Backgrounds and Aims Lifestyle changes to healthy diet (HD) and habitual physical activity (HPA) are recommended in type 2 diabetes mellitus (T2DM). Yet for most people with diabetes, there are may be difficulties to start the path of change. Such lifelong process requires the acquisition of knowledge and a change of attitudes and perceptions to adapt to life events. The aim of the present study was to investigate the stage of change, according to Prochaska’s model, towards healthier lifestyles and the psychological factors associated with motivation in T2DM patients attending tertiary centers for the assessment and treatment of diabetes, as a prerequisite to improve strategies to implement behavior changes in the population. Methods 1,353 consecutive outpatients with T2DM attending 12 diabetes units completed the validated EMME-3 questionnaire, consisting of two parallel sets of instruments to define the stage of change for HD and HPA, respectively. Logistic regression analysis was used to determine the factors associated with stages that may hinder behavioral changes. Results A prevalent stage of change favoring change to healthier behaviors was more common in the area of HD than HPA, with higher scores in action and maintenance. Differences were observed in relation to gender, age and duration of disease. After adjustment for confounders, resistance to change to HD was associated with higher BMI. Resistance to HPA also increased with BMI and decreased with education level . Conclusion Changing lifestyle, particularly in the area of HPA, is not perceived as an essential part of treatment by many subjects with T2DM. This evidence must be considered when planning behavioral programs. Specific interventions are needed to promote adherence to HPA.
Stage of change and motivation to healthy diet and habitual physical activity in type 2 diabetes.
TRENTO, Marina;
2014-01-01
Abstract
Backgrounds and Aims Lifestyle changes to healthy diet (HD) and habitual physical activity (HPA) are recommended in type 2 diabetes mellitus (T2DM). Yet for most people with diabetes, there are may be difficulties to start the path of change. Such lifelong process requires the acquisition of knowledge and a change of attitudes and perceptions to adapt to life events. The aim of the present study was to investigate the stage of change, according to Prochaska’s model, towards healthier lifestyles and the psychological factors associated with motivation in T2DM patients attending tertiary centers for the assessment and treatment of diabetes, as a prerequisite to improve strategies to implement behavior changes in the population. Methods 1,353 consecutive outpatients with T2DM attending 12 diabetes units completed the validated EMME-3 questionnaire, consisting of two parallel sets of instruments to define the stage of change for HD and HPA, respectively. Logistic regression analysis was used to determine the factors associated with stages that may hinder behavioral changes. Results A prevalent stage of change favoring change to healthier behaviors was more common in the area of HD than HPA, with higher scores in action and maintenance. Differences were observed in relation to gender, age and duration of disease. After adjustment for confounders, resistance to change to HD was associated with higher BMI. Resistance to HPA also increased with BMI and decreased with education level . Conclusion Changing lifestyle, particularly in the area of HPA, is not perceived as an essential part of treatment by many subjects with T2DM. This evidence must be considered when planning behavioral programs. Specific interventions are needed to promote adherence to HPA.
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