Identifying a motivational process surrounding adherence to exercise and diet among adults with type 2 diabetes

ABSTRACT

Objectives: This paper aims to provide physicians with knowledge about the motivational processes surrounding exercise and diet for patients with type 2 diabetes and to offer patient support measures to favor self-management. To respond to this objective, the links between two kind of motivators (i.e., promotion and prevention foci), the Selection, Optimization and Compensation (SOC) self-management strategy, and adherence to exercise and diet of patients with type 2 diabetes were investigated for the first time in the literature.

Method: A cross-sectional study was conducted with 491 French volunteer participants with type 2 diabetes diagnosed for at least 3 months (Age = 61.66 ± 9.63; BMI = 29.8 ± 5.9). Participants completed an online self-report survey measuring SOC strategy, promotion and prevention foci, and adherence to exercise and diet.

Results: The main results of path and bootstrapping analysis demonstrated that promotion focus was positively related with SOC strategy (β = .69, p < .001) whereas prevention focus was not (β = −.01, ns.). On the other hand, SOC strategy was positively related with exercise (β = .20, p < .05), general diet (β = .49, p < .001), fruit and vegetable consumption (β = .27, p < .001), and spacing of carbohydrates (β = .40, p < .001), and mediated the positive link between promotion focus and these behaviors (bootstrapped 95% CI: [.11; .40], [.52; .81], [.22; .54], [.37; .70], respectively).

Conclusion: This paper addresses a gap in previous research by evidencing a motivator that promotes self-management for exercise and diet among patients with type 2 diabetes. Our results suggest that physicians should privilege an interaction with patients oriented toward promotional motivation so as to favor their patients’ self-management regarding exercise and diet.

KEYWORDS:

• Regulatory focus
• selection optimization and compensation strategy
• exercise
• diet
• type 2 diabetes
• motivation

Declaration of interest

No potential conflict of interest was reported by the authors.

Transparency

The authors and peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Notes

1. The effects of diabetes duration and diabetes treatment (no treatment vs. insulin vs. oral medication) were also checked in complementary analyses. The results of structural analyses showed that diabetes duration was not associated with exercise, nor with general diet, fruit and vegetable consumption, high-fat food consumption, or spacing of carbohydrates. On the other hand, the results of ANOVAs showed that diabetes treatment had no effect on exercise, general diet, fruit and vegetable consumption, or high-fat food consumption. However, patients with insulin as diabetes treatment reported more spacing of carbohydrates than patients with oral medication. Given this result, we therefore compared the contribution of promotion focus, prevention focus, and SOC strategy on spacing of carbohydrates in these two sub-groups. The results of these analyses indicated that whatever the group, SOC strategy was positively associated with spacing of carbohydrates, promotion focus was positively associated with spacing of carbohydrates through SOC strategy, and prevention focus was not associated with SOC strategy.

Additional information

Funding

This paper was not funded.