ArticleBMJ open2023
Intervention development of 'Diabetes Together' using the person-based approach: a couples-focused intervention to support self-management of type 2 diabetes in South Africa.
Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- How is goal setting used in interventions for chronic disease prevention and management in sub-Saharan Africa? A systematic review and narrative synthesis.Global health action · 2026Pooled it
- Evaluation of a diabetes decentralization program in rural Madagascar using the RE-AIM framework.PLOS global public health · 2026Article
- Using places of worship to recruit and retain couples for the 'Diabetes Together' intervention.African journal of primary health care & family medicine · 2025Article
- "You always have a high sugar if you don't communicate": A qualitative secondary analysis of 'Diabetes Together' process evaluation data from couples in South Africa.PLOS global public health · 2025Article
- Exploration of Nakivale Refugees' and Stakeholders' Perceptions and Priorities of Male Engagement in Pregnancy, Childbirth, Postpartum, and Family Planning: A Qualitative Study.Journal of pregnancy · 2025Article
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- Supported self-management in long-term conditions in an African context.The South African journal of physiotherapy · 2024Article
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Authors and funding
7 authors.
Funding
Abstract
objectivesType 2 diabetes (T2D) is a growing concern in South Africa, where many find self-management challenging. Behaviour-change health interventions are enhanced by involving partners of patients. We aimed to develop a couples-focused intervention to improve self-management of T2D among adults in South Africa.
designWe used the person-based approach (PBA): synthesising evidence from existing interventions; background research; theory; and primary qualitative interviews with 10 couples to ascertain barriers and facilitators to self-management. This evidence was used to formulate guiding principles that directed the intervention design. We then prototyped the intervention workshop material, shared it with our public and patient involvement group and ran iterative co-discovery think-aloud sessions with nine couples. Feedback was rapidly analysed and changes formulated to improve the intervention, optimising its acceptability and maximising its potential efficacy.
settingWe recruited couples using public-sector health services in the area of Cape Town, South Africa, during 2020-2021.
participantsThe 38 participants were couples where one person had T2D.
interventionWe developed the 'Diabetes Together' intervention to support self-management of T2D among couples in South Africa, focussing on: improved communication and shared appraisal of T2D; identifying opportunities for better self-management; and support from partners. Diabetes Together combined eight informational and two skills-building sections over two workshops.
resultsOur guiding principles included: providing equal information on T2D to partners; improving couples' communication; shared goal-setting; discussion of diabetes fears; discussing couples' roles in diabetes self-management; and supporting couples' autonomy to identify and prioritise diabetes self-management strategies.Participants viewing Diabetes Together valued the couples-focus of the intervention, especially communication. Feedback resulted in several improvements throughout the intervention, for example, addressing health concerns and tailoring to the setting.
conclusionsUsing the PBA, our intervention was developed and tailored to our target audience. Our next step is to pilot the workshops' feasibility and acceptability.
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