ArticleBMC public health2021
Use of the socio-ecological model to explore factors that influence the implementation of a diabetes structured education programme (EXTEND project) inLilongwe, Malawi and Maputo, Mozambique: a qualitative study.
Article in BMC public health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07568028 (Examining Multilevel Factors Affecting Participation in Physical Activity Among Adolescents With Type 1 Diabetes Using the Socio-Ecological Model), which is not on this map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Examining Multilevel Factors Affecting Participation in Physical Activity Among Adolescents With Type 1 Diabetes Using the Socio-Ecological Model
Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Structured diabetes self-management education and glycaemic control in low- and middle-income countries: A systematic review.Diabetic medicine : a journal of the British Diabetic Association · 2022Pooled it
- Multilevel influences on family caregiver burden in diabetic foot ulcer care: a qualitative study.BMC nursing · 2026Article
- Lived experiences and perceptions of social support in diabetes self-management among patients, families, and friends in Ethiopia.Scientific reports · 2026Article
- Cognitive and Behavioral Transformation in Type 2 Diabetes Through a Self-Efficacy-Focused Structured Education Program: A Descriptive Qualitative Study.Patient preference and adherence · 2026Article
- Editorial: Patient-centered care: strengthening trust and communication in healthcare relationships.Frontiers in medicine · 2026Article
- Caregiver beliefs and practices about communication disorders in early childhood development centres from Durban: A qualitative study.BMJ public health · 2026Article
- Development of a collaborative chronic care model for management of cardiometabolic disease in low- and middle-income countries.PloS one · 2026Article
- The Multilevel Limb-loss and Preservation Rehabilitation Continuum model (MLPRC): An evidence-based implementation model integrating multiple perspectives to improve outcomes for people facing limb loss.PM & R : the journal of injury, function, and rehabilitation · 2025Article
- Factors Influencing Mental Health Outcomes Amongst Senescent County Residents.International journal of environmental research and public health · 2025Article
- Social Determinants of COVID-19 Pandemic Control: Participatory Learnings From Everyday Experiences in Cape Town, South Africa.Health expectations : an international journal of public participation in health care and health policy · 2024Article
- Behavioral change interventions, theories, and techniques to reduce physical inactivity and sedentary behavior in the general population: a scoping review.BMC public health · 2024Article
- Investigating socio-ecological factors influencing implementation of tuberculosis infection prevention and control in rural Papua New Guinea.Journal of public health (Oxford, England) · 2024Article
- The practice, nature, and impact of nurse-led type 2 diabetic foot prevention services and educational programs in Sub-Saharan Africa: a scoping review.Frontiers in public health · 2024Article
- Using the Socioecological Model to Understand Medical Staff and Older Adult Patients' Experience with Chronic Pain: A Qualitative Study in an Underserved Community Setting.Journal of pain research · 2024Article
- Facilitators and barriers of implementation of routine postnatal care guidelines for women: A systematic scoping review using critical interpretive synthesis.Journal of global health · 2023Article
- Construction and validation of safe care theory for older inpatients from the perspective of socio-ecological model: a study protocol.BMJ open · 2023Article
- Exploring barriers and enablers of self-management behaviours in patients with diabetic foot ulcers: A qualitative study from the perceptions of patients, caregivers, and healthcare professionals in primary care.International wound journal · 2023Article
- Diabetes self-management education interventions and self-management in low-resource settings; a mixed methods study.PloS one · 2023Article
- Cultural adaptation of a diabetes self-management education and support (DSMES) programme for two low resource urban settings in Ghana, during the COVID-19 era.BMC health services research · 2022Article
Corrections and comments
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Authors and funding
11 authors at 6 institutions in 5 countries.
Funding
Abstract
backgroundDiabetes Self-Management Education and Support (DSMES) programmes are vital for type 2 diabetes mellitus (T2DM) management. However, they are limited in Sub-Saharan Africa (SSA). To address this gap, a DSMES, namedEXTEND was developed in Lilongwe (Malawi) and Maputo (Mozambique). This qualitative study aimed to explore factors that influence the implementation of DSMES in these settings.
methodsThe Socio-ecological model was applied to explore factors influencing the implementation of DSMES in SSA. Data was analysed using the Framework method and constant comparative techniques. Sixty-six people participated in the study: people with T2DM who participated in the EXTEND programme; healthcare professionals (HCPs), EXTEND educators, EXTEND trainers, and stakeholders.
resultsOur findings indicate that there is a need to develop an integrated and dedicated diabetes services in SSA healthcare systems, incorporating culturally adapted DSMES and tailored diabetes training to all professions involved in diabetes management. Traditional media and the involvement of community leaders were proposed as important elements to help engage and promote DSMES programmes in local communities. During the design and implementation of DSMES, it is important to consider individual and societal barriers to self-care.
conclusionFindings from this study suggest that multi-faceted factors play a significant role to the implementation of DSMES programmes in LICs. In the future, EXTEND could be incorporated in the development of diabetes training and dedicated diabetes services in SSA healthcare systems, acting as an educational tool for both people with T2DM and HCPs. This project was supported by the Medical Research Council GCRF NCDs Foundation Awards 2016 Development Pathway Funding.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.