ArticleBMJ open2026
Assessing self-management responses to educational interventions in at-risk diabetes population: a cluster-based longitudinal analysis.
Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo assess the effect of three educational interventions on self-management behaviours among individuals at risk of diabetes in Burkina Faso, Comoros and Mali, using cluster analysis to identify distinct respondent profiles.
designSingle-arm before-after longitudinal study with 6-month follow-up.
settingCommunity screening initiatives and antenatal clinics in Burkina Faso, Comoros and Mali.
participants540 adults at risk of diabetes (body mass index ≥25 kg/m² and/or family history of diabetes and/or impaired fasting glucose ≥1.10 g/L; mean age 38.2 years, 69% female) recruited through community screening initiatives and antenatal clinics in Burkina Faso, Comoros and Mali.
interventionsThree educational interventions: (1) social media video broadcasting, (2) peer educator outreach and (3) gestational diabetes education at antenatal clinics. PRIMARY AND SECONDARY OUTCOME MEASURES: Changes in domain-specific Health Education Impact Questionnaire scores over 6 months assessed using Cohen's
resultsOf the 540 initial participants, 528 responded to the follow-up survey 6 months later. Cluster analysis revealed two distinct self-management profiles: cluster 1 showed significant improvement in only two domains, self-monitoring (d=0.35, p=0.006) and skill acquisition (d=0.30, p=0.020), indicating limited but focused gains. In contrast, cluster 2 suggested significant progress in seven out of eight domains, including large gains in positive engagement in life (d=0.74, p<0.001) and health-directed activity (d=0.61, p<0.001). Emotional distress decreased significantly in cluster 2 (d=-0.27, p=0.009), underscoring its greater responsiveness.
conclusionDistinct self-management profiles among diabetes-risk populations revealed critical heterogeneity that demands tailored, context-specific public health strategies to effectively address diverse needs and optimise prevention efforts.
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