期刊论文详细信息
BMC Public Health
Perceived need to increase physical activity levels among adults at high risk of type 2 diabetes. A cross-sectional analysis within a community-based diabetes prevention project FIN-D2D
Marita Poskiparta8  Heikki Oksa4  Leo Niskanen2  Leena Moilanen3  Urho M Kujala8  Eeva Korpi-Hyövälti5  Sirkka Keinänen-Kiukaanniemi7  Markku Peltonen1  Timo Saaristo4  Mauno Vanhala2  Pauli Rintala6  Jari Villberg8  Sanna Salmela8  Kati Vähäsarja8 
[1] National Institute for Health and Welfare, Helsinki, 00271, Finland;University of Eastern Finland, Kuopio, 70211, Finland;Department of Medicine, Kuopio University Hospital, Kuopio, 70210, Finland;Pirkanmaa Hospital District, Tampere, 33680, Finland;Department of Internal Medicine, Seinäjoki Central Hospital, Seinäjoki, 60220, Finland;Department of Sport Sciences, University of Jyväskylä, Jyväskylä, 40014, Finland;Institute of Health Sciences, University of Oulu, Oulu, 90014, Finland;Department of Health Sciences, University of Jyväskylä, Jyväskylä, 40014, Finland
关键词: Lifestyle intervention;    FIN-D2D;    Prevention;    Type 2 diabetes;    Awareness;    Perception;    Behaviour change;    Exercise;    Physical activity;   
Others  :  1163461
DOI  :  10.1186/1471-2458-12-514
 received in 2011-12-14, accepted in 2012-06-21,  发布年份 2012
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【 摘 要 】

Background

Increased physical activity is a cornerstone of type 2 diabetes prevention. The perception of a need to change is considered essential in behaviour change processes. However, the existing literature on individuals’ perceived need to change health behaviour is limited. In order to improve understanding of diabetes prevention through increased physical activity levels (PAL), we assessed factors associated with perceiving a need to increase PAL among adults at high risk of diabetes.

Methods

Opportunistic screening was used within a primary-care based lifestyle intervention covering 10 149 men and women at high risk of type 2 diabetes. Data were obtained at baseline visits. The explored determinants were demographic, anthropometric/clinical, behavioural and psychosocial characteristics, along with four categories of PAL awareness. Logistic regression was used in the analysis.

Results

74% of men (n = 2 577) and 76% of women (n = 4 551) perceived a need to increase their PAL. The participants most likely to perceive this need were inactive, had a larger waist circumference, rated their PAL as insufficient, and were at the contemplation stage of change. Smoking, elevated blood pressure, dyslipidaemia, and a family history of diabetes were not associated with this perception. The likelihood was also greater among women with less perceived fitness and less education. Demographic factors other than education did not determine participants’ perceived need to increase PAL. PAL overestimators were less likely to perceive the need to increase their PAL than realistic inactive participants.

Conclusions

Subjective rather than objective health factors appear to determine the perception of a need to increase PAL among adults at high risk of diabetes. Client perceptions need to be evaluated in health counselling in order to facilitate a change in PAL. Practical descriptions of the associations between metabolic risk factors, PAL, and diabetes are needed in order to make the risk factors concrete for at-risk individuals.

