Exploring the barriers and facilitators of following a meal plan for Type 2 Diabetes: a survey using the theoretical domains framework

Wilson, Taylor (2020) Exploring the barriers and facilitators of following a meal plan for Type 2 Diabetes: a survey using the theoretical domains framework. Masters thesis, Memorial University of Newfoundland.

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Abstract

Background: Type 2 Diabetes Mellitus (T2DM) is a critical health topic in Newfoundland and Labrador (NL). In 2016, the Canadian Diabetes Association estimates that 179,000 residents in NL are living with diabetes or pre-diabetes, which is approximately 35% of our population and the highest prevalence within Canada. Patients with this disease find it challenging to make health-related choices to reduce the negative impacts associated with diabetes on their long-term well-being and to improve their lifestyles. Using a Theoretical Domains Framework (TDF), we will identify what domains play a significant role in creating barriers and facilitators for the self-management of T2DM. As the global prevalence of diabetes continues to grow and technology continues to develop, there is an obvious potential for technology to help support individuals self-manage T2DM. Purpose: The primary objective of the study is to identify which behavioral domains of the TDF (e.g., knowledge, social influence, skills) will predict the intention to follow a meal plan for the self-management of diabetes for subsequent intervention development. The secondary objective is to explore if patients in a Remote Monitoring Program (RMP) for diabetes would use technology to help manage their diabetes and whether they perceive technology as an effective tool for self-management. Methods: Patients enrolled in the RMP for T2DM through the Eastern Regional Health Authority, NL (n=300) received a questionnaire via mail as part of a cross-sectional study to assess their experience with following a meal plan for diabetes self-management. The questionnaire also included an open-ended question to evaluate the attitudes of NL residents regarding the effectiveness of technology as a self-management tool. Results: The Regression model (n=54) indicated only two significant predictors of meal plan intention, Emotions (b=-0.648, p=0.003) and Social Influences (b=0.475, p=0.0026), accounting for three quarters of the variance. Conclusions: Now that the influence of others in one’s social environment and one’s emotional health have been identified as the significant predictors of the self-management of T2DM, these domains will be the focus for the creation of intervention content in a subsequent project.

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