The impact of a culturally tailored telehealth education programme on glucose management and self-care behaviours in Jordanian adults living with type 2 diabetes: a randomised controlled trial

The prevalence of type 2 diabetes mellitus (T2DM) in Jordan is a significant public health challenge, with glucose management frequently remaining suboptimal. The aim was to assess the impact of a culturally tailored telehealth education programme on glycemic management and self-care behaviours in Jordanian adults with T2D M. We conducted a two-arm, parallel-group, randomised controlled trial in outpatient diabetes clinics in Amman, Jordan. A total of 104 adults with elevated HbA1c levels (HbA1c 7.5–11%) were randomized (1:1) to either a 6-month intervention or standard care (control). The low-burden intervention consisted of educational content via WhatsApp broadcasts and personalised telephonic coaching for goal-setting. The primary outcome was the change in HbA1c whereas secondary included self-care behaviours, medication adherence, diabetes knowledge, and diabetes fatalism, as well as patient acceptability with the intervention. A total of 92 of 104 randomised participants (88%) completed the 6-month follow-up. The intervention group demonstrated a more pronounced mean reduction in HbA1c compared to the control group (-1.1% ± 1.1% vs. -0.2% ± 1.2%; adjusted mean difference − 0.9%, 95% CI -1.3 to -0.5; P < 0.001). This clinical improvement coincided with marked improvements in psychosocial and behavioural measures. Culturally grounded fatalistic beliefs were significantly reduced in the intervention group ( P < 0.001), and diabetes knowledge scores increased substantially ( P < 0.001). The proportion of participants with low medication adherence decreased from 64% to 20% in the intervention group, compared to a minimal change in the control group (68% to 62%) ( P < 0.001). Self-care activities, particularly for general diet and blood glucose monitoring, also improved markedly (both P < 0.001). A culturally tailored telehealth education programme was successful in improving glycemic management and key psychosocial and behavioural outcomes among Jordanian adults with T2DM. Randomized Controlled Trials with Registration No. ISRCTN81615946; Date 9th February 2026; retrospectively registered. Trial registration.