Socio-economic factors, mood, primary care utilization, and quality of life as predictors of intervention cessation and chronic stress in a type 2 diabetes prevention intervention (PREVIEW Study)

Abstract

Background Sedentary lifestyle and unhealthy diet combined with overweight are risk factors for type 2 diabetes (T2D). Lifestyle interventions with weight-loss are effective in T2D-prevention, but unsuccessful completion and chronic stress may hinder efficacy. Determinants of chronic stress and premature cessation at the start of the 3-year PREVIEW study were examined. Methods Baseline Quality of Life (QoL), social support, primary care utilization, and mood were examined as predictors of intervention cessation and chronic stress for participants aged 25 to 70 with prediabetes (n = 2,220). Moderating effects of sex and socio-economic status (SES) and independence of predictor variables of BMI were tested. Results Participants with children, women, and higher SES quitted intervention earlier than those without children, lower SES, and men. Lower QoL, lack of family support, and primary care utilization were associated with cessation. Lower QoL and higher mood disturbances were associated with chronic stress. Predictor variables were independent (p ≤ .001) from BMI, but moderated by sex and SES. Conclusions Policy-based strategy in public health should consider how preventive interventions may better accommodate different individual states and life situations, which could influence intervention completion. Intervention designs should enable in-built flexibility in delivery enabling response to individual needs. Trial registration ClinicalTrials.gov Identifier: NCT01777893.

One Size Does Not Fit All: Complexity of Lifestyle Interventions in Primary Care T2D Prevention – Supporting Weight Loss and Weight Loss Maintenance

“…During the initial stages of lifestyle interventions, action self-efficacy is more important as it enables individuals to form new behaviors. Conversely, coping self-efficacy is central to maintaining newly formed behaviors despite challenges such as work and family commitments [78].…”

“…One Size Does Not Fit All: Complexity of Lifestyle Interventions in Primary Care T2D Prevention… DOI: http://dx.doi.org/10.5772/intechopen.1004694 [2,35,79], especially those with family and work commitments [78,80]. This often leads to missed opportunities for individuals to receive support in achieving their intervention goals, such as sustained weight loss [78].…”

“…One Size Does Not Fit All: Complexity of Lifestyle Interventions in Primary Care T2D Prevention… DOI: http://dx.doi.org/10.5772/intechopen.1004694 [2,35,79], especially those with family and work commitments [78,80]. This often leads to missed opportunities for individuals to receive support in achieving their intervention goals, such as sustained weight loss [78]. Improving self-efficacy is essential in addressing this issue and ensuring that intervention participants maintain new behaviors despite challenges and barriers until they become habits [80].…”

“…Instead, accessing the support offered by an intervention appears to moderate success in weight loss and weight loss maintenance. Regular intervention attendance has been linked to better weight loss outcomes, not necessarily by increasing self-efficacy [78,82,83], but by taking advantage of the support provided by the intervention [76].…”

“…Being a man with a lower degree of education is considered a risk factor for less favorable intervention outcomes in T2D prevention [4,106,107]. However, studies have also implied that women with a higher degree of education may also experience less favorable intervention outcomes [47,78]. Overall, the degree of education and sex can moderate the relationship between individual participants and intervention outcomes, but the pathways are complex [4,63].…”