Barriers and facilitators of self-care in adults with pre-diabetes: a directed qualitative content analysis

Adults with prediabetes are at 5 to 15 times higher risk of developing type 2 diabetes compared with others. Without self-care behaviors to promote health and prevention, more than 70% of them will ultimately develop type 2 diabetes during their lives.

This was a qualitative study guided by the directed content analysis method. Purposive sampling was done with maximum demographic diversity. The experiences of adults with prediabetes (39 people) and healthcare workers (6 people) were assessed through individual, face-to-face, semi-structured interviews lasting between 30 and 45 min for four months, from June to November 2023.

Five main themes were found to be influential on the self-care behaviors of adults with prediabetes after analyzing the data: intrapersonal factors, interpersonal level factors, organizational factors, community-level factors, and public policy factors. The important barriers were a lack of screening programs, lack of knowledge about prediabetes and how to modify and change lifestyles, cultural practices, insufficient counseling, lack of prediabetic peers and groups, inflexible work environment, lack of native digital applications, lack of self-care behavior assessment tools for counseling, and financial problems. The major facilitators were motivation, support from family and friends, and the availability of resources in the community.

Our findings suggest that a multilevel approach is needed to address these barriers and facilitators. These findings will help guide strategies to develop programs that impart knowledge and skills to improve the self-care behaviors of prediabetics.