Exploring Additional Intention Predictors within Dietary Behavior among Type 2 Diabetes
Authors: D. O. Omondi, M. K. Walingo, G. M. Mbagaya
Abstract:
Objective: This study explored the possibility of integrating Health Belief Concepts as additional predictors of intention to adopt a recommended diet-category within the Theory of Planned Behavior (TPB). Methods: The study adopted a Sequential Exploratory Mixed Methods approach. Qualitative data were generated on attitude, subjective norm, perceived behavioral control and perceptions on predetermined diet-categories including perceived susceptibility, perceived benefits, perceived severity and cues to action. Synthesis of qualitative data was done using constant comparative approach during phase 1. A survey tool developed from qualitative results was used to collect information on the same concepts across 237 legible Type 2 diabetics. Data analysis included use of Structural Equation Modeling in Analysis of Moment Structures to explore the possibility of including perceived susceptibility, perceived benefits, perceived severity and cues to action as additional intention predictors in a single nested model. Results: Two models-one nested based on the traditional TPB model {χ2=223.3, df = 77, p = .02, χ2/df = 2.9; TLI = .93; CFI =.91; RMSEA (90CI) = .090(.039, .146)} and the newly proposed Planned Behavior Health Belief Model (PBHB) {χ2 = 743.47, df = 301, p = .019; TLI = .90; CFI=.91; RMSEA (90CI) = .079(.031, .14)} passed the goodness of fit tests based on common fit indicators used. Conclusion: The newly developed PBHB Model ranked higher than the traditional TPB model with reference made to chi-square ratios (PBHB: χ2/df = 2.47; p=0.19 against TPB: χ2/df = 2.9, p=0.02). The integrated model can be used to motivate Type 2 diabetics towards healthy eating.
Keywords: Theory, intention, predictors, mixed methods design.
Digital Object Identifier (DOI): doi.org/10.5281/zenodo.1336098
Procedia APA BibTeX Chicago EndNote Harvard JSON MLA RIS XML ISO 690 PDF Downloads 1413References:
[1] A. Ramachandran, C. Snehalatha, S. Mary, B. Mukesh, A.D. Bhaskar & V. Vijay. The Indian Diabetes Prevention Programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1). Diabetologia, Vol 49, issue 2, pp. 289-297, 2006.
[2] J. Lindström, A. Louheranta, M. Mannelin, Rastas, V. Salminen, J. Eriksson et al. The Finnish Diabetes Prevention Study (DPS): Lifestyle intervention and 3-year results on diet and physical activity. Diabetes Care, vol. 26, issue 12, pp. 3230-3236, 2003.
[3] X.R. Pan, G.W. Li, Y.H. Hu, J.X. Wang, Wy Yang, Z.X. An et al. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study. Diabetes Care, vol. 20, issue4, pp.537-544, 1997.
[4] K.F. Eriksson & F. Lindgarde. Prevention of type 2 (non-insulin-dependent) diabetes mellitus by diet and physical exercise. The 6-year Malmo feasibility study. Diabetologia, vol. 34, issue 12, pp.891-898, 1991.
[5] National Diabetic Control Programmeme. National Clinical Guidelines for Management of Diabetes Mellitus. Ministry of Public Health, Nairobi, Kenya, 2010.
[6] I. Ajzen. The Theory of Planned Behavior. Organizational Behavior and Human Decision Processes, Vol. 50 pp. 179-211, 1991.
[7] J.B.F. de Wit, R. Vet, M. Schutten, & J. van Streenbergen. Social cognitive determinants of vaccination behavior against hepatitis B: An assessment among men who have sex with men. Preventive medicine, Vol.40, issue 6, pp. 795-802, 2005.
[8] N.A. Åstrøm & I. Okullo. Temporal Stability of the Theory of Planned Behavior: A Prospective Analysis of Sugar Consumption among Ugandan Adolescents. Community Dentistry and Oral Epidemiology, Vol. 32, issue 6, pp 426-434, 2004.
