{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T15:22:23Z","timestamp":1775488943290,"version":"3.50.1"},"reference-count":36,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T00:00:00Z","timestamp":1775433600000},"content-version":"unspecified","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"NGO Sant\u00e9 Diab\u00e8te"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,2,25]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess the effect of three educational interventions on self-management behaviours among individuals at risk of diabetes in Burkina Faso, Comoros and Mali, using cluster analysis to identify distinct respondent profiles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Single-arm before\u2013after longitudinal study with 6-month follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Community screening initiatives and antenatal clinics in Burkina Faso, Comoros and Mali.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>540 adults at risk of diabetes (body mass index \u226525\u2009kg\/m\u00b2 and\/or family history of diabetes and\/or impaired fasting glucose \u22651.10\u2009g\/L; mean age 38.2 years, 69% female) recruited through community screening initiatives and antenatal clinics in Burkina Faso, Comoros and Mali.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Three educational interventions: (1) social media video broadcasting, (2) peer educator outreach and (3) gestational diabetes education at antenatal clinics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>\n                      Changes in domain-specific Health Education Impact Questionnaire scores over 6 months assessed using Cohen\u2019s\n                      <jats:italic>d<\/jats:italic>\n                      effect sizes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 540 initial participants, 528 responded to the follow-up survey 6 months later. Cluster analysis revealed two distinct self-management profiles: cluster 1 showed significant improvement in only two domains, self-monitoring (d=0.35, p=0.006) and skill acquisition (d=0.30, p=0.020), indicating limited but focused gains. In contrast, cluster 2 suggested significant progress in seven out of eight domains, including large gains in positive engagement in life (d=0.74, p&lt;0.001) and health-directed activity (d=0.61, p&lt;0.001). Emotional distress decreased significantly in cluster 2 (d=-0.27, p=0.009), underscoring its greater responsiveness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Distinct self-management profiles among diabetes-risk populations revealed critical heterogeneity that demands tailored, context-specific public health strategies to effectively address diverse needs and optimise prevention efforts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-114924","type":"journal-article","created":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T14:10:27Z","timestamp":1775484627000},"page":"e114924","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Assessing self-management responses to educational interventions in at-risk diabetes population: a cluster-based longitudinal analysis"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4010-0236","authenticated-orcid":false,"given":"Nacanabo","family":"Relwend\u00e9","sequence":"first","affiliation":[{"name":"Biomedical and Public Health Department, Research Institute of Health Sciences, Ouagadougou, Burkina Faso"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moise","family":"Nguemeni","sequence":"additional","affiliation":[{"name":"NGO Sant\u00e9 Diab\u00e8te, Bamako, Mali"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kamouni","family":"Patricia","sequence":"additional","affiliation":[{"name":"Burkina Faso delegation of the NGO Sant\u00e9 Diab\u00e8te, Ouagadougou, Burkina Faso"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachmat Attoumane","family":"Ben Ali","sequence":"additional","affiliation":[{"name":"Union of the Comoros delegation of the Sant\u00e9 Diab\u00e8te NGO, Moroni, Comoros"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"St\u00e9phane","family":"Besan\u00e7on","sequence":"additional","affiliation":[{"name":"NGO Sant\u00e9 Diab\u00e8te, Bamako, Mali"},{"name":"Laboratoire MESuRS (Mod\u00e9lisation, \u00e9pid\u00e9miologie et surveillance des risques sanitaires) au Conservatoire National des Arts et M\u00e9tiers (Cnam), Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre Henri","family":"Moury","sequence":"additional","affiliation":[{"name":"TIMC, CIC-IT, 38000 Grenoble, France, Univ. 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