WhatsApp-Based Education Program for Stroke Patients
WEPS-P
The Effect of WhatsApp-Supported Education and Counseling on Healthy Lifestyle Behaviors, Glycemic Control, and Knowledge Levels in Patients With Stroke
2 other identifiers
interventional
84
0 countries
N/A
Brief Summary
Stroke is one of the leading causes of death and disability worldwide, with type 2 diabetes mellitus (T2DM) being a major risk factor that doubles the risk of ischemic stroke. Glycemic dysregulation is observed in nearly two-thirds of patients after acute stroke and is associated with both the severity of the initial cerebrovascular event and the risk of recurrence. Effective glycemic control, patient education, and adherence to treatment are therefore critical for secondary stroke prevention and improved patient outcomes. Mobile health technologies, particularly social media applications, have become increasingly important in supporting chronic disease management. WhatsApp-based education has been shown to improve self-efficacy, self-management, and diabetes knowledge in patients with T2DM. However, there is a limited number of studies investigating the effect of WhatsApp-supported education and counseling on stroke patients with T2DM, especially regarding healthy lifestyle behaviors, glycemic control, and disease-related knowledge. This randomized controlled trial aims to evaluate the effect of WhatsApp-supported education and counseling on healthy lifestyle behaviors, glycemic control, and knowledge levels among stroke patients receiving insulin therapy. Participants will be randomly assigned to either the intervention group or the control group. The control group will receive routine face-to-face diabetes education and insulin injection training during hospitalization. The intervention group will receive the same routine education plus a structured WhatsApp-based diabetes education program over four weeks. Educational content will include videos, photos, and booklets focusing on diabetes definition and symptoms, complications, hypoglycemia and hyperglycemia management, foot care, nutrition, exercise, oral antidiabetic and insulin therapy, and insulin injection demonstration. Participants' questions will be answered through WhatsApp messages, supporting continuous learning and adherence after discharge. A total of 84 participants (42 per group) will be included, based on power analysis with a 5% significance level, 95% power, and accounting for a 10% dropout rate. Randomization will be conducted using block randomization with six combinations via an independent researcher through an online randomization tool. Data will be collected at baseline (T0) and six months after the intervention (T1). The primary outcomes include diabetes knowledge measured by the Revised Diabetes Knowledge Test-2, healthy lifestyle behaviors assessed using the Healthy Lifestyle Behavior Scale, and glycemic control parameters (fasting glucose, fasting insulin, HbA1c, and HOMA-IR). All assessments will be performed by a trained nurse in the stroke clinic. Data analysis will include descriptive statistics, parametric or non-parametric tests depending on distribution, and reliability analyses using Cronbach's alpha. Ethical approval has been obtained from the Ethics Committee of SBÜ Gaziler Physical Training and Rehabilitation Research Hospital (Approval No: E-34215015). This study is expected to demonstrate that WhatsApp-supported education and counseling improve patient knowledge, promote healthy lifestyle behaviors, and enhance glycemic control in stroke patients with T2DM. These findings may support the integration of digital counseling interventions into rehabilitation programs for secondary prevention and long-term disease management.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P50-P75 for not_applicable
Started Oct 2025
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
September 25, 2025
CompletedFirst Posted
Study publicly available on registry
October 6, 2025
CompletedStudy Start
First participant enrolled
October 15, 2025
CompletedPrimary Completion
Last participant's last visit for primary outcome
August 15, 2026
ExpectedStudy Completion
Last participant's last visit for all outcomes
November 15, 2026
October 6, 2025
August 1, 2025
10 months
September 25, 2025
October 2, 2025
Conditions
Keywords
Outcome Measures
Primary Outcomes (6)
Change in Diabetes Knowledge
Assessed using the Revised Diabetes Knowledge Test-2 (23 items). Scores range from 0 to 23, with higher scores indicating greater diabetes knowledge.
Baseline (T0) and 6 months after intervention (T1)
Change in HbA1c
Laboratory value HbA1c (%). Lower levels indicate better glycemic control.