【 授权许可】

   
2012 Vähäsarja et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Laaksonen DE, Lindstrom J, Lakka TA, Eriksson JG, Niskanen L, Wikstrom K, Aunola S, Keinanen-Kiukaanniemi S, Laakso M, Valle TT, Ilanne-Parikka P, Louheranta A, Hamalainen H, Rastas M, Salminen V, Cepaitis Z, Hakumaki M, Kaikkonen H, Harkonen P, Sundvall J, Tuomilehto J, Uusitupa M, Finnish diabetes prevention study: Physical activity in the prevention of type 2 diabetes: the Finnish diabetes prevention study. Diabetes 2005, 54:158-165.
  • [2]Bassuk SS, Manson JE: Epidemiological evidence for the role of physical activity in reducing risk of type 2 diabetes and cardiovascular disease. J Appl Physiol 2005, 99:1193-1204.
  • [3]Warburton DE, Nicol CW, Bredin SS: Health benefits of physical activity: the evidence. CMAJ 2006, 174:801-809.
  • [4]Hu G, Qiao Q, Silventoinen K, Eriksson JG, Jousilahti P, Lindstrom J, Valle TT, Nissinen A, Tuomilehto J: Occupational, commuting, and leisure-time physical activity in relation to risk for Type 2 diabetes in middle-aged Finnish men and women. Diabetologia 2003, 46:322-329.
  • [5]Borodulin K, Tuomilehto J, Peltonen M, Lakka TA, Sundvall J, Jousilahti P: Association of leisure time physical activity and abdominal obesity with fasting serum insulin and 2-h postchallenge plasma glucose levels. Diabet Med 2006, 23:1025-1028.
  • [6]Healy GN, Dunstan DW, Salmon J, Cerin E, Shaw JE, Zimmet PZ, Owen N: Objectively measured light-intensity physical activity is independently associated with 2-h plasma glucose. Diabetes Care 2007, 30:1384-1389.
  • [7]Waller K, Kaprio J, Lehtovirta M, Silventoinen K, Koskenvuo M, Kujala UM: Leisure-time physical activity and type 2 diabetes during a 28 year follow-up in twins. Diabetologia 2010, 53:2531-2537.
  • [8]LaMonte MJ, Blair SN, Church TS: Physical activity and diabetes prevention. J Appl Physiol 2005, 99:1205-1213.
  • [9]Boyle RG, O'Connor PJ, Pronk NP, Tan A: Stages of change for physical activity, diet, and smoking among HMO members with chronic conditions. Am J Health Promot 1998, 12:170-175.
  • [10]Brewer NT, Chapman GB, Gibbons FX, Gerard M, McCaul KD, Weinstein ND: Meta-analysis of the relationship between risk perception and health behavior: The example of vaccination. Health Psychol 2007, 26:136-145.
  • [11]Kim C, Mc Ewen LN, Piette JD, Goewey J, Ferrara A, Walker E: Risk perception for diabetes among women with histories of gestational diabetes mellitus. Diabetes Care 2007, 30:2281-2286.
  • [12]Delahanty LM, Conroy MB, Nathan DM, Diabetes Prevention Program Research Group: Psychological predictors of physical activity in the diabetes prevention program. J Am Diet Assoc 2006, 106:698-705.
  • [13]Centers for Disease Control and Prevention (CDC): Self-reported prediabetes and risk-reduction activities--United States, 2006. MMWR Morb Mortal Wkly Rep 2008, 57:1203-1205.
  • [14]Blue CL: Does the theory of planned behavior identify diabetes-related cognitions for intention to be physically active and eat a healthy diet? Public Health Nurs 2007, 24:141-150.
  • [15]Hivert MF, Warner AS, Shrader P, Grant RW, Meigs JB: Diabetes risk perception and intention to adopt healthy lifestyles among primary care patients. Diabetes Care 2009, 32:1820-1822.
  • [16]Prochaska JO, Norcross JC: Systems of psychotherapy. A Transtheoretical analysis. 7th edition. Belmont, CA: Brooks/Cole; 2010.
  • [17]Miller WR, Rose GS: Toward a theory of motivational interviewing. Am Psychol 2009, 64:527-537.
  • [18]Hettema J, Steele J, Miller WR: Motivational interviewing. Annu Rev Clin Psychol 2005, 1:91-111.
  • [19]Paisley CM, Sparks P: Expectations of reducing fat intake: the role of perceived need within the theory of planned behaviour. Psychol Health 1998, 13:341-353.
  • [20]Povey R, Conner M, Sparks P, James R, Shepherd R: Application of the theory of planned behaviour to two dietary behaviours: roles of perceived control and self-efficacy. Br J Health Psychol 2000, 5:121-139.
  • [21]Raats MM, Sparks P, James R, Shepherd R: Understanding dietary change: Perceptions of ten dietary changes. Proc Nutr Soc 1996, 55:1A-77A.
  • [22]Payne N, Jones F, Harris PR: The role of perceived need within the theory of planned behaviour: a comparison of exercise and healthy eating. Br J Health Psychol 2004, 9(Pt 4):489-504.
  • [23]Ajzen I: The theory of planned behaviour. Organ Behav Hum Decis Process 1991, 50:179-211.
  • [24]Prochaska JO, DiClemente CC: Stages and processes of self-change of smoking: toward an integrative model of achange. J Consult Clin Psychol 1983, 51:390-395.
