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April 8, 2026Open Access

Assessing self-management responses to educational interventions in at-risk diabetes population: a cluster-based longitudinal analysis

Puntos clave

To evaluate the effectiveness of three educational interventions on self-management behaviors in individuals at risk of diabetes.
Conducted a single-arm before-after longitudinal study with a 6-month follow-up.
Recruited 540 adults at risk of diabetes from community screenings and antenatal clinics in Burkina Faso, Comoros, and Mali.
Implemented three educational interventions: social media video broadcasting, peer educator outreach, and gestational diabetes education.
Used cluster analysis to identify distinct profiles of respondents based on their self-management behaviors.
Assessed changes in Health Education Impact Questionnaire scores using Cohen's d effect sizes.
Of the 540 participants, 528 completed the follow-up survey after 6 months.
Cluster analysis identified two distinct self-management profiles: Cluster 1 showed limited improvements in self-monitoring and skill acquisition.
Cluster 2 demonstrated significant progress across seven domains, with notable improvements in positive engagement (d=0.74) and health-directed activity (d=0.61).
Emotional distress significantly decreased in Cluster 2 (d=-0.27), highlighting its effectiveness.

Resumen

Objectives To 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. Design Single-arm before–after longitudinal study with 6-month follow-up. Setting Community screening initiatives and antenatal clinics in Burkina Faso, Comoros and Mali. Participants 540 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. Interventions Three 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 d effect sizes. Results Of 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. Conclusion Distinct 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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