Baseline (T0) and 6 months after intervention (T1)
Change in Healthy Lifestyle Behaviors
Measured by the Healthy Lifestyle Behavior Scale (34 items, 5-point Likert). Scores range from 0-100, with higher scores reflecting healthier lifestyle behaviors
Baseline (T0) and 6 months after intervention (T1)
Change in fasting glucose
Laboratory value: fasting glucose (mg/dL). Measurement of blood glucose levels after at least 8 hours of fasting. Lower values indicate better glycemic control.
Baseline (T0) and 6 months after intervention (T1)
Change in fasting insulin
Laboratory value: fasting insulin (µIU/mL). Measurement of circulating insulin levels after at least 8 hours of fasting. Lower levels indicate improved insulin sensitivity and better glycemic control.
Baseline (T0) and 6 months after intervention (T1)
Change in HOMA-IR
Laboratory value: HOMA-IR (Homeostatic Model Assessment of Insulin Resistance). Calculated from fasting glucose and fasting insulin using the formula: HOMA-IR=Fasting Glucose (mg/dL)×Fasting Insulin (µIU/mL):405 Higher values indicate greater insulin resistance, whereas lower values reflect better glycemic control.
Baseline (T0) and 6 months after intervention (T1)
Study Arms (2)
control group
ACTIVE COMPARATORParticipants in the control group will receive routine face-to-face diabetes education and insulin injection training provided during hospitalization. The education is delivered verbally to patients and their caregivers by the clinical staff. After the follow-up period and data collection are completed, participants in the control group will also be offered access to the WhatsApp-based educational materials used in the intervention group.
WhatsApp-based education group
EXPERIMENTALParticipants in the intervention group will receive the same routine face-to-face diabetes education and insulin injection training as the control group, plus a structured WhatsApp-based educational program. The WhatsApp intervention will be delivered over four weeks and include booklets/brochures, photos, and videos on diabetes definition and symptoms, complications, recognition and management of hypoglycemia and hyperglycemia, foot care, nutrition, exercise, oral antidiabetic and insulin therapy, and insulin injection demonstration. Participants' questions will be answered through WhatsApp to provide interactive support.
Interventions
Participants in the intervention group will receive the same routine face-to-face diabetes education and insulin injection training as the control group, plus a structured WhatsApp-based educational program. The WhatsApp intervention will be delivered over four weeks and include booklets/brochures, photos, and videos on diabetes definition and symptoms, complications, recognition and management of hypoglycemia and hyperglycemia, foot care, nutrition, exercise, oral antidiabetic and insulin therapy, and insulin injection demonstration. Participants' questions will be answered through WhatsApp to provide interactive support.
Participants in the control group will receive routine face-to-face diabetes education and insulin injection training provided during hospitalization. The education is delivered verbally to patients and their caregivers by the clinical staff. After the follow-up period and data collection are completed, participants in the control group will also be offered access to the WhatsApp-based educational materials used in the intervention group.
Eligibility Criteria
You may qualify if:
- Adults aged 18 years and older
- Diagnosis of ischemic stroke
- Mini-Mental Test (MMT) score \> 18
- Receiving insulin therapy for type 2 diabetes mellitus (T2DM)
- Ability to use WhatsApp on a smartphone (participant or caregiver)
- Willingness to provide informed consent
You may not qualify if:
- Presence of major organ failure
- Development of severe T2DM-related complications (e.g., diabetic foot, nephropathy, cardiovascular disease)
- Cognitive or communication impairments preventing participation
Contact the study team to confirm eligibility.
Sponsors & Collaborators
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Central Study Contacts
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- NONE
- Purpose
- OTHER
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- Ph.D.
Study Record Dates
First Submitted
September 25, 2025
First Posted
October 6, 2025
Study Start
October 15, 2025
Primary Completion (Estimated)
August 15, 2026
Study Completion (Estimated)
November 15, 2026
Last Updated
October 6, 2025
Record last verified: 2025-08
Data Sharing
- IPD Sharing
- Will not share