cp dir=\"LTR\"\u003e21.70 (3.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.173160173160174%\"\u003e\n \u003cp dir=\"LTR\"\u003e0.962\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.281385281385282%\" rowspan=\"4\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eAttitude\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.173160173160174%\" rowspan=\"4\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.223880597014926%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eAttitude\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.17910447761194%\"\u003e\n \u003cp dir=\"LTR\"\u003e35.37 (3.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.522388059701493%\"\u003e\n \u003cp dir=\"LTR\"\u003e36.70 (2.81)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.522388059701493%\"\u003e\n \u003cp dir=\"LTR\"\u003e37.07 (4.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.522388059701493%\"\u003e\n \u003cp dir=\"LTR\"\u003e35.50 (3.12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.029850746268657%\"\u003e\n \u003cp dir=\"LTR\"\u003e0.156\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.223880597014926%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eEnabling factor\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.17910447761194%\"\u003e\n \u003cp dir=\"LTR\"\u003e7.33 (1.64)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.522388059701493%\"\u003e\n \u003cp dir=\"LTR\"\u003e8.70 (1.23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.522388059701493%\"\u003e\n \u003cp dir=\"LTR\"\u003e7.77 (1.35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.522388059701493%\"\u003e\n \u003cp dir=\"LTR\"\u003e6.67 (0.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.029850746268657%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.223880597014926%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eSubjective norms\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.17910447761194%\"\u003e\n \u003cp dir=\"LTR\"\u003e17.87 (3.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.522388059701493%\"\u003e\n \u003cp dir=\"LTR\"\u003e18.30 (3.31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.522388059701493%\"\u003e\n \u003cp dir=\"LTR\"\u003e16.33 (3.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.522388059701493%\"\u003e\n \u003cp dir=\"LTR\"\u003e15.73 (2.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.029850746268657%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.009\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"7.034632034632034%\" rowspan=\"4\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eSix months follow-up\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.29004329004329%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eKnowledge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.281385281385282%\"\u003e\n \u003cp dir=\"LTR\"\u003e24.10 (2.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.255411255411255%\"\u003e\n \u003cp dir=\"LTR\"\u003e24 (3.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.255411255411255%\"\u003e\n \u003cp dir=\"LTR\"\u003e24.17 (3.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.255411255411255%\"\u003e\n \u003cp dir=\"LTR\"\u003e21.97 (3.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.173160173160174%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.013\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.281385281385282%\" rowspan=\"4\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eEnabling factor\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.173160173160174%\" rowspan=\"4\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.223880597014926%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eAttitude\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.17910447761194%\"\u003e\n \u003cp dir=\"LTR\"\u003e37.03 (4.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.522388059701493%\"\u003e\n \u003cp dir=\"LTR\"\u003e38.8 (2.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.522388059701493%\"\u003e\n \u003cp dir=\"LTR\"\u003e38.90 (3.06)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.522388059701493%\"\u003e\n \u003cp dir=\"LTR\"\u003e35.73 (3.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.029850746268657%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.223880597014926%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eEnabling factor\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.17910447761194%\"\u003e\n \u003cp dir=\"LTR\"\u003e10.30 (3.97)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.522388059701493%\"\u003e\n \u003cp dir=\"LTR\"\u003e10.67 (2.98)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.522388059701493%\"\u003e\n \u003cp dir=\"LTR\"\u003e9.27 (2.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.522388059701493%\"\u003e\n \u003cp dir=\"LTR\"\u003e7.10 (1.18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.029850746268657%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.223880597014926%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eSubjective norms\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.17910447761194%\"\u003e\n \u003cp dir=\"LTR\"\u003e19.23 (3.62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.522388059701493%\"\u003e\n \u003cp dir=\"LTR\"\u003e20.03 (3.58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.522388059701493%\"\u003e\n \u003cp dir=\"LTR\"\u003e17.60 (2.83)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.522388059701493%\"\u003e\n \u003cp dir=\"LTR\"\u003e15.93 (2.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.029850746268657%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"7.034632034632034%\" rowspan=\"4\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eTwelve months follow-up\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.29004329004329%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eKnowledge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.281385281385282%\"\u003e\n \u003cp dir=\"LTR\"\u003e25.03 (2.39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.255411255411255%\"\u003e\n \u003cp dir=\"LTR\"\u003e24.63 (2.65)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.255411255411255%\"\u003e\n \u003cp dir=\"LTR\"\u003e25.23 (2.97)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.255411255411255%\"\u003e\n \u003cp dir=\"LTR\"\u003e21.83 (3.