Type 2 Diabetes Preventive Health Behaviors of Adults with Prediabetes:
[Thesis]
Morel L'Horset, Amy M.
A Mixed Methods Study
Lancaster, Kristie
New York University
2019
175
Ph.D.
New York University
2019
Prediabetes, a condition that denotes high risk for developing type 2 diabetes (T2DM), affects 1 in 3 American adults. People with prediabetes can reduce their risk of developing T2DM through preventive health behaviors that promote weight loss such as regular physical activity and healthy eating habits. Illness perceptions and treatment experiences have been linked to self-management behaviors in adults with T2DM, but these relationships have not been investigated among adults with prediabetes. The purpose of this study was to explore prediabetes treatment experiences and illness perceptions among adults with newly diagnosed (<10 months) and established prediabetes (>12 months) in relation to their self-reported preventive health behaviors and weight management outcomes. Using a mixed methods convergent design, 30 adults with new and established prediabetes participated in semi-structured interviews and completed standardized instruments measuring their diet and physical activity behaviors. We found three subgroups, each characterized by a unique treatment experience and illness perception profile (Self-directed, Watch and Wait, and Overwhelmed). Although groups were similar in demographic characteristics, they differed in their length of diagnosis, degree of active management of their condition, and weight outcomes. The Self-directed group took a more active role in their treatment experiences and had better weight management outcomes. The Watch and Wait and Overwhelmed groups took a less active role in their treatment experiences and were less successful in achieving weight management goals. More newly diagnosed individuals were characterized as Self-directed compared to established individuals. These findings suggest that differences in prediabetes illness perceptions and levels of patient activation may impact T2DM prevention efforts and weight management outcomes among adults with prediabetes. These results also highlight that self-directed efforts to prevent T2DM may diminish over time. Although larger scale research is needed to elucidate these findings, strategies to assess and modify illness perceptions and increase patient activation may be important in the treatment of prediabetes.