Table 1.
Study characteristics of studies included in meta-analysis of psychological interventions to improve glycaemic levels in type 2 diabetes.
| Reference | Brief intervention description | WHAT (Target behavioural domain vs primary outcome) | WHY (type of psychological intervention) | Control group | WHO (provider of intervention) | HOW (Mode, format) | WHERE (country of recruitment) | WHEN and HOW MUCH (number of sessions, duration of intervention) | HOW WELL (fidelity of intervention reported)? |
|---|---|---|---|---|---|---|---|---|---|
| (25) | Empowerment (BATHE technique to increase diabetes self-efficacy) | Mood management vs psychological outcome | Counselling | Usual care | Physicians | Face to face, one-to-one | Europe | 3 sessions over 3 months | O |
| (26) | Behavioral intervention to increase physical activity and reduce sedentary time | Self-management target vs Self-management outcome | Counselling | Usual care | Diabetologists, exercise specialists | Face to face, one-to-one | Europe | 9 sessions over 3 years | O |
| (27) | Motivational interviewing intervention to promote diabetes behavior change to reach treatment goal HbA1c <7% | Self-management target vs HbA1c outcome | Counselling | Usual care | Clinicians (doctors, nurses, psychologists) | Telephone and face to face, one-to-one | Asia | 9 sessions over 12 months | O |
| (28) | Motivational interviewing intervention to promote diabetes behavior change and provide diabetes health education | Self-management target vs HbA1c outcome | Counselling | Enhanced usual care | Community health workers | Telephone and face to face, one-to-one | North America | Variable number of sessions over 12 months | P |
| (29) | Lifestyle nutrition intervention to increase physical activity | Self-management target vs HbA1c outcome | Counselling | Usual care | Dietician and physician | Face to face, one-to-one | Asia | 1 session over 2 weeks | O |
| (30) | Motivational interviewing intervention to improve diabetes self-management behaviors | Self-management target vs HbA1c outcome | Counselling | Diabetes education | Diabetes nurses | Face to face, one-to-one | Asia | Not reported | O |
| (31) | Value-based emotion-focused educational programme | Mood management vs psychological outcome | Counselling | Attention control | Nurse and physician | Face to face, group | Asia | 4 sessions over 6 weeks | O |
| (32) | Minimal psychological intervention (MPI) on improving psychological well-being | Mood management vs psychological outcome | Counselling | Usual care | Psychology assistants | Telephone, one-to-one | Asia | 4 sessions | O |
| (33) | Motivational interviewing intervention on diabetes regimen adherence. | Self-management target vs Self-management outcome | Counselling | Usual care | Diabetes nurse | Face to face, one-to-one | North America | 4-6 sessions over 3 months | P |
| (34) | Collaborative care model to treat community mental health centre (CMHC) people with psychosis and suboptimal glycaemic levels. | psychological target vs HbA1c outcome | Counselling | Usual care | Nurse case manager, psychiatrist, advanced practice nurse | Face to face, one-to-one | North America | 12 sessions over 9 months | O |
| (35) | Peer telephone intervention to enhance self-efficacy | Mood management vs psychological outcome | Counselling | Usual care | Diabetes nurses | Telephone, one-to-one | Europe | 6 sessions over 150 days | O |
| (36) | A cognitive-behavioral pedometer-based group intervention on physical activity and sedentary behavior | Self-management target vs Self-management outcome | CBT | Usual care | MSc level coaches (PE or clinical psychology) | Face to face, group | Europe | 5 sessions over 12 weeks | O |
| (37) | Pedometer-based physical activity program | Self-management target vs Self-management outcome | Counselling | Usual care | Clinical psychologist | Face to face, group | Europe | 3 sessions over 12 weeks | O |
| (38) | Telephone-Delivered Lifestyle Support with Action Planning and Motivational Interviewing Techniques to Improve Rehabilitation Outcomes | Self-management target vs Self-management outcome | Counselling | Usual care | Counsellors | Face to face, one-to-one | Europe | 12 sessions over 12 months | P |
| (39) | Telephone Delivered Weight Loss and Physical Activity Intervention | Self-management target vs Biomedical outcome | Counselling | Usual care | Counsellors | Telephone, one-to-one | Australia | 27 sessions over 18 months | P |
| (40) | Psychotherapy for depression via home telehealth | Mood management vs psychological outcome | CBT | Same-room treatment | Therapists with 5 years’ experience | Face to face, one-to-one | North America | 8 sessions over 8 weeks | P |
