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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).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Linguistic Nudging Group | Experimental | Receives communication training + preference app |
|
| Standard Care Group | Other | Receives routine diabetes management only |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Linguistic Nudging Training | Behavioral | Physicians receive 4-hour communication training to optimize shared decision-making using behavioral nudging techniques |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change in Glycated Hemoglobin (HbA1c) Level | Absolute change in HbA1c (%) from baseline to 6 months, measured by high-performance liquid chromatography (HPLC). Reflects average blood glucose control over 3 months. | Baseline and Month 6 |
| Diabetes Self-Management Capacity Scale Score | Composite score (0-100) based on validated 20-item scale assessing medication adherence, dietary control, physical activity, and blood glucose monitoring. Higher scores indicate better self-management capacity. | Baseline, Month 3, Month 6 |
| Shared Decision Making Questionnaire (SDM-Q-9) Score | Patient-reported evaluation of shared decision quality using 9-item Likert scale (0-45). Assesses physician-patient collaboration in treatment choices. Higher scores indicate better shared decision-making. | Baseline |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Wei WANG, M.D. | Contact | +8613939809540 | wwei19742007@hotmail.com | |
| Yunxuan Li, Master Candidate | Contact | +8613939809540 | yunxuanli@stu.xmu.edu.cn |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Xiang'an Hospital Affiliated to Xiamen University | Recruiting | Xiamen | Fujian | 0592361101 | China |
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| ID | Term |
|---|---|
| D003924 | Diabetes Mellitus, Type 2 |
| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
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| Medication Preference App | Device | Patients use WeChat-based mini-program to record daily medication preferences and concerns |
|
| Standard Diabetes Care | Other | Routine follow-up visits, HbA1c monitoring, and basic health education per hospital protocol |
|
| D004700 | Endocrine System Diseases |