Predicting Dietary Practice Behavior among Type 2 Diabetics Using the Theory of Planned Behavior and Mixed Methods Design
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Predicting Dietary Practice Behavior among Type 2 Diabetics Using the Theory of Planned Behavior and Mixed Methods Design

Authors: D.O. Omondi, M.K. Walingo, G.M. Mbagaya, L.O.A. Othuon


This study applied the Theory of Planned Behavior model in predicting dietary behavior among Type 2 diabetics in a Kenyan environment. The study was conducted for three months within the diabetic clinic at Kisii Hospital in Nyanza Province in Kenya and adopted sequential mixed methods design combing both qualitative and quantitative phases. Qualitative data was analyzed using grounded theory analysis method. Structural equation modeling using maximum likelihood was used to analyze quantitative data. The results based on the common fit indices revealed that the theory of planned behavior fitted the data acceptably well among the Type 2 diabetes and within dietary behavior {χ2 = 223.3, df = 77, p = .02, χ2/df = 2.9, n=237; TLI = .93; CFI =.91; RMSEA (90CI) = .090(.039, .146)}. This implies that the Theory of Planned Behavior holds and forms a framework for promoting dietary practice among Type 2 diabetics.

Keywords: Dietary practice, Kenya, Theory of PlannedBehavior, Type 2 diabetes, Mixed Methods Design.

