Motivational and behaviour change approaches for improving diabetes management

Abstract

Effective diabetes management requires both good clinical care, and good self‐management by the person with diabetes to achieve optimal health outcomes. Both diabetes‐specific behaviours, and lifestyle behaviours need to be addressed. Self‐management is challenging, due to the characteristics of diabetes, a condition which can be unpredictable, variable over the lifespan, lifelong, and often psychologically demanding, requiring knowledge, confidence, motivation and behaviour change skills to maintain optimal control. Health professionals can support people to self‐manage more effectively if they have psychological skills to promote motivation and to support behaviour change. This review summarises some of the skills needed by people with diabetes and by health professionals to support self‐management, including person‐centred working and ‘MAP’ motivational, action and prompting behaviour change techniques. The review takes a critical look at motivational and behavioural interventions and their outcomes, in the wider context of the process of behaviour change. We look at evidence for effectiveness of motivational approaches – from the perspective of the patient outcomes and health practitioner training required. We also evaluate behaviour change interventions which use ‘action‐based’ approaches, followed by suggestions for longer‐term, sustainable models of training.