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.173160173160174%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.281385281385282%\" rowspan=\"4\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eSubjective norms\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.173160173160174%\" rowspan=\"4\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.223880597014926%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eAttitude\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.17910447761194%\"\u003e\n \u003cp dir=\"LTR\"\u003e38.23 (4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.522388059701493%\"\u003e\n \u003cp dir=\"LTR\"\u003e40.17 (2.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.522388059701493%\"\u003e\n \u003cp dir=\"LTR\"\u003e39.70 (2.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.522388059701493%\"\u003e\n \u003cp dir=\"LTR\"\u003e35.27 (3.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.029850746268657%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.223880597014926%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eEnabling factor\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.17910447761194%\"\u003e\n \u003cp dir=\"LTR\"\u003e11.60 (3.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.522388059701493%\"\u003e\n \u003cp dir=\"LTR\"\u003e12.07 (3.16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.522388059701493%\"\u003e\n \u003cp dir=\"LTR\"\u003e10.17 (2.81)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.522388059701493%\"\u003e\n \u003cp dir=\"LTR\"\u003e6.97 (1.29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.029850746268657%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.223880597014926%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eSubjective norms\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.17910447761194%\"\u003e\n \u003cp dir=\"LTR\"\u003e20.83 (3.35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.522388059701493%\"\u003e\n \u003cp dir=\"LTR\"\u003e21.23 (3.29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.522388059701493%\"\u003e\n \u003cp dir=\"LTR\"\u003e19.17 (3.52)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.522388059701493%\"\u003e\n \u003cp dir=\"LTR\"\u003e14.43 (2.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.029850746268657%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cp dir=\"LTR\"\u003eSD=\u0026nbsp;Standard deviation\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u003csup\u003e*\u003c/sup\u003e\u003c/strong\u003eP-value: Between groups\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u003csup\u003e**\u003c/sup\u003e\u003c/strong\u003eP-value: ANOVA Repeated Measure\u0026nbsp;\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv dir=\"RTL\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eTable 3.\u003c/strong\u003e \u003cstrong\u003eComparison of the mean scores of dietary components between investigation groups at the pre-intervention, two, six and twelve months\u0026rsquo; follow-ups\u003c/strong\u003e\u003c/p\u003e\n \u003cdiv align=\"\" dir=\"ltr\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"962\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.557172557172557%\" colspan=\"3\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Groups\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eConstructs \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.81081081081081%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eMI group\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eMean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.81081081081081%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eCCM\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eMean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.81081081081081%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eFCEM\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eMean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.81081081081081%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eControl\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eMean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.602910602910603%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u003csup\u003e*\u003c/sup\u003e\u003c/strong\u003e\u003cstrong\u003eP- value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.81081081081081%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eVariables\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.785862785862786%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u003csup\u003e**\u003c/sup\u003e\u003c/strong\u003e\u003cstrong\u003eP- value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"3.8461538461538463%\" rowspan=\"6\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003ePre-intervention\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.395010395010395%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eCarbohydrates\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.316008316008316%\"\u003e\n \u003cp dir=\"LTR\"\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.81081081081081%\"\u003e\n \u003cp dir=\"LTR\"\u003e319.26 (53.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.81081081081081%\"\u003e\n \u003cp dir=\"LTR\"\u003e337.65 (34.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.81081081081081%\"\u003e\n \u003cp dir=\"LTR\"\u003e296.49 (60.91)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.81081081081081%\"\u003e\n \u003cp dir=\"LTR\"\u003e332.59 (46.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.602910602910603%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.009\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.81081081081081%\" rowspan=\"4\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eCarbohydrates\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.785862785862786%\" rowspan=\"4\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.326647564469914%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eFat\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.461318051575931%\"\u003e\n \u003cp dir=\"LTR\"\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e88.52 (20.97)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e89.22 (24.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e90.81 (45.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e81.37 (23.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.613180515759312%\"\u003e\n \u003cp dir=\"LTR\"\u003e0.630\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.326647564469914%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eSaturated fat\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.461318051575931%\"\u003e\n \u003cp dir=\"LTR\"\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e31.66 (8.12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e33.03 (9.29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e33.43 (11.35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e30.62 (9.34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.613180515759312%\"\u003e\n \u003cp dir=\"LTR\"\u003e0.655\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.326647564469914%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eProtein\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.461318051575931%\"\u003e\n \u003cp dir=\"LTR\"\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e113.53 (26.78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e115.62 (21.