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[1] M.I. Harris, "Frequency of Blood Glucose Monitoring in Relation to Glycemic Control in Patients with Type II diabetes," Diabetes Care, Vol.24, no.6, pp.979-982, 2001.
[2] A. Thanopoulou, B. Karamanos, F. Angelico, S. Assaad-Khalil, A. Barbato, M. Del Ben, et al. "Nutritional Habits of Subjects with Type II diabetes Mellitus in the Mediterranean Basin: Comparison with the Non- Diabetic Population and the Dietary Recommendations. Multi-Centre Study of the Mediterranean Group for the Study of Diabetes (MGSD)," Diabetologia, Vol. 47, no.3, pp. 367-376, March 2004.
[3] M. Peyrot, R.R. Rubin, T. Lauritzen, F.J. Snoek, D.R. Matthews and S.E. Skovlund, "Psychosocial Problems and Barriers to Improved Diabetes Management: Results of the Cross-National Diabetes Attitudes, Wishes and Needs (DAWN) Study," Diabetes Medicine, Vol. 22 no.10, pp.1379-1385, Oct. 2005.
[4] R.E. Glasgow, S.E. Hampson, L.A. Strycker, and L. Ruggiero "Personal- Model Beliefs and Social-Environmental Barriers Related To Diabetes Self-Management," Diabetes Care, Vol. 20, no.4, pp. 556-561, Apr. 1997.
[5] K.M. Nelson, G. Reiber and E.J Boyko, "Diet and Exercise among Adults with Type II diabetes: Findings from the Third National Health and Nutrition Examination Survey (NHANES III)," Diabetes Care, Vol. 25, no.10, pp. 1722-1728, Oct. 2002
[6] Shimakawa T, Herrera-Acena MG, Colditz GA, Manson JE, Stampfer MJ, Willett WC and Stamper MJ Comparison of Diets of Diabetic and Nondiabetic Women. Diabetes Care, 1993; 16(10):1356-1362.
[7] D.B. Panagiotakos, C. Pitsavos, C. Chrysohoou and C. Stefanadis, "The Epidemiology of Type II diabetes Mellitus in Greek Adults: the ATTICA study," Diabetes Medicine, Vol. 22, no.11, 1581-1588, ref 46, 2005.
[8] J.C. Guare, R.R. Wing and A. Grant, "Comparison of Obese NIDDM and Non-diabetic Women: Short- and Long-term Weight Loss," Obesity Research, Vol. 3, no.4, pp. 329-335, Jul. 1995
[9] K. Gauthier-Chelle, L. Mennen, N. Arnault, V. Rigalleau, S. Hercberg and H. Gin, "Comparison of the Diet of Self-Declared Diabetics with Non-Diabetic Patients in the SU.VI.MAX Study: Did the Diabetics Modify Their Nutritional Behavior?" Diabetes &Metabolism, Vol. 30, no.6, pp. 535-542, Dec. 2004.
[10] Kenyatta National Hospital Diabetic, "Manual Report (Unpublished work style)," Unpublished.
[11] Anderson RM, Funnell MM Compliance and Adherence are Dysfunctional Concepts in Diabetes Care. Diabetes Education, Vol. 26, no.4, pp.597-604, Nov/Dec, 2000.
[12] I. Ajzen, "The Theory of Planned Behavior," Organizational Behavior and Human Decision Processes, Vol.50, pp. 179-211, Dec. 1991.
[13] S.L. Norris, M.M. Engelgau and K.M. Narayan, "Effectiveness of Self Management Training in Type II diabetes: A Systematic Review of Randomized Controlled Trials," Diabetes Care, Vol. 24, pp. 56 - 587, March 2001.
[14] R.M. Anderson and M.M. Funnell, "Theory in the Cart, Vision is the Horse: Reflections on Research in Diabetes Patient Education," Diabetic Education, Vol. 25, no.6, pp.43-51, 1999.
[15] Lysack CL and Krefting L Qualitative methods in field research: An Indonesian experience in community based practice. The Occupational Therapy Journal of Research, Vol. 14, no. 2, pp.93-110, 1994
[16] J.W. Creswell and V.l. Plano Clark, Designing and conducting mixed methods research. Thousand Oaks, CA: Sage, 2007.
[17] Creative Research Systems (2003). The survey system: Sample size calculator. Available:
[18] L. Ibironke, (Fall 2002) "Scholarly Communication: The Use and Non- Use of E-Print Archives for the Dissemination of Scientific Information," Science and Technology Librarianship. Available:
[19] R. Mugnaini, A.L. Packer and R. Meneghini, "Comparison of scientists of the Brazilian Academy of Sciences and of the National Academy of Sciences of the USA on the basis of the h-index," Brazilian Journal of Medical and Biological Research, Vol. 41, No.4, 258-262, Feb. 2008.
[20] A.P. Field Discovering Statistics using SPSS (2nd e.d.). London: Sage, 2005.
[21] W.J. Creswell Research Design. Qualitative, quantitative, and mixed methods approach. SAGE Publications, Inc, California, USA, 2009.
[22] G.D. Garson (Dec 2009). Structural equation modeling. Available:
[23] R.E. Schumacker and G.L. Richard A beginner-s guide to structural equation modeling (2nd ed.). Mahwah, N.J: Lawrence Erlbaum Associates, 2004.
[24] B. Kline Rex Principles and practice of structural equation modeling. New York. Guilford Press, 1998.
[25] S. Sutton "Theory of planned behavior," in Cambridge handbook of psychology, health and medicine ed. A. Baum, S. Newman, J. Weinman, R. West, C. McManus. Cambridge: Cambridge University Press, 1997, pp. 177-179.
[26] I. Ajzen and M. Fishbein Understanding Attitude and Predicting Behavior. Englewood Cliffs, NJ: Prentice-Hall, 1980.
[27] M. Fishbein and I. Ajzen Belief, attitude, intention and behavior: An introduction to theory and research Menlo Park: Addison-Wesley, 1975.
[28] L. Luzzi and A.J. Spencer "Factors influencing the use of public dental services: An application of the Theory of Planned Behavior," BMC Health Service Research, Vol 8, no.93, 2008.
[29] L. Johansson, K. Solvoll, G-E.A. Bj├©rneboe and& C.A. Drevon, "Dietary habits among Norwegian men and women," Scandinavian Journal of Nutrition, Vol.41, pp.63-70, 1997.
[30] J.C. Loehlin Latent variables models: An introduction to factor, path, and structural analysis (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum, 1992.
[31] D. George and P. Mallery SPSS for Windows step by step: A simple guide and reference. 11.0 update (4th ed.). Boston: Allyn & Bacon, 2003.