| (41) | Collaborative care intervention to reduce depressive symptoms | Mood management vs psychological outcome | CBT | Enhanced usual care | Primary care physicians, graduate social workers, diabetes depression clinical specialists | Telephone and face to face, one-to-one | North America | Variable number of sessions over 12 months | O |
| (42) | Group based cognitive behavioral therapy program to improve depression, anxiety and stress | Mood management vs psychological outcome | CBT | Waiting list control | Not reported | Face to face, group | Australia | 7 sessions over 3 months | O |
| (43) | Individualized diabetes education with tailored self-care plan (covering dietary modification, exercises programs, adherence to medications, self-monitoring of blood glucose and blood pressure, and psychological counselling) | Self-management target vs Biomedical outcome | Counselling | Group education | Nurses, clinical psychologists | Face to face, group | Asia | 3 sessions over 3 months | O |
| (44) | Nurse-led intervention to support people with type 2 diabetes with adherence to taking glucose lowering medication | Self-management target vs Self-management outcome | Counselling | Usual care | Clinical nurses | Face to face, one-to-one | Europe | 1 session over 1 day | P |
| (45) | Novel model of care (“Stepping Up”) intervention in normalising insulin initiation for type 2 diabetes | Self-management target vs HbA1c outcome | Counselling | Usual care | Registered nurses | Face to face, one-to-one | Australia | Variable number of sessions over 12 months | O |
| (46) | Culturally sensitive family-oriented intervention to discuss family or other psychosocial factors that could interfere with their diabetes control. | psychological target vs HbA1c outcome | Counselling | Usual care | Healthcare team | Face to face, family | South America | 4 sessions over 12 months | O |
| (47) | Family social support to stimulate dialogue between person with diabetes and family to increase interest and assistance in achieving diabetes self-management goals | Self-management target vs HbA1c outcome | Counselling | Education | Family | Telephone, family | South America | 4 sessions over 9 months | O |
| (48) | Acceptance and commitment therapy to improve diabetes self-management | Self-management target vs HbA1c outcome | CBT | Education alone | Psychologist | Face to face, group | North America | 1 session over 1 day | O |
| (49) | Theory-based behavior change intervention to improve physical activity, dietary change, medication adherence and smoking cessation | Self-management target vs Self-management outcome | Counselling | Intensive treatment alone | Lifestyle facilitator | Telephone and face to face, one-to-one | Europe | 8 sessions over 1 year | P |
| (50) | Mindfulness-Based Stress-Reduction Intervention | Mood management vs psychological outcome | Counselling | Usual care | Psychologist, resident in internal medicine | Face to face, group | Europe | 8 sessions over 8 weeks | O |
| (51) | Videophone Motivational Diabetes Self-Management Intervention | Self-management target vs HbA1c outcome | Counselling | Attentional control | Nurse practitioner | Telephone, one-to-one | North America | 12 sessions over 3 months | P |
| (52) | Diabetes-Specific Cognitive Behavioral Treatment Program (DIAMOS) for Patients with Diabetes and Subclinical Depression | Mood management vs psychological outcome | CBT | Diabetes education | Psychologist | Face to face, group | Europe | 5 sessions over variable time period | O |
| (53) | A self-management-oriented education programme (MEDIAS 2 BSC) for people with Type 2 diabetes who are on a non-intensive insulin treatment regimen | Self-management target vs HbA1c outcome | Counselling | Diabetes education | Diabetes educators | Face to face, group | Europe | 6 sessions over 6 weeks | O |
| (54) | Motivational enhancement therapy plus cognitive behavior therapy on depressive symptoms and health-related quality of life in adults with type 2 diabetes | psychological target vs HbA1c outcome | CBT | Usual care | Psychotherapist, clinical nurse | Face to face, group | Asia | 12 sessions over 3 months | O |
| (55) | Nurse-led motivational interviewing plus cognitive behavioral therapy intervention to change and address barriers to diabetes self-management behaviors | Self-management target vs HbA1c outcome | Counselling | Usual care | Nurses | Face to face, one-to-one | Europe | 12 sessions over 12 months | P |