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e113.51 (24.63)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e104.79 (25.98)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.613180515759312%\"\u003e\n \u003cp dir=\"LTR\"\u003e0.342\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.81081081081081%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eCholesterol\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.64864864864865%\"\u003e\n \u003cp dir=\"LTR\"\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.243243243243244%\"\u003e\n \u003cp dir=\"LTR\"\u003e470.17 (217.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.243243243243244%\"\u003e\n \u003cp dir=\"LTR\"\u003e398.22 (199.62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.243243243243244%\"\u003e\n \u003cp dir=\"LTR\"\u003e466.81 (231.13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.243243243243244%\"\u003e\n \u003cp dir=\"LTR\"\u003e389.29 (222.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.027027027027026%\"\u003e\n \u003cp dir=\"LTR\"\u003e0.318\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.243243243243244%\" rowspan=\"4\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eFat\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.297297297297296%\" rowspan=\"4\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.326647564469914%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eEnergy\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.461318051575931%\"\u003e\n \u003cp dir=\"LTR\"\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e2532.46(443.91)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e2617.01(340.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e2464.59(676.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e2467.87(384.63)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.613180515759312%\"\u003e\n \u003cp dir=\"LTR\"\u003e0.573\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.034013605442177%\" rowspan=\"6\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eTwo months follow-up\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.605442176870747%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eCarbohydrates\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.884353741496598%\"\u003e\n \u003cp dir=\"LTR\"\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.149659863945578%\"\u003e\n \u003cp dir=\"LTR\"\u003e317.49 (43.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.149659863945578%\"\u003e\n \u003cp dir=\"LTR\"\u003e306.65 (38.39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.149659863945578%\"\u003e\n \u003cp dir=\"LTR\"\u003e295.83 (46.57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.149659863945578%\"\u003e\n \u003cp dir=\"LTR\"\u003e344.24 (37.23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.877551020408163%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.326647564469914%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eFat\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.461318051575931%\"\u003e\n \u003cp dir=\"LTR\"\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e67.74 (16.16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e41.20 (8.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e52.97 (16.06)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e71.54 (18.21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.613180515759312%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.81081081081081%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eSaturated fat\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.64864864864865%\"\u003e\n \u003cp dir=\"LTR\"\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.243243243243244%\"\u003e\n \u003cp dir=\"LTR\"\u003e24.78 (7.13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.243243243243244%\"\u003e\n \u003cp dir=\"LTR\"\u003e14.94 (3.61)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.243243243243244%\"\u003e\n \u003cp dir=\"LTR\"\u003e17.45 (4.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.243243243243244%\"\u003e\n \u003cp dir=\"LTR\"\u003e25.58 (7.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.027027027027026%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.243243243243244%\" rowspan=\"4\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eSaturated fat\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.297297297297296%\" rowspan=\"4\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.326647564469914%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eProtein\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.461318051575931%\"\u003e\n \u003cp dir=\"LTR\"\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e103.53 (15.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e104.32 (19.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e113.66 (16.45)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e106.32 (18.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.613180515759312%\"\u003e\n \u003cp dir=\"LTR\"\u003e0.103\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.326647564469914%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eCholesterol\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.461318051575931%\"\u003e\n \u003cp dir=\"LTR\"\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e406.46 (117.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e266.08 (118.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e430.73 (204.81)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e392.88 (211.92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.613180515759312%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.326647564469914%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eEnergy\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.461318051575931%\"\u003e\n \u003cp dir=\"LTR\"\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e2276.01(322.73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e2000.55(217.94)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e2084.71(239.