Effectiveness of Motivational Interviewing on Improving Care for Type 2 Diabetes Mellitus Patients in China

This RCT was implemented from May 2016 to April 2017 in Shenzhen, China. Shenzhen is the fourth‐biggest city in China, with a rapidly expanding population of 12 million people and the highest GDP in the country. Most DM patients in China are managed at Endocrine Specialist hospital clinics, while the more stable patients are treated in the community. Therefore, we chose an endocrine specialist outpatient clinic and a family medicine clinic at the University of Hong Kong‐Shenzhen Hospital (HKU‐SZH), as well as three community health centers in the Luohu district as the sampling frame. DM patients were recruited by doctors at consultations. This is because health education lectures are one of the routine diabetes management strategies used by healthcare providers in China and patients are normally invited by their doctors to attend these lectures. Sample size estimation was calculated based on the previous published research conducted elsewhere in which the DM patients were given MI‐guided behavior change counselling. The "Problem Areas in Diabetes" (PAID) score in that study was 29±22.64 in the intervention group vs. 29±24.32 in the control group. Therefore, 192 participants were needed to detect 10% effect size with an alpha of 0.05 and a power of 80.0%. With 15% of loss to follow‐up anticipated, a total of 225 participants were targeted. Descriptive statistics were used to summarize characteristics of the participants. We analyzed the baseline data of the intervention and control groups to determine the consistency of the characteristics across the two groups of patients. The t‐test was used for continuous variables such as waist circumference, body weight, and BMI, whereas chi‐squared test was used for categorical variables in stages of change such as smoking, drinking, and exercise. Changes in PAID and PEI in post‐intervention and follow‐ups between the two groups were calculated and tested. When analyzing the two sets of variables in the intervention and control groups, we followed the principle of intent‐to‐treat analysis i.e. if the participant failed to participate in all four modules, the first questionnaire results would be assumed and analyzed as the final data, using the mixed design analysis of variance. In detecting the relationship between the continuity variable and categorical variable, we used bivariate correlation analyses. All analyses were performed in SPSS 20.0. We used p value<0.05 as the cut‐off point of statistical significance.