A cross‐sectional study of barriers to physical activity among overweight and obese patients with type 2 diabetes in Iran

The objective of this study was to identify common barriers to physical activity practice among overweight/obese patients with type 2 diabetes in Iran and their associations with physical activity level. In this cross‐sectional study, 146 overweight/obese volunteers with type 2 diabetes were recruited from diabetes clinics in Tabriz, Iran, between July 2012 and March 2013. A Persian version of the long‐format International Physical Activity Questionnaire was used to assess physical activity level. A 12‐item structured questionnaire was designed to assess physical activity barriers. The validity and reliability of the latter scale were assessed by related measures. An exploratory factor analysis with the principal component analysis extraction method and varimax rotation was performed to extract the underlying factors. Multivariate regression analysis was used to assess the relationship between barriers and physical activity level. About 73% of patients had moderate physical activity. Factor analysis yielded four factors as barriers to physical activity including: (i) negative attitude towards physical activity, (ii) discouragement, (iii) physical problems and (iv) cost/environmental factors. These factors explained about 51% of the total variance. There was a negative relationship between the factor ‘physical problems’ and physical activity level (P = 0.024). Overall, there were some barriers to physical activity. Health counsellors should address these barriers to increase the patients' adherence to physical activity recommendations. Physical conditions of the patients must be taken into account.     

Motivation to physical activity among adults with high risk of type 2 diabetes who participated in the Oulu substudy of the Finnish Diabetes Prevention Study

Type 2 diabetes can be prevented by lifestyle changes such as sufficient level of physical activity. The number of persons at high risk of or diagnosed with type 2 diabetes is increasing all over the world. In order to prevent type 2 diabetes and develop exercise counselling, more studies on motivators and barriers to physical activity are needed. Thus, the aim of this qualitative study was to describe the motivators and barriers to physical activity among individuals with high risk of type 2 diabetes who participated in a substudy of the Finnish Diabetes Prevention Study in Oulu and to consider whether the motivators or barriers changed during the follow-up from 2003 to 2008. Questionnaires with open-ended questions were conducted twice: in the first follow-up in 2003 altogether 63 participants answered the questionnaire (n = 93), and in the second follow-up in 2008 altogether 71 participants answered the questionnaire (n = 82). Thus, response rate was 68% in 2003 and 87% in 2008. The study was conducted in the city of Oulu in Finland. Qualitative data were analysed by inductive content analysis using the QSR NVivo 8 software. The results of this study showed that motivators to physical activity included weight management, feelings of physical and mental well being. In addition, social relationships associated with exercise were also motivators. In conclusion, we present that regular counselling is important in order to promote exercise among older people, and that motivators to exercise are strengthened by positive experiences of exercise as one grows older.     

南京市居民体力活动与2型糖尿病关系

目的 探讨江苏省南京市居民体力活动状况及与2型糖尿病(T2DM)发病的关系。方法 选取南京市的3个城区和2个乡村,调查年满35周岁并在当地居住满5年的常住人口5 978人,采用自行编制的《南京市慢病防制社区居民健康相关调查表》进行调查,收回有效调查表5 616份。结果 全市总的2型糖尿病现患率为4.6%,其中城区为6.9%,乡村为1.5%。与不太活动者相比,轻度、中度、重度体力活动者罹患2型糖尿病的风险分别降低24.5%,83.5%和73.0%。经多因素调整后,从事中度体力活动的人群糖尿病现患率仍明显低于不太活动者(调整OR值为0.280,95%CI=0.162~0.484)。结论 中等强度的体力活动可明显降低2型糖尿病发病危险,体力活动是2型糖尿病的保护因素。     

Motives for regular physical activity in women and men: a qualitative study in French adults with type 2 diabetes, belonging to a patients' association