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e2427.36(330.77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.613180515759312%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"3.8461538461538463%\" rowspan=\"6\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eSix months follow-up\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.395010395010395%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eCarbohydrates\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.316008316008316%\"\u003e\n \u003cp dir=\"LTR\"\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.81081081081081%\"\u003e\n \u003cp dir=\"LTR\"\u003e263.66 (37.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.81081081081081%\"\u003e\n \u003cp dir=\"LTR\"\u003e237.45 (39.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.81081081081081%\"\u003e\n \u003cp dir=\"LTR\"\u003e254.30 (44.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.81081081081081%\"\u003e\n \u003cp dir=\"LTR\"\u003e278.93 (37.01)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.602910602910603%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.81081081081081%\" rowspan=\"4\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eProtein\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.785862785862786%\" rowspan=\"4\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.326647564469914%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eFat\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.461318051575931%\"\u003e\n \u003cp dir=\"LTR\"\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e68.98 (21.16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e39.27 (10.34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e38.55 (9.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e84.99 (12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.613180515759312%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.326647564469914%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eSaturated fat\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.461318051575931%\"\u003e\n \u003cp dir=\"LTR\"\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e24.57 (9.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e13.60 (2.87)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e12.36 (2.69)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e35.22 (5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.613180515759312%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.326647564469914%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eProtein\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.461318051575931%\"\u003e\n \u003cp dir=\"LTR\"\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e95.89 (17.80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e89.49 (11.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e88.31 (13.81)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e112.93 (15.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.613180515759312%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.81081081081081%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eCholesterol\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.64864864864865%\"\u003e\n \u003cp dir=\"LTR\"\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.243243243243244%\"\u003e\n \u003cp dir=\"LTR\"\u003e401.99 (208.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.243243243243244%\"\u003e\n \u003cp dir=\"LTR\"\u003e257.46 (154.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.243243243243244%\"\u003e\n \u003cp dir=\"LTR\"\u003e262 (178.64)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.243243243243244%\"\u003e\n \u003cp dir=\"LTR\"\u003e578.19 (260.37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.027027027027026%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.243243243243244%\" rowspan=\"4\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eCholesterol\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.297297297297296%\" rowspan=\"4\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.326647564469914%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eEnergy\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.461318051575931%\"\u003e\n \u003cp dir=\"LTR\"\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e2266.36(316.76)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e1995.71(215.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e2075.91(233.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e2417.08(317.12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.613180515759312%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.034013605442177%\" rowspan=\"6\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eTwelve months follow-up\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.605442176870747%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eCarbohydrates\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.884353741496598%\"\u003e\n \u003cp dir=\"LTR\"\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.149659863945578%\"\u003e\n \u003cp dir=\"LTR\"\u003e255.93 (38.13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.149659863945578%\"\u003e\n \u003cp dir=\"LTR\"\u003e232.43 (39.21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.149659863945578%\"\u003e\n \u003cp dir=\"LTR\"\u003e246.71 (43.83)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.149659863945578%\"\u003e\n \u003cp dir=\"LTR\"\u003e283.81 (38.64)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.877551020408163%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.326647564469914%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eFat\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.461318051575931%\"\u003e\n \u003cp dir=\"LTR\"\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e68.50 (20.98)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e38.45 (10.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e37.92 (9.51)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e85.55 (12.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.613180515759312%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.81081081081081%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eSaturated fat\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.64864864864865%\"\u003e\n \u003cp dir=\"LTR\"\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.243243243243244%\"\u003e\n \u003cp dir=\"LTR\"\u003e23.90 (8.82)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.243243243243244%\"\u003e\n \u003cp dir=\"LTR\"\u003e12.81 (2.55)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.243243243243244%\"\u003e\n \u003cp dir=\"LTR\"\u003e12.10 (2.51)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.243243243243244%\"\u003e\n \u003cp dir=\"LTR\"\u003e35.49 (4.