The Diabetes Intention, Attitude, and Behavior Questionnaire: evaluation of a brief questionnaire to measure physical activity, dietary control, maintenance of a healthy weight, and psychological antecedents

Figures & data

Figure 1 Conceptual framework of DIAB-Q.

Abbreviation: DIAB-Q, Diabetes Intention, Attitude, and Behavior Questionnaire.

Table 1 Demographic characteristics of the Stage II population

Characteristics (N=1,015)	n (%)
Sex
Male	604 (60)
Female	411 (40)
Age (mean ± SD), y	63±11
Race/ethnicity
Caucasian	855 (84)
Black or African American	44 (4)
Hispanic	69 (7)
Other	31 (3)
Decline to answer	16 (2)
Married	653 (64)
College educated	467 (46)
Income
<$50,000	390 (38)
$50,000–$100,000	318 (31)
<$100,000	166 (16)
Declined to answer	141 (14)
BMI, kg/m^2
Normal (<25)	98 (10)
Overweight (25–29.9)	317 (31)
Obese (30–39.9)	498 (49)
Extremely obese (≥40)	102 (10)
Antihyperglycemic treatment
Oral only	651 (64)
Oral + insulin ± non-insulin injectable	176 (17)
Non-insulin injectable ± oral or insulin	67 (7)
Insulin only	101 (10)
None	20 (2)
Years since T2DM diagnosis (mean ± SD)	12±9
Most commonly reported types of health care providers visited in the past 12 months for T2DM care*
General practitioner	871 (86)
Ophthalmologist	351 (35)
Cardiologist	197 (19)
Endocrinologist/diabetologist	178 (18)
Podiatrist	172 (17)
Nurse practitioner/physician assistant	153 (15)
Diabetes nurse educator	99 (10)

Note:

* Includes provider types visited by ≥10% of respondents in the past 12 months.

Abbreviations: SD, standard deviation; T2DM, type 2 diabetes mellitus; y, years.

Table 2 Construct validity – correlations between the DIAB-Q and the collateral measures

DIAB-Q scale	Baseline (n=1,015)		1-year follow-up (n= 560)
	SF-36 PCS	SF-36 MCS	SDSCA diet	SDSCA exercise	MDQ self-efficacy
Subjective Norm	0.177*	0.087**	0.100***	0.192*	0.095***
Attitude	0.169*	0.023	0.209*	0.250*	0.164*
Perceived Behavioral Control	0.214*	0.160*	0.062	0.075	0.059
Intention	0.202*	0.140*	0.295*	0.337*	0.342*
Planning	0.228*	0.167*	0.331*	0.391*	0.389*
Behavior	0.290*	0.201*	0.500*	0.498*	0.512*

Notes:

* P<0.001.

** P<0.01.

*** P<0.05.

Abbreviations: DIAB-Q, Diabetes Intention, Attitude, and Behavior Questionnaire; SF-36, Short Form-36 version 2 acute; PCS, physical component summary; MCS, mental component summary; SDSCA, Summary of Diabetes Self-Care Activities; MDQ, Multidimensional Diabetes Questionnaire.

Table 3 Mean scale scores for DIAB-Q constructs by BMI category, HbA_1c category, and disease severity

Scale	N	Mean ± SD§	P-value for group differences
BMI categories (kg/m^2) (n=1,015)
Intention
<25	98	63.2±20.0^a	0.01
25–29.9	317	69.1±18.3^b
30–39.9	498	66.1±19.3^a,b
≥40	102	63.8±17.9^a
Planning
<25	98	55.0±24.2^a	0.002
25–29.9	317	62.0±21.4^b
30–39.9	498	57.3±23.3^a,b
≥40	102	54.2±22.1^a
Behavior
<25	98	63.0±24.8^a	<0.001
25–29.9	317	56.8±23.2^b
30–39.9	498	47.4±23.9^c
≥40	102	41.7±24.8^c
HbA1c categories (%) (n=821)
Intention
≤6.0	130	71.5±19.2^a	0.001
6.1–6.5	211	67.9±18.5^a
6.6–7.0	218	69.6±17.3^a
7.1–7.5	147	65.8±18.2^a,b
7.6–8.0	51	64.5±20.3^a,b
>8.0	64	60.7±19.1^b
Planning
≤6.0	130	64.8±21.3^a	<0.001
6.1–6.5	211	60.6±23.1^a,b
6.6–7.0	218	60.9±21.8^a,b
7.1–7.5	147	54.7±21.9^b,c
7.6–8.0	51	54.8±22.7^b,c
>8.0	64	50.8±22.2^c
Behavior
≤6.0	130	58.7±21.9^a	<0.001
6.1–6.5	211	53.8±23.0^a,b
6.6–7.0	218	55.6±23.8^a,b
7.1–7.5	147	48.1±24.9^b,c
7.6–8.0	51	41.3±24.3^c,d
>8.0	64	37.2±22.7^d
Disease severity (n=1,015)
Intention
Mild	305	68.5±17.9^a	0.041
Moderate	602	66.2±19.2^a,b
Severe	61	62.2±22.3^b
Planning
Mild	305	62.8±21.4^a	<0.001
Moderate	602	57.4±22.8^a
Severe	61	50.0±23.8^b
Behavior
Mild	305	56.6±23.5^a	<0.001
Moderate	602	50.2±24.3^b
Severe	61	41.0±25.6^c

Notes: Scale scores range from 0–100, with higher scores representing a higher level of the psychological construct.

§ Mean values not sharing common superscripts are significantly different at P<0.05 based on Tukey’s b post hoc. For example, under Behavior, the <25 group is significantly different from all other groups (no shared letter), whereas there are no differences between the 30–39.9 and ≥40 groups (both share the letter “c”).

Abbreviations: DIAB-Q, Diabetes Intention, Attitude, and Behavior Questionnaire; BMI, body mass index; HbA_1c, glycated hemoglobin; SD, standard deviation.