Patients' associations are an integral but often overlooked component of the French healthcare system dominated by the medical profession. Very few patients' associations exist to enable patients to self-manage into physical activity programmes. The aim of this qualitative study was to examine perceived motives for regular physical activity in male and female individuals, with type 2 diabetes involved in one French patients' association, called 'Move for Health'. Twenty-three adults (14 women and 9 men) with type 2 diabetes ranging in age from 35 to 78 volunteered to participate. The participants undertook regular physical activities autonomously with some medico-sporting educators' help. Results showed that participants reported intrinsic motives such as enjoyment, interest, fun, stimulation and highlighted gender differences. Female participants were more likely than male participants to emphasise the importance of emotional support obtained from the group meetings, and the pleasure of doing something together, and male participants emphasised the knowledge acquisition and skill development for disease control. Moreover, female participants indicated the importance of the sense of well-being and the positive body image related to regular physical activity, and male participants underlined the strength of the relationship between physical activity and health-promoting behaviours. This study provides insights into how gender motives are related to the interest and usefulness of physical activities in the management of diabetes. Findings lend support to the setting up of this type of patients' association in the French healthcare system and underline its contribution to self-determination and the behaviour change process in people with diabetes.     

Moderate changes in weight and physical activity can prevent or delay the development of type 2 diabetes mellitus in susceptible individuals

The prevalence of type 2 diabetes mellitus is rising significantly, paralleling the increase in obesity observed around the world. Diabetes is a progressive disease that frequently results in serious complications including retinopathy, neuropathy, nephropathy, and cardiovascular disease. Early detection and treatment of hyperglycemia, the cornerstone of diabetes, can decrease the incidence of these sequelae. Moderate changes in both body weight and physical activity improve the control of hyperglycemia associated with diabetes. Recent studies indicate that similar lifestyle changes can help to prevent or delay the onset of diabetes in people at risk of developing this disorder.     

Physical environmental correlates of self-reported and objectively assessed physical activity in Belgian type 2 diabetes patients

Despite the well-known beneficial effects of physical activity (PA) on the long-term outcomes of type 2 diabetes patients, the majority of this patient group remains inactive. Therefore, it is necessary to understand the most important PA determinants in type 2 diabetes patients in order to develop efficacious interventions to increase PA participation. The main aim of this study was to investigate the associations of physical environmental factors with objectively assessed and self-reported PA in type 2 diabetes patients. A total of 133 type 2 diabetes patients participated in this cross-sectional study (response rate: 43.3%). All participants completed the long International PA Questionnaire and two validated questionnaires to measure physical environmental perceptions and psychosocial factors. They also wore an accelerometer and a pedometer to measure PA objectively. Selection criteria were age 35-80, BMI 25-35 kg m(-2), treated for type 2 diabetes and no PA limitations. Data were collected in 2007. Physical environmental factors contributed significantly to the explained variance of all objective and self-reported PA measures (explained variance from 4% to 18%) after controlling for sociodemographic variables. Home PA equipment, walkability, aesthetics and convenience of PA facilities were the most consistent environmental correlates. The contribution of physical environmental factors remained significant for most PA measures after taking into account the variance explained by psychosocial factors (explained variance from 4% to 10%), except for step counts and recreational walking. Physical environmental factors could be important correlates of PA in type 2 diabetes patients, even beyond the contribution of sociodemographic and psychosocial variables, but additional research is needed. Nevertheless, sociodemographic and psychosocial factors remain very important and when developing future interventions, all these multidimensional correlates should be kept in mind.     

Attitudes and barriers to dietary advice aimed at reducing risk of type 2 diabetes in first-degree relatives of patients with type 2 diabetes

OBJECTIVE: To evaluate the attitudes to and adoption of dietary advice in nondiabetic first-degree relatives of patients with type 2 diabetes and to examine barriers to adherence. DESIGN: One-year controlled intervention study, where treatment group (n=73) received lifestyle education. Attitudes towards dietary advice, change in dietary habits and importance of potential barriers to adherence were evaluated by questionnaires. Nondiabetic relatives (25-55 years; males and females) of individuals with type 2 diabetes were recruited. Education was based on current nutrition recommendations and aimed at improving dietary fat quality, increasing intake of fruit and vegetables, with additional advice to reduce dietary glycaemic index (GI). MAIN OUTCOME MEASURES: Attitudes and importance of barriers were classified by the intervened subjects into four categories ranging from 'No problem' to 'Yes, definitely a problem'. Dietary adherence was monitored by food frequency questionnaire at baseline and after 1 year. RESULTS: Participants were generally in favour of advice aimed at improving dietary fat quality. Attitudes towards advice to reduce GI varied widely. Food selection changed in accordance with predefined dietary goals. 'Forgetfulness', 'low availability in lunch restaurant' and 'lack of ideas for cooking' were barriers to adherence. CONCLUSIONS: Dietary advice aimed at reducing risk of type 2 diabetes was generally positively received and adopted in subjects with heredity for the disease. The most prevalent barriers reported are potentially modifiable.     