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.027027027027026%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.243243243243244%\" rowspan=\"4\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eEnergy\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.297297297297296%\" rowspan=\"4\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.326647564469914%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eProtein\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.461318051575931%\"\u003e\n \u003cp dir=\"LTR\"\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e93.86 (17.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e87.37 (9.94)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e86.96 (12.73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e116.44 (15.39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.613180515759312%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.326647564469914%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eCholesterol\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.461318051575931%\"\u003e\n \u003cp dir=\"LTR\"\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e391.87 (201.96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e250.53 (144.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e254.55 (174.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e587.02 (262.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.613180515759312%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.326647564469914%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eEnergy\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.461318051575931%\"\u003e\n \u003cp dir=\"LTR\"\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e2185.93(301.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e1971.33(199.68)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e2052.59(231.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.899713467048711%\"\u003e\n \u003cp dir=\"LTR\"\u003e2449.14(313.80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.613180515759312%\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cp dir=\"LTR\"\u003eSD= Standard deviation\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003csup\u003e*\u003c/sup\u003eP-value: Between groups\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003csup\u003e**\u003c/sup\u003eP-value: ANOVA Repeated Measure\u0026nbsp;\u003c/p\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4. Comparison of the mean scores of FBS and HbA\u003csub\u003e1\u003c/sub\u003eC between investigation groups at the pre-intervention, two, six and twelve months\u0026rsquo; follow-ups\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.384146341463415%\" rowspan=\"2\"\u003e\n \u003cp\u003eGroup\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.432926829268293%\" colspan=\"2\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.054878048780488%\" colspan=\"2\"\u003e\n \u003cp\u003ePre-intervention\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.75%\" colspan=\"2\"\u003e\n \u003cp\u003eTwo follow-up\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.121951219512194%\" colspan=\"2\"\u003e\n \u003cp\u003eSix follow-up\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.25609756097561%\" colspan=\"2\"\u003e\n \u003cp\u003eTwelve follow-up\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.547528517110266%\"\u003e\n \u003cp\u003eFBS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.216730038022813%\"\u003e\n \u003cp\u003eHbA\u003csub\u003e1\u003c/sub\u003eC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.547528517110266%\"\u003e\n \u003cp\u003eFBS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.836501901140684%\"\u003e\n \u003cp\u003eHbA\u003csub\u003e1\u003c/sub\u003eC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.547528517110266%\"\u003e\n \u003cp\u003eFBS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.547528517110266%\"\u003e\n \u003cp\u003eHbA\u003csub\u003e1\u003c/sub\u003eC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.448669201520913%\"\u003e\n \u003cp\u003eFBS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.307984790874524%\"\u003e\n \u003cp\u003eHbA\u003csub\u003e1\u003c/sub\u003eC\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.384146341463415%\"\u003e\n \u003cp\u003eFCEM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.432926829268293%\" colspan=\"2\"\u003e\n \u003cp\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.060975609756097%\"\u003e\n \u003cp\u003e8.22 (2.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.99390243902439%\"\u003e\n \u003cp\u003e162.43 (21.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.060975609756097%\"\u003e\n \u003cp\u003e159.53 (17.86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.689024390243903%\"\u003e\n \u003cp\u003e7.90 (2.01)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.060975609756097%\"\u003e\n \u003cp\u003e157 (16.65)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.060975609756097%\"\u003e\n \u003cp\u003e7.45 (1.36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.585365853658537%\"\u003e\n \u003cp\u003e154.73 (16.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.670731707317072%\"\u003e\n \u003cp\u003e7.04 (1.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.384146341463415%\"\u003e\n \u003cp\u003eCCM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.432926829268293%\" colspan=\"2\"\u003e\n \u003cp\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.060975609756097%\"\u003e\n \u003cp\u003e8.41 (2.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.99390243902439%\"\u003e\n \u003cp\u003e163.80 (23.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.060975609756097%\"\u003e\n \u003cp\u003e160.97 (22.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.689024390243903%\"\u003e\n \u003cp\u003e7.86 (1.58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.060975609756097%\"\u003e\n \u003cp\u003e157.37 (20.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.060975609756097%\"\u003e\n \u003cp\u003e7.48 (1.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.585365853658537%\"\u003e\n \u003cp\u003e150.87 (15.96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.670731707317072%\"\u003e\n \u003cp\u003e6.89 (1.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.384146341463415%\"\u003e\n \u003cp\u003eMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.432926829268293%\" colspan=\"2\"\u003e\n \u003cp\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.060975609756097%\"\u003e\n \u003cp\u003e9.02 (2.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.99390243902439%\"\u003e\n \u003cp\u003e165.63 (27.48)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.060975609756097%\"\u003e\n \u003cp\u003e157.63 (28.55)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.689024390243903%\"\u003e\n \u003cp\u003e8.80 (2.