| (56) | Lifestyle counselling based on motivational interviewing principles to improve diabetes care | Self-management target vs HbA1c outcome | Counselling | Usual care | Primary care nurse | Face to face, one-to-one | Europe | 5-8 sessions over 6 months | O |
| (57) | Care intervention including dietary intervention, exercise intervention, and psychology intervention | Self-management target vs HbA1c outcome | Counselling | Usual care | Dieticians, psychologists | Telephone and face to face, group | Asia | 12 sessions over 12 months | O |
| (58) | Self-determination intervention for general practice nurses to improve care in people with type 2 diabetes | Self-management target vs HbA1c outcome | Counselling | Usual care | General practitioner nurses | Face to face, one-to-one | Europe | Not reported | O |
| (59) | Theory-based health promotion intervention to improve health behavior | Self-management target vs Biomedical outcome | Counselling | Usual care | Dietician, occupational therapist | Face to face, group | Europe | 6 sessions over 6 months | O |
| (60) | Tailored, supportive intervention strategy to increasing self-efficacy and improving illness perceptions in people with type 2 diabetes shortly after a first acute coronary event. | Mood management vs psychological outcome | Counselling | Attentional control | Diabetes nurses | Face to face, one-to-one | Europe | 3 sessions over 2.5 months | O |
| (61) | Self-management program for Thais with type 2 diabetes | Self-management target vs HbA1c outcome | CBT | Diabetes education | Diabetes researcher | Face to face, group | Asia | 5 sessions over 2 weeks | O |
| (62) | Psychological Family Intervention to improve diabetes self-management and mobilise family support | Self-management target vs HbA1c outcome | Counselling | Usual care | Health psychologist | Face to face, family | Europe | 3 sessions over 3 weeks | O |
| (63) | Community-based, culturally tailored, multimodal behavioral intervention in an ethic/linguistic minority group with type 2 diabetes | Self-management target vs HbA1c outcome | Counselling | Education only | Nurses, community health workers | Face to face, group | North America | 6 sessions over 6 weeks | P |
| (64) | Nurse-administered minimal psychological intervention for depressive symptoms | mood management vs psychological outcome | CBT | Usual care | Primary care nurse | Face to face, one-to-one | Europe | Variable number of sessions over variable time period | P |
| (65) | Motivational interviewing intervention focused on behavior change | Self-management target vs HbA1c outcome | Counselling | Diabetes education | Therapist | Face to face, one-to-one | Asia | 4 sessions over 6 months | O |
| (66) | Music therapy to improve diabetes self-management | Self-management target vs HbA1c outcome | CBT | Diabetes education | Music therapist | Face to face, group | North America | 4 sessions over 8 weeks | P |
| (67) | Culturally relevant group diabetes self-management training (DSMT), coping skills training (CST), and diabetes care intervention | Self-management target vs HbA1c outcome | CBT | Usual care | Diabetes nurses | Face to face, group | North America | 11 sessions over 11 weeks | P |
| (68) | Group motivational interviewing therapy to promote positive lifestyle changes | Self-management target vs HbA1c outcome | Counselling | Wait-list control | Psychiatrist | Face to face, group | Asia | 4 sessions over 4 weeks | O |
| (69) | A brief culturally tailored intervention for Puerto Ricans with type 2 diabetes to promote health behavior change | Self-management target vs Self-management outcome | Counselling | Usual care | Medical assistant (trained by diabetes educator) | Face to face, one-to-one | North America | 1 session over 1 day | O |
| (70) | Psychoeducational Intervention (SWEEP) for Depressed Women with Diabetes | Mood management vs psychological outcome | CBT | Usual care | CBT trained nurse | Face to face, group | North America | 8 sessions over 8 weeks | P |
| (71) | Cognitive behavioral therapy people with diabetes and depression | psychological target vs HbA1c outcome | CBT | Sertraline treatment + usual care | Clinical psychologist | Face to face, group | Europe | 10 sessions over 12 weeks | O |
| (72) | Psychoeducation and physical exercise for people with type 2 diabetes and subsyndromal depression. | Mood management vs psychological outcome | CBT | Enhanced usual care | Psychologist | Face to face, group | Europe | 6 sessions over 6 weeks | O |
| (73) | Telephonic counselling plus walking for depressed people with type 2 diabetes | psychological target vs HbA1c outcome | CBT | Enhanced usual care | Nurse | Telephone, one-to-one | North America | 12 sessions over 12 months | P |