[9] L.C. Blue. Does the Theory of Planned Behavior Identify Diabetes-related Cognitions for Intention to be Physically Active and Eat a Healthy Diet? Public Health Nursing; vol. 24, issue 2, pp. 141-150, 2007.
[10] J.A. Harrison, P.D. Mullen, & L.W. Green. A meta-analysis of studies of the health belief model with adults. Health Education Research, vol 7, pp. 107-116, 1992.
[11] P.D. Mullen, J. Hersey & D.C. Iverson. "Health Behavior Models Compared." Social Science and Medicine, vol. 24, pp. 973–981, 1987.
[12] J.W. Creswell & V.l. Plano Clark (2007). Designing and conducting mixed methods research. Thousand Oaks, CA: Sage.
[13] C.L. Lysack & L. Krefting. Qualitative methods in field research: An Indonesian experience in community based practice. The Occupational Therapy Journal of Research, vol.14 issue 20, pp. 93-110, 1994.
[14] Creative Research Systems. The survey system: Sample size calculator, 2003 (Online). Available: {http://www.surveysystem.com/sscalc.htm} (Accessed on November 15, 2004).
[15] L. Ibironke. Scholarly Communication: The Use and Non-Use of E-Print Archives for the Dissemination of Scientific Information. Science and Technology Librarianship; Fall 2002. (Online). Available: {http://www.istl.org/02-fall/article3.html} (Accessed on November 15, 2004)..
[16] R. Mugnaini, A. L. Packer & 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, issue 4, pp. 258-262, 2008
[17] G.D. Garson. Structural equation modeling,2009 (Retrieved on 2009-12-16): http://faculty.chass.ncass.ncsu.edu/garson/Pa 765/structur.htm
[18] R.E. Schumacker & G.L. Richard. A beginner’s guide to structural equation modeling (Second Edition). Mahwah, N.J: Lawrence Erlbaum Associates, 2004.
[19] R.B. Kline. Principles and practice of structural equation modeling. New York. Guilford Press, 1998.
[20] D. George, & P. Mallery. SPSS for Windows step by step: A simple guide and reference. 11.0 update (4th ed.). Boston: Allyn & Bacon, 2003.
[21] D.O. Omondi, M.K. Walingo, G.M. Mbagaya & A.O.L., Othoun. Understanding Physical Activity Behavior of Type 2 diabetes Using the Theory of Planned Behavior and Structural Equation Modeling. International Journal of Human and Social Science (Journal of social science), vol 5, issue 3, pp. 160-167, 2010.
[22] S.T. Kershaw, M.L. Niccolai, A.K. Esther, B.J. Lewis & R.J. Ickovics. Perceived susceptibility to pregnancy and sexual transmitted disease among pregnant and nonpregnant adolescents. Journal of Community Psychology, vol.31, issue 4, pp. 419-434, 2003
[23] J.B.F. de Wit, R. Vet, M. Schutten, & J. van Streenbergen. Social cognitive determinants of vaccination behavior against hepatitis B: An assessment among men who have sex with men. Preventive medicine, vol. 40, issue 6, issue, pp. 795-802, 2005.
[24] L. Belcher, M.R. Sternmberg, R.J. Wolotski, P. Halkitis, & C. Hoff. Condom use and perceived risk of HIV transmission among sexually active HIV positive men who have sex with men. AIDS Education and Prevention, vol. 17, issue 1, pp. 79-89, 2005
[25] L.H. Forsyth & V.L. Goetsch (1997). Perceived threat of illness and health protective behaviors in offspring of adults with non-insulin dependent diabetes mellitus. Behavioral medicine, vol. 23, issue 3, pp. 112-120, 2007.
[26] K. McCormic-Brown (1999). Health Belief Model. (Retrieved 2009-12-3).http//hsc.usf.edu/~kmbrown/Health_Belief_Model_Overview.htm.
[27] Graham ME (2002). Health beliefs and self breast examination in black women. Journal of Cultural Diversity, vol. 9 issue 2, pp. 49-54, 1999.
[28] R.E. Schumacker & G.L. Richard. A beginner’s guide to structural equation modeling (Second Edition). Mahwah, N.J: Lawrence Erlbaum Associates, 2004.