  • [25]Miller WR, Rollnick S: Motivational interviewing: preparing people for change. 2nd edition. New York: Guilford Press; 2002.
  • [26]Amrhein PC, Miller WR, Yahne CE, Palmer M, Fulcher L: Client commitment language during motivational interviewing predicts drug use outcomes. J Consult Clin Psychol 2003, 71:862-878.
  • [27]Moyers TB, Martin T, Christopher PJ, Houck JM, Tonigan JS, Amrhein PC: Client language as a mediator of motivational interviewing efficacy: where is the evidence? Alcohol Clin Exp Res 2007, 31(10 Suppl):40s-47s.
  • [28]Apodaca TR, Longabaugh R: Mechanisms of change in motivational interviewing: a review and preliminary evaluation of the evidence. Addiction 2009, 104:705-715.
  • [29]Hardcastle S, Taylor A, Bailey M, Castle R: A randomised controlled trial on the effectiveness of a primary health care based counselling intervention on physical activity, diet and CHD risk factors. Patient Educ Couns 2008, 70:31-39.
  • [30]Bennett JA, Lyons KS, Winters-Stone K, Nail LM, Scherer J: Motivational interviewing to increase physical activity in long-term cancer survivors: a randomized controlled trial. Nurs Res 2007, 56:18-27.
  • [31]Brodie DA, Inoue A: Motivational interviewing to promote physical activity for people with chronic heart failure. J Adv Nurs 2005, 50:518-527.
  • [32]Harland J, White M, Drinkwater C, Chinn D, Farr L, Howel D: The Newcastle exercise project: a randomised controlled trial of methods to promote physical activity in primary care. Br Med J 1999, 319:828-832.
  • [33]Hutchison AJ, Breckon JD, Johnston LH: Physical activity behavior change interventions based on the transtheoretical model: a systematic review. Health Educ Behav 2009, 36:829-845.
  • [34]Spencer L, Adams TB, Malone S, Roy L, Yost E: Applying the transtheoretical model to exercise: a systematic and comprehensive review of the literature. Health Promot Pract 2006, 7:428-443.
  • [35]Carino JL, Coke L, Gulanic M: Using motivational interviewing to reduce diabetes risk. Prog Cardiovasc Nurs 2004, 19:149-154.
  • [36]Penn L, White M, Oldroyd J, Walker M, Alberti KG, Mathers JC: Prevention of type 2 diabetes in adults with impaired glucose tolerance: the European Diabetes Prevention RCT in Newcastle upon Tyne, UK. BMC Public Health 2009, 9:342. BioMed Central Full Text
  • [37]Ronda G, Van Assema P, Brug J: Stages of change, psychological factors and awareness of physical activity levels in The Netherlands. Health Promot Int 2001, 16:305-314.
  • [38]Garber CE, Allsworth JE, Marcus BH, Hesser J, Lapane KL: Correlates of the stages of change for physical activity in a population survey. Am J Public Health 2008, 98:897-904.
  • [39]De Ridder C, Lechner L: Overschatting van het eigen bewegingsgedrag: gevolgen voor determinanten en stage of change. Tijdschrift Sociale Gezondheidszorg 2004, 79:346-355.
  • [40]van Sluijs EM, Griffin SJ, van Poppel MN: A cross-sectional study of awareness of physical activity: associations with personal, behavioral and psychosocial factors. Int J Behav Nutr Phys Act 2007, 4:53. BioMed Central Full Text
  • [41]Watkinson C, van Sluijs EM, Sutton S, Hardeman W, Corder K, Griffin SJ: Overestimation of physical activity level is associated with lower BMI: a cross-sectional analysis. Int J Behav Nutr Phys Act 2010, 7:68. BioMed Central Full Text
  • [42]Lechner L, Bolman C, Van Dijke M: Factors related to misperception of physical activity in The Netherlands and implications for health promotion programmes. Health Promot Int 2006, 21:104-112.
  • [43]Corder K, van Sluijs EM, McMinn AM, Ekelund U, Cassidy A, Griffin SJ: Perception versus reality awareness of physical activity levels of British children. Am J Prev Med 2010, 38:1-8.
  • [44]Finnish Diabetes Association: Programme for the Prevention of Type 2 Diabetes in Finland 2003–2010. Gummerus Printing, Jyväskylä: Finnish Diabetes Association; 2003.
  • [45]Finnish Diabetes Association: Dehkon 2D-hanke (D2D) 2003–2007. Loppuraportti. In Finnish. Kirjapaino Hermes Oy: Finnish Diabetes Association; 2009.
  • [46]Saaristo T, Peltonen M, Keinanen-Kiukaanniemi S, Vanhala M, Saltevo J, Niskanen L, Oksa H, Korpi-Hyövälti E, Tuomilehto J, FIN-D2D Study Group: National type 2 diabetes prevention programme in Finland: FIN-D2D. Int J Circumpolar Health 2007, 66:101-112.
  • [47]Saaristo T, Moilanen L, Korpi-Hyovalti E, Vanhala M, Saltevo J, Niskanen L, Jokelainen J, Peltonen M, Oksa H, Tuomilehto J, Uusitupa M, Keinanen-Kiukaanniemi S: Lifestyle intervention for prevention of type 2 diabetes in primary health care: one-year follow-up of the Finnish National Diabetes Prevention Program (FIN-D2D). Diabetes Care 2010, 33:2146-2151.