| (74) | Motivational interviewing intervention to improve medication adherence | Self-management target vs HbA1c outcome | Counselling | Usual care | Diabetes nurses, pharmacists | Telephone and face to face, one-to-one | North America | 6 sessions over 18 months | P |
| (75) | Theory-based intervention to increase physical activity in adults with type 2 diabetes | Self-management target vs HbA1c outcome | Counselling | Physical activity education materials | Individuals with a degree in physical activity promotion/counselling | Telephone, one-to-one | North America | 22 sessions over 18 months | O |
| (76) | Problem-solving therapy for adults with diabetic retinopathy and diabetes specific distress | Mood management vs psychological outcome | CBT | Usual care | Research assistant trained in problem solving therapy | Telephone and face to face, one-to-one | Australia | 8 sessions over variable time period | O |
| (77) | A brief telephone coaching intervention to promote diabetes self-management | Self-management target vs Self-management outcome | Counselling | Usual care | Undergraduate psychologist | Telephone, one-to-one | North America | 18 sessions over 6 months | O |
| (78) | Cognitive behavioral therapy for medication adherence and depression | Self-management target vs Self-management outcome | CBT | Enhanced usual care | Therapist | Face to face, one-to-one | North America | 9-12 sessions over 4 months | O |
| (79) | Acceptance and Commitment Therapy for type 2 diabetes management | Self-management target vs HbA1c outcome | CBT | Education with routine treatment | Clinical psychologist | Face to face, group | Asia | 10 sessions over 3 months | O |
| (80) | Self-monitoring blood glucose intervention | Self-management target vs HbA1c outcome | Counselling | Non-standardised counselling | Physician | Face to face, one-to-one | Europe | 4 sessions over 24 weeks | O |
| (81) | Self-management intervention for type 2 diabetes | Self-management target vs psychological outcome | Counselling | Usual care | Diabetes specialist nurses, dieticians | Face to face, group | Europe | 5 sessions over 5 weeks | O |
| (82) | Mindfulness-based cognitive therapy for people with diabetes and emotional problems | Mood management vs psychological outcome | CBT | Usual care | Psychologist | Face to face, group | Europe | 8 sessions over 8 weeks | O |
| (83) | Stress management intervention for Latinos with type 2 diabetes | Mood management vs psychological outcome | Counselling | Diabetes education; | Community health worker | Face to face, one-to-one | North America | 8 sessions over 10 weeks | P |
| (84) | Motivational interviewing diabetes self-management education intervention to improve behavior change | Self-management target vs HbA1c outcome | Counselling | Diabetes self-management education | Diabetes educators | Face to face, one-to-one | North America | 4 sessions over 6 months | P |
| (85) | Individualised cognitive behavioral treatment to promote behavior change | Self-management target vs Biomedical outcome | CBT | Usual care | Diabetes nurse, dietician | Face to face, one-to-one | Europe | 3-6 sessions over variable time period | P |
| (86) | Motivational interviewing to improve weight loss | Self-management target vs Biomedical outcome | Counselling | Attention control | Clinical psychologist | Face to face, one-to-one | North America | 5 sessions over 12 months | P |
| (87) | Nurse-coaching intervention for women with type 2 diabetes to integrate diabetes self-management into their daily lives | Self-management target vs Self-management outcome | Counselling | Usual care | Nurses | Face to face, one-to-one | North America | 6 sessions over 6 months | O |
| (88) | Collaborative treatment for depression and diabetes | psychological target vs HbA1c outcome | CBT | Usual care | Depression clinical specialist | Face to face, one-to-one | North America | 7 sessions over variable time period | O |
| (89) | Integrative health coaching for people with type 2 diabetes | Self-management target vs Self-management outcome | Counselling | Usual care | MSc level coaches (in social work or psychology) | Face to face, one-to-one | North America | 14 sessions over 6 months | O |
| (90) | Cognitive behavioral therapy focusing on depression and anxiety | Mood management vs psychological outcome | CBT | Usual care | IAPT practitioners | Face to face, group | Europe | 6 sessions over 6 weeks | O |
*CBT, cognitive behavioral therapy; IPT, Interpersonal psychotherapy NR, not reported.