Diabetes distress in Barbadian adults with type 2 diabetes

PurposePsychological disorders such as diabetes distress may negatively influence how patients effectively manage their illness. Therefore, discernment of such influential psychosocial components could be pertinent in promoting competent diabetes management. The vital psychosocial aspect of diabetes distress in diabetes management within the Caribbean context remains unexplored. The purpose of this study therefore was to investigate the prevalence and distribution of diabetes distress (DD), and explore its relationship to socio-demographic and clinical characteristics in Barbadian adults with type 2 diabetes(T2DM).MethodsA cross-sectional survey was conducted with adults (n = 509) ages 20–80 years with T2DM. The survey comprised, a profile section, and a standardized questionnaire—the Diabetes Distress Scale (DDS). In addition, biological (A1C and blood pressure measurements were also collected.ResultsThe sample comprised 30.8% males and 69.2% females. Moderate to high DD identified in 17% of the patients (9.4% moderate distress, 7.2% high distress). Moderate distress was more frequent in unmarried persons; younger persons had high DD. There was no difference in rates of moderate to high DD in women (16.7%) compared to men (16.2%) and, as age and years lived with diabetes increased, diabetes distress decreased.ConclusionsThe results emphasized the need for considerations that must be given to Barbadian diabetes patients'' mental well-being. In recognition of the role DD plays in the patients'' experiences, screening should be incorporated into clinical care.     

Assessment of the transtheoretical model as used by dietitians in promoting physical activity in people with type 2 diabetes

BACKGROUND: The transtheoretical model of change (TTM) is an approach to behaviour change, which has been successful in increasing physical activity levels. This study examined the application of a TTM approach to increase physical activity in people with type 2 diabetes by a specialist dietitian. METHODS: Forty participants were recruited to either an exercise consultation interview (ECI) or a control group. All participants received a physical activity leaflet and those in the ECI group also received a one-to-one interview with a dietitian a week after their routine appointment. Both self-reported physical activity levels and stage of change were measured at baseline and after 6 weeks. RESULTS: Thirty-four participants (17 in each group) completed the study. Both groups showed an increase in physical activity levels. However, there was a significant difference in change of physical activity levels in the ECI group alone [F(1,32)=15.99;P相似文献   

Self-care adherence and affective disorders in Barbadian adults with type 2 diabetes

PurposeDiabetes management requires adherence to complicated self-care behaviors. Therefore, the emotional state of the individual living with diabetes, is likely to affect their ability to comply with recommendations. This study explored the relationship of self-care adherence to diabetes distress and depression in Barbadian adults with type 2 diabetes.MethodsAdults aged 20 to 80 years, with type 2 diabetes, completed self-report questionnaires comprised of a profile section consisting of demographic and clinical characteristics; and standardized questionnaires comprising, The Diabetes Distress Scale (DDS), The Patient Health Questionnaire (PQH-9), and the Summary of Diabetes Self-care Activities Scale (SDSCA). Additionally biological measures (BP and HbA1c) were collected.ResultsFor the 509 participants there were no differences in adherence for males (30.8%) and females (69.2%), high diabetes distress and depression were associated with low adherence. General diet was negatively associated with BP and HbA1c; while HbA1c was positively correlated with blood glucose testing.ConclusionSelf-care non-adherence is more than a behavioral problem; it is a multidimensional phenomenon inclusive of demographic factors, condition or disease factors, psychological and social factors.     