  • [48]Lindstrom J, Tuomilehto J: The diabetes risk score: a practical tool to predict type 2 diabetes risk. Diabetes Care 2003, 26:725-731.
  • [49]World Health Organisation: Definition, Diagnosis and Classification of Diabetes Mellitus and Its complications. Report of a Who Consultation . Part 1: Diagnosis and Classification of Diabetes Mellitus. 1999. 99.2
  • [50]Graham I, Atar D, Borch-Johnsen K, Boysen G, Burell G, Cifkova R, Dallongeville J, De Backer G, Ebrahim S, Gjelsvik B, Herrmann-Lingen C, Hoes A, Humphries S, Knapton M, Perk J, Priori SG, Pyorala K, Reiner Z, Ruilope L, Sans-Menendez S, Op Reimer WS, Weissberg P, Wood D, Yarnell J, Zamorano JL, Walma E, Fitzgerald T, Cooney MT, Dudina A, Vahanian A, et al.: European guidelines on cardiovascular disease prevention in clinical practice: full text. Fourth Joint Task Force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts). Eur J Cardiovasc Prev Rehabil 2007, 14(Suppl 2):S1-S113.
  • [51]Alberti KG, Zimmet P, Shaw J: International Diabetes Federation: a consensus on Type 2 diabetes prevention. Diabet Med 2007, 24:451-463.
  • [52]Geiss LS, James C, Gregg EW, Albright A, Williamson DF, Cowie CC: Diabetes risk reduction behaviors among U.S. adults with prediabetes. Am J Prev Med 2010, 38:403-409.
  • [53]Williams SL, French DP: What are the most effective intervention techniques for changing physical activity self-efficacy and physical activity behaviour–and are they the same? Health Educ Res 2011, 26:308-322.
  • [54]Jallinoja P, Absetz P, Kuronen R, Nissinen A, Talja M, Uutela A, Patja K: The dilemma of patient responsibility for lifestyle change: perceptions among primary care physicians and nurses. Scand J Prim Health Care 2007, 25:244-249.
  • [55]Noar SM, Benac CN, Harris MS: Does tailoring matter? Meta-analytic review of tailored print health behavior change interventions. Psychol Bull 2007, 133:673-693.
  • [56]Lorentzen C, Ommundsen Y, Holme I: Psychosocial correlates of stages of change in physical activity in an adult community sample DOI:dx.doi.org. Eur J Sport Sci 2007, 7:93-106.
  • [57]Miilunpalo S, Nupponen R, Laitakari J, Marttila J, Parosnen O: Stages of change in two modes of health-enhancing physical activity: methodological aspects and promotional implications. Health Educ Res 2000, 15:435-448.
  • [58]Marcus BH, Forsyth LH, Stone EJ, Dubbert PM, McKenzie TL, Dunn AL, Blair SN: Physical activity behaviour change: issues in adoption and maintenance. Health Psychol 2000, 19(Suppl 1):32-41.
  • [59]Marcus BH, Williams DM, Dubbert PM, Sallis JF, King AC, Yancey AK, Franklin BA, Buchner D, Daniels SR, Claytor RP, American Heart Association Council on Nutrition Physical Activity, and Metabolism (Subcommittee on Physical Activity) American Heart Association Council on Cardiovascular Disease in the Young Interdisciplinary Working Group on Quality of Care and Outcomes Research, American Heart Association Council on Nutrition Physical Activity, and Metabolism (Subcommittee on Physical Activity) American Heart Association Council on Cardiovascular Disease in the Young Interdisciplinary Working Group on Quality of Care and Outcomes Research: Physical activity intervention studies: what we know and what we need to know: a scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity); Council on Cardiovascular Disease in the Young; and the Interdisciplinary Working Group on Quality of Care and Outcomes Research. Circulation 2006, 114:2739-2752.
  • [60]Foster C, Hillsdon M, Thorogood M: Interventions for promoting physical activity. Cochrane Database Syst Rev 2009., 1
  • [61]Saaristo T: Assessment of risk and prevention of type 2 diabetes in primary health care. 2011. PhD thesis. Acta Universitas Ouluensis D1144, University of Oulu
  • [62]Shephard RJ: Limits to the measurement of habitual physical activity by questionnaires. Br J Sports Med 2003, 37:197-206. discussion 206
  • [63]Troiano RP, Pettee Gabriel KK, Welk GJ, Owen N, Sternfeld B: Reported physical activity and sedentary behaviour: why do you ask? J Phys Act Health 2012, 9(Suppl 1):S68-S72.
  • [64]Hooker SP, Fulton J, Mudd LM: Practice-based evidence: A novel concept for self-report physical activity measurement. J Phys Act Health 2012, 9(Suppl 1):S85-S87.
  • [65]Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, Macera CA, Heath W, Thompson PD, Bauman A: Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc 2007, 39:1423-1434.
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