Motivating Self-Care and Enhancing Treatment Adherence in Elderly Type 2 Diabetes: An Extended Parallel Process Model Intervention.

Background: This study aimed to examine the effectiveness of an intervention based on the Extended Parallel Process Model (EPPM) in improving treatment adherence and self-care among elderly individuals with type 2 diabetes. Methods: This randomized clinical trial was conducted among 70 elderly individuals with type 2 diabetes attending the Deziani Diabetes Clinic in Gorgan, Iran, during 2022. Participants were aged 60 years or older and capable of participating in the study. They were randomly assigned to either an intervention or a control group. The intervention was delivered over 5 weeks, and a posttest was conducted 4 weeks after the final session. Results: The Mann-Whitney U test revealed a statistically significant difference in treatment adherence between the intervention and control groups (U = -5.78, p = 0.01). The intervention group showed higher treatment adherence (mean = 102.91 SD = 6.67) than the control group (mean = 88.51, SD = 10.63), with a confidence interval of 11.18, a p-value of 0.001, and an effect size of η = 0.61 (p < 0.01), indicating that approximately 61% of the posttest variance was attributable to the intervention. There was a significant difference between total self-care scores after the intervention (t = 6.66, p = 0.01, CI: 8.31, 15.4). These findings suggest that the EPPM-based intervention effectively improved treatment adherence among elderly individuals with type 2 diabetes. Conclusion: The EPPM-based educational intervention significantly improved treatment adherence and self-care among elderly patients with type 2 diabetes. These results support the integration of the EPPM framework into diabetes education and management programs.