Risk Perception and Self-Management in Urban,Diverse Adults with Type 2 Diabetes: The Improving Diabetes Outcomes Study

Purpose and Background

The relationship between risk perceptions and diabetes self-care remains ambiguous. This study aimed to assess baseline, 1-year follow-up, and change score relationships among perceived risk, diabetes self-care, and glycemic control for adult individuals participating in a behavioral intervention that improved glycemic control relative to the active control.

Method

One-year randomized trial compared a behavioral telephonic intervention with a print only intervention. Participants (N?=?526) are members of a union/employer sponsored health benefit plan, with HbA_1c?≥?7.5 %, prescribed at least one oral diabetes medication. Participants rated perceived risk of diabetes and its complications and diabetes self-care at baseline and 1 year. Data were collected in a large urban area in the USA.

Results

There were no relationships between risk perceptions and glycemic control during the study. Baseline perceived risk predicted follow-up self-care. Additionally, participants assigned to the intervention group showed significant changes in dietary and exercise adherence at high levels of risk knowledge and low levels of optimistic bias.

Conclusion

Perceived risk relates to dietary, exercise, and medication adherence in diabetes. The perceived risk construct might foster a more coherent conceptualization of the relationship between one’s diabetes, possible complications, and diabetes self-care behaviors.