Affecting behavior change in individuals with diabetes: findings from the Study to Help Improve Early Evaluation and Management of Risk Factors Leading to Diabetes (SHIELD)

Diabetes Educ. 2008 Nov-Dec;34(6):1025-36. doi: 10.1177/0145721708325767.

Abstract

Purpose: This study evaluated whether health knowledge, attitudes, and behaviors of individuals with type 1 (T1DM) or type 2 (T2DM) diabetes mellitus and those at high or low risk of T2DM were reflected in healthy behaviors and whether these attributes differed for T2DM respondents who did or did not see a health educator.

Methods: SHIELD, a U.S. population-based study, included respondents (> or =18 years of age) with T1DM (n = 366), T2DM (n = 3897), high risk (HR, n = 5449) defined as > or =3 of the following: abdominal obesity, high body mass index, dyslipidemia, hypertension, cardiovascular disease, and low risk (LR, n = 5725) defined as < or =2 factors.

Results: T2DM respondents were more likely to receive health care professional recommendations to change their lifestyle habits (56%-62%) during their average 11 visits annually than the other groups (P < .0001). More T2DM and HR respondents tried losing weight, but fewer exercised regularly than T1DM and LR (P < .0001). T2DM respondents who saw a dietitian or health educator reported better current health and expectations for better future health, tried to make healthy food choices, and followed a prescribed eating plan than those who did not see these providers (P < .01). However, < or =30% of these T2DM respondents exercised regularly, or maintained desired weight.

Conclusions: SHIELD findings show that respondents know and understand that improving their diet or exercise will affect their health, but the majority of respondents have not translated it into a behavior. Interaction with health educators and patient-empowering support may improve the transition to behavior change.

MeSH terms

  • Adult
  • Behavior*
  • Body Mass Index
  • Cardiovascular Diseases / complications
  • Cardiovascular Diseases / prevention & control
  • Demography
  • Diabetes Mellitus / epidemiology
  • Diabetes Mellitus / prevention & control
  • Diabetes Mellitus / psychology*
  • Diabetes Mellitus, Type 1 / epidemiology
  • Diabetes Mellitus, Type 1 / prevention & control
  • Diabetes Mellitus, Type 1 / psychology
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / prevention & control
  • Diabetes Mellitus, Type 2 / psychology
  • Dyslipidemias / complications
  • Dyslipidemias / psychology
  • Educational Status
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Income
  • Male
  • Middle Aged
  • Obesity / complications
  • Obesity / psychology
  • Overweight / complications
  • Overweight / prevention & control
  • Risk Assessment
  • Risk Factors
  • United States
  • Young Adult