The purpose of this research was to identify factors that affect the nutrition and exercise behaviors of persons over the age of 55 with type 2 diabetes.
METHODS
Focus groups were conducted using a validated focus group interview guide to determine primary health concerns and health behaviors, favored learning modalities, barriers to learning, food preferences, and exercise preferences.
RESULTS
The following major themes and subthemes were identified: some risk factors for diabetes and heart disease seem more salient than others; perceived susceptibility for serious outcomes of diabetes can occur through vicarious learning; willpower, often obtained through a belief in God, is necessary for successful behavior change; effective modification of behavior and building self-efficacy starts with small steps; and intrinsic reinforcement is necessary for behavior change.
CONCLUSIONS
These data were used to identify strategies and messages to enhance adherence to nutrition and activity recommendations for persons with type 2 diabetes and accompanying cardiovascular risk factors.
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References
1.
1. Mokdad AH, Bowman BA, Ford ES, Vinicor F, Marks JS, Koplan JP. The continuing epidemics of obesity and diabetes in the United States. JAMