Patient decision making: strategies for diabetes diet adherence intervention

Area of Science:

• Behavioral Science
• Health Psychology
• Clinical Pharmacy

Background:

• Patient self-care is crucial for managing diabetes and preventing complications.
• Dietary adherence presents a significant challenge in effective diabetes interventions.
• The Transtheoretical Model (TTM), decision-making theory, and self-efficacy inform intervention design.

Purpose of the Study:

• To develop a diagnostic tool for pharmacists to assess diet regimen adherence in diabetic patients.
• The tool incorporates Transtheoretical Model (TTM) measures for stages of change, decisional balance, and self-efficacy.
• To support pharmacists in tailoring interventions for patients resistant to dietary changes.

Main Methods:

• A questionnaire was developed using literature review, patient interviews, expert input, and pretesting.
• Cross-sectional study of 193 type 1 and type 2 diabetic patients across four US care sites.
• Validated measures assessed TTM variables, demographics, diabetes history, and social desirability.

Main Results:

• TTM measures for diet adherence showed relationships consistent with other behavioral studies.
• Identified facilitators (pros) and barriers (cons, self-efficacy) to dietary change.
• Social desirability significantly correlated with self-reported diet adherence and varied across racial groups.

Conclusions:

• TTM measures are valuable for creating individualized diet adherence interventions for diabetes.
• Caution is advised regarding potential social desirability bias in patient self-reporting.
• Findings offer directions for future research, implications for practice, and acknowledge study limitations.