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.060975609756097%\"\u003e\n \u003cp\u003e152.47 (23.93)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.060975609756097%\"\u003e\n \u003cp\u003e8.10 (1.62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.585365853658537%\"\u003e\n \u003cp\u003e144.03 (21.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.670731707317072%\"\u003e\n \u003cp\u003e7.49 (1.47)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.384146341463415%\"\u003e\n \u003cp\u003eControl\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.432926829268293%\" colspan=\"2\"\u003e\n \u003cp\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.060975609756097%\"\u003e\n \u003cp\u003e8.74 (2.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.99390243902439%\"\u003e\n \u003cp\u003e168.57 (33.35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.060975609756097%\"\u003e\n \u003cp\u003e167.37 (32.70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.689024390243903%\"\u003e\n \u003cp\u003e8.50 (2.37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.060975609756097%\"\u003e\n \u003cp\u003e167.40 (32.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.060975609756097%\"\u003e\n \u003cp\u003e8.32 (2.23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.585365853658537%\"\u003e\n \u003cp\u003e168.33 (32.42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.670731707317072%\"\u003e\n \u003cp\u003e8.18 (2.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.817073170731707%\" colspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003csup\u003e*\u003c/sup\u003e\u003c/strong\u003eP-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.060975609756097%\"\u003e\n \u003cp\u003e0.833\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.99390243902439%\"\u003e\n \u003cp\u003e0.552\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.060975609756097%\"\u003e\n \u003cp\u003e0.207\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.689024390243903%\"\u003e\n \u003cp\u003e0.499\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.060975609756097%\"\u003e\n \u003cp\u003e0.105\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.060975609756097%\"\u003e\n \u003cp\u003e0.111\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.585365853658537%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.670731707317072%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.008\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.585365853658537%\" colspan=\"2\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003csup\u003e**\u003c/sup\u003e\u003c/strong\u003eP-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.231707317073171%\"\u003e\n \u003cp\u003eFBS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"80.1829268292683%\" colspan=\"8\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.310344827586206%\"\u003e\n \u003cp\u003eHbA\u003csub\u003e1\u003c/sub\u003eC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"90.6896551724138%\" colspan=\"8\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eSD= Standard deviation\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003csup\u003e*\u003c/sup\u003e\u003c/strong\u003eP-value: Between groups\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003csup\u003e**\u003c/sup\u003e\u003c/strong\u003eP-value: ANOVA Repeated Measure\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Blood Glucose, Diabetes Mellitus Type 2, Motivational Interviewing, Single-Blind Method","lastPublishedDoi":"10.21203/rs.3.rs-4639811/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4639811/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eType 2 diabetes mellitus has imposed increasingly burden on health systems worldwide. Self-care behaviors improve and enhance by receiving support from family of diabetic patients. The present study aims to compare the effectiveness of the family-centered empowerment model, collaborative care model and motivational interviewing on blood glucose control and nutritional behaviors based on the BASNEF model.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA single blind randomized clinical trial survey was run among patients with T2DM who were referred to the Rural Health Centers located in Gorgan city of Iran. In total, 120 patients were classified randomly into four groups of interventions (family-centered empowerment model n\u0026thinsp;=\u0026thinsp;30, collaborative care model n\u0026thinsp;=\u0026thinsp;30, and motivational interviewing n\u0026thinsp;=\u0026thinsp;30 and control (n\u0026thinsp;=\u0026thinsp;30). Blood glucose control, nutritional behaviors and constructs of the model were measured in pre-intervention, 2,6 and 12 months\u0026rsquo; follow-ups. P-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered significant.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe mean age of participants was 57.19\u0026thinsp;\u0026plusmn;\u0026thinsp;5.79 year. Constructs of the model and nutrition variables (except for carbohydrates) did not present statistically significant difference in the pre-intervention, while in six and twelve months showed statistically significant differences (p\u0026thinsp;=\u0026thinsp;0.001). In addition, FBS (p\u0026thinsp;=\u0026thinsp;0.001) and HbA\u003csub\u003e1\u003c/sub\u003eC (p\u0026thinsp;=\u0026thinsp;0.008), decreased significantly in 12-month follow-up.​\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eGiven the present findings, FCEM, CCM and MI techniques might be likely applicable and useful to improve nutritional behavior and control chronic diseases such as diabetes which is a serious threat to people's health.\u003c/p\u003e\u003ch2\u003eTrial registration:\u003c/h2\u003e \u003cp\u003e The study protocol was approved by the Iranian Registry of Clinical Trials (trial ID 34852 in 2018-12-05).\u003c/p\u003e","manuscriptTitle":"Comparison of the Effectiveness of Family-centered Empowerment Model, Collaborative Care Model and Motivational Interviewing on Blood Glucose Control and Nutritional Behaviors Based on BASNEF Model in Patients Attended to Rural Health Centers","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-07-27 00:36:41","doi":"10.21203/rs.3.rs-4639811/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"3c17937d-ad1b-4cb5-927d-1590734d61d3","owner":[],"postedDate":"July 27th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-09-15T02:38:31+00:00","versionOfRecord":[],"versionCreatedAt":"2024-07-27 00:36:41","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4639811","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4639811","identity":"rs-4639811","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}