Regulatory focus and adherence to self-care behaviors among adults with type 2 diabetes

Abstract

The aims of this study were, first, to test the association between regulatory focus of adults with type 2 diabetes and their adherence to two types of self-care behaviors - lifestyle change (e.g. physical activity and diet) and medical care regimens (blood-glucose monitoring, foot care and medication usage). Second, to explore whether a fit between the message framing and patients' regulatory focus would improve their intentions to adhere specifically when the type of behavior fits the patients' regulatory focus as well. A cross-sectional study was conducted among 130 adults with type 2 diabetes who were hospitalized in an academic medical center. The patients completed a set of questionnaires that included their diabetes self-care activities, regulatory focus, self-esteem and demographic, socioeconomic and clinical data. In addition, participants were exposed to either a gain-framed or a loss-framed message, and were then asked to indicate their intention to improve adherence to self-care behaviors. A multivariable linear regression model revealed that promoters reported higher adherence to lifestyle change behaviors than preventers did (B = .60, p = .028). However, no effect of regulatory focus on adherence to medical care regimens was found (B = .46, p = .114). In addition, preventers reported higher intentions to adhere to medical care behaviors when the message framing was congruent with prevention focus (B = 1.16, p = .023). However, promoters did not report higher intentions to adhere to lifestyle behaviors when the message framing was congruent with promotion focus (B = -.16, p = .765). These findings justify the need to develop tailor-made interventions that are adjusted to both patients' regulatory focus and type of health behavior.

Regulatory focus and self-determination motives interact to predict students’ nutrition-habit intentions.

“…This supports the idea that one person can hold different motives that coexist and together drive behaviour (see Ingledew & Markland, 2008;Ingledew et al, 2009;Teixeira et al, 2012, for similar considerations). Moreover, regulatory focus framing per se did not produce any main effect, which is congruent with a large body of literature showing that the regulatory focus effects are seldom direct but most often moderated by another factor (e.g., Avraham et al, 2016;Berezowska et al, 2017;Florack et al, 2013).…”

“…Individuals adopt more behaviours that are supposed to be beneficial for their health when the persuasion message fits with the person's focus: participants reported a greater intention to increase their fruits and vegetables intake when an eagerness (vigilance) message framing matched their promotion (prevention) focus (Cesario et al, 2004), and when the emphasis was put on benefits versus costs, respectively (Spiegel, Grant-Pillow, & Higgins, 2004). Similarly, intention to adhere to medical care regimens was higher amongst prevention-oriented patients when the message framing fit their orientation (Avraham et al, 2016). Regulatory focus also interacts with temporal distance of the highlighted health outcomes: a promotion focus increases intention and behaviour when distant outcomes are highlighted whereas a prevention focus proves more efficient when immediate outcomes are highlighted (Berezowska et al, 2017).…”

Does message framing affect changes in behavioural intentions in people with psoriasis? A randomized exploratory study examining health risk communication

“…Similar findings have been observed for physical activity and making dietary changes (de Bruijn et al, 2014;van Assema et al, 2001), and health behaviours more generally (Avraham et al, 2016).…”

Motivational interviewing to improve adherence behaviours for the prevention of diabetic foot ulceration

“…Although this review has demonstrated that there is insufficient evidence to support motivational interviewing to improve adherence in this population, its efficacy in other conditions suggests that further research is warranted . Studies have demonstrated motivational interviewing to effectively enhance adherence to physical activity, healthy eating, alcohol intake, and medication adherence to improve control of long term‐conditions such as hypertension, diabetes, or HIV . The measurement of effectiveness in these studies is facilitated by having clearly defined behavioural or physiological targets based on evidence of efficacy, for example known levels of physical activity to reduce risk.…”