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, it may be difficult to start changing. We investigated the stage of change toward healthier lifestyles according to Prochaska's model, and the associated psychological factors in T2DM patients, as a prerequisite to improve strategies to implement behavior changes in the population. A total of 1,353 consecutive outpatients with T2DM attending 14 tertiary centers for diabetes treatment 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 was used to determine the factors associated with stages that may hinder behavioral changes. A stage of change favoring progress to healthier behaviors was more common in the area of HD than in 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 toward HD was associated with higher body mass index (BMI) (odds ratio (OR) 1.05; 95 % confidence interval (CI) 1.02-1.08). Resistance to improve HPA also increased with BMI (OR 1.06; 95 % CI 1.03-1.10) and decreased with education level (OR 0.74; 95 % CI 0.64-0.92). 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, and 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 / E., Centis; M., Trento; DEI CAS, Alessandra; Pontiroli, A. E.; P., De Feo; A., Bruno; Sasdelli, A. S.; F., Arturi; F., Strollo; S., Vigili De' Kreutzenberg; C., Invitti; P., Di Bonito; M., Di Mauro; G., Pugliese; A., Molteni; G., Marchesini. - In: ACTA DIABETOLOGICA. - ISSN 0940-5429. - 51 (4):(2014), pp. 559-566. [doi: 10.1007/s00592-013-0551-1]

Stage of change and motivation to healthy diet and habitual physical activity in type 2 diabetes.

DEI CAS, Alessandra;
2014-01-01

Abstract

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, it may be difficult to start changing. We investigated the stage of change toward healthier lifestyles according to Prochaska's model, and the associated psychological factors in T2DM patients, as a prerequisite to improve strategies to implement behavior changes in the population. A total of 1,353 consecutive outpatients with T2DM attending 14 tertiary centers for diabetes treatment 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 was used to determine the factors associated with stages that may hinder behavioral changes. A stage of change favoring progress to healthier behaviors was more common in the area of HD than in 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 toward HD was associated with higher body mass index (BMI) (odds ratio (OR) 1.05; 95 % confidence interval (CI) 1.02-1.08). Resistance to improve HPA also increased with BMI (OR 1.06; 95 % CI 1.03-1.10) and decreased with education level (OR 0.74; 95 % CI 0.64-0.92). 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, and specific interventions are needed to promote adherence to HPA.
2014
Stage of change and motivation to healthy diet and habitual physical activity in type 2 diabetes / E., Centis; M., Trento; DEI CAS, Alessandra; Pontiroli, A. E.; P., De Feo; A., Bruno; Sasdelli, A. S.; F., Arturi; F., Strollo; S., Vigili De' Kreutzenberg; C., Invitti; P., Di Bonito; M., Di Mauro; G., Pugliese; A., Molteni; G., Marchesini. - In: ACTA DIABETOLOGICA. - ISSN 0940-5429. - 51 (4):(2014), pp. 559-566. [doi: 10.1007/s00592-013-0551-1]
File in questo prodotto:
File Dimensione Formato  
Centis-Motivation.pdf

non disponibili

Tipologia: Documento in Post-print
Licenza: NON PUBBLICO - Accesso privato/ristretto
Dimensione 665.88 kB
Formato Adobe PDF
665.88 kB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11381/2763730
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 32
  • ???jsp.display-item.citation.isi??? 26
social impact