Promoting physical activity and exercise in older adults

Although the benefits of increased physical activity and exercise are universally recognized, many older persons remain sedentary, and relatively few achieve recommended levels of activity. Effective interventions to reverse the lack of physical activity in older adults are clearly needed. By understanding correlates of inactivity and appreciating those factors that contribute to a sedentary lifestyle, appropriate strategies can be employed to help order patients reap the benefits of increased physical activity and exercise. In this article, we offer to the reader a brief overview of the field as well as our own thoughts on how clinicians might help individual patients at a more practical level.     

社区成年人腹型肥胖与2型糖尿病的现况调查

目的研究社区成年人2型糖尿病的患病率与分布，以分析腹型肥胖与2型糖尿病关系。方法以社区为单位，开展20岁以上成年人2型糖尿病普查。结果2689人中糖尿病患病率为6．32％，空腹血糖受损者2．79％；人群中腹型肥胖的分布为66．05％。结论糖尿病的发生与性别无关，随年龄增长糖尿病患病率增高：腹型肥胖是糖尿病发生的危险因素。     

The facilitators and barriers of physical activity among Aboriginal and Torres Strait Islander regional sport participants

Background : Disparities in health perspectives between Indigenous and non‐Indigenous populations are major concerns in many of the world's well‐developed nations. Indigenous populations are largely less healthy, more prone to chronic diseases, and have an earlier overall mortality than non‐Indigenous populations. Low levels of physical activity (PA) contribute to the high levels of disease in Indigenous Australians. Method : Qualitative analysis of structured one‐on‐one interviews discussing PA in a regional setting. Participants were 12 Indigenous Australian adults, and 12 non‐Indigenous Australian adults matched on age, sex, and basketball division. Results : Most participants reported engaging in regular exercise; however, the Indigenous group reported more barriers to PA. These factors included cost, time management and environmental constraints. The physical facilitators identified by our Indigenous sample included social support, intrinsic motivation and role modelling. Conclusion : Findings describe individual and external factors that promote or constraint PA as reported by Indigenous Australian adults. Results indicate that Indigenous people face specific barriers to PA when compared to a non‐Indigenous sample. Implications for public health: This study is the first to compare the perspective of Indigenous Australians to a matched group of non‐Indigenous Australians and provides useful knowledge to develop public health programs based on culturally sensitive data.     

Perceived benefits and barriers of physical activity: A social marketing formative study

ABSTRACT

The aim of this study was to gain formative research insights that can be used to design social marketing campaigns. One thousand four hundred fifty-nine people participated in an online survey. Factor analysis was undertaken to establish perceived benefits and barriers, and indexes were created for barriers, benefits, and healthy living knowledge. Four attitude groups were formed and analysis of variance was undertaken to explore group differences. Consumers with high perceived barriers report less physical activity than consumers with low perceived barriers to exercise. The current study provides evidence to suggest that exchange theory can offer important insights to inform social marketing intervention planning.     

南京市城区居民体力活动与2型糖尿病罹患风险关系的随访研究

目的 探讨南京市城区居民体力活动与2型糖尿病罹患风险之间的关系.方法 于2004年和2007年分别在南京市抽取5个居委会,以所抽取的居委会中35岁以上常住居民为研究对象.研究内容主要包括慢性疾病罹患情况及相关生活行为因素,使用国际体力活动量表测量体力活动情况.对完成有效基线调查效对象5 659人进行为期3年的随访研究,采用多因素Logistic回归模型分析体力活动与2型糖尿病罹患风险之间的关系.结果 有效随访4 550人,随访率为80.4％.充足体力活动的比例为16.5％ (753/4 550),2型糖尿病的3年累计发病率为5.1％ (95％CI=4.48,5.80).充足体力活动者其罹患2TD的风险显著低于体力活动不足者的罹患风险,只约为后者的一半(RR =0.45,95％CI=0.31,0.77),这种关联在男女性人群中也分别存在.结论 充足体力活动都可以显著降低人们罹患2型糖尿病的风险,倡导充足体力活动是2型糖尿病社区防制的可性和有效策略之一.