Application of Pender's Health Promotion Model for Healthy Dietary Practice Promotion Among Type 2 Diabetes Mellitus Patients: A Quasi-Experimental Study in Lalitpur District, Nepal.

Background and Aims: Type 2 Diabetes Mellitus (T2DM) is a serious public health issue that is considered the leading cause of death. However, it can be controlled and treated with simple interventions, including good dietary practices. This study aims to assess the effect of a diabetes management self-care program on dietary practices among patients with T2DM seeking health services at diabetes and thyroid centers in Lalitpur, Nepal. Methods: The quasi-experimental study was conducted in three phases. The first phase employed a cross-sectional, quantitative survey to assess the existing status of dietary practices among patients with T2DM. The second phase was the development of the program. Based on Pender's health promotion model, the Diabetes Self-management Program (DSMP) was designed following the P-process of strategic communication. The third phase involves the post-test in the control group, during which quantitative data were collected. Results: Wilcoxon Signed Rank-test, and there were no statistically significant differences between the intervention and control group in the pretest score of Pender's Health Promotion Model (PHPM) related variables, perceived benefits, perceived barriers, perceived self-efficacy, social support, situational influence, and attitudes towards healthy dietary practice. After 1 month of intervention, the Mann-Whitney U-test was applied to examine the difference between the intervention and control groups, and it found identical significance in perceived barriers, social support, and attitudes with PHPM at p < 0.01. Conclusion: The DSMP was found to be effective in changing attitudes toward dietary practices and perceived behavioral control over good nutritional practices, which were considered responsible for the increase in good dietary practice intention in the intervention group compared to the control group. Thus, the practices are not only standard but also play a fundamental role in the effective management of diabetes mellitus, complementing pharmacological and lifestyle interventions.