Nudge-Based Shared Decision Making and Self-Management in Type 2 Diabetes: A Randomized Trial

Conditions studied

Diabetes Mellitus, Type 2, Physician-Patient Relations, Self-management

About this study

This study aims to test whether a communication strategy called "linguistic nudging" can help doctors and patients with type 2 diabetes make better treatment decisions together, and whether this improves patients' ability to manage their condition. What will happen in the study? - 250 adults with type 2 diabetes from Xiang'an Hospital (Xiamen) will be randomly assigned to one of two groups: Intervention group:Doctors will receive special training in "linguistic nudging" techniques to encourage shared decision-making. Patients will use a mobile app to record medication preferences, and doctors will adjust advice based on these preferences. Control group:Patients will receive standard diabetes care without these additional strategies. \- All participants will be followed for 6 months. What is the study aiming to find out? The main goal is to see if patients in the intervention group: Better follow medication plans Improve blood sugar monitoring Have better blood sugar control Feel more satisfied with doctor-patient communication Why is this important? Good self-management is key to controlling diabetes, but many patients struggle with it. Effective communication during shared decision-making may empower patients to manage their condition day-to-day with greater confidence. Patient safety and rights: Participation is completely voluntary All personal information will be kept strictly confidential Medical support will be provided if any health problems occur during the study Participants may withdraw at any time This research has been approved by the Ethics Committee of Xiang'an Hospital (Approval date: October 2025).

Interventions

• Behavioral: Linguistic Nudging Training — Physicians receive 4-hour communication training to optimize shared decision-making using behavioral nudging techniques
• Device: Medication Preference App — Patients use WeChat-based mini-program to record daily medication preferences and concerns
• Other: Standard Diabetes Care — Routine follow-up visits, HbA1c monitoring, and basic health education per hospital protocol

Primary outcomes

• Change in Glycated Hemoglobin (HbA1c) Level (Baseline and Month 6)
• Diabetes Self-Management Capacity Scale Score (Baseline, Month 3, Month 6)
• Shared Decision Making Questionnaire (SDM-Q-9) Score (Baseline)

Eligibility information

Study locations

• Xiang'an Hospital Affiliated to Xiamen University, Xiamen, Fujian 0592361101 China