The use of health services by the participants in this study did not change during Time 2, but decreased by
Time 3. It is clear that the behavioral change might need time to take effect. The SEEIP assisted the patients to maintain
healthy self-care behavior, seek support, solve problems, and make an action plan and represented an improvement over
traditional health education for persons with diabetes. This study suggested that the self-efficacy model should be incorporated into the design of patient education, as it effectively provides support-based interventions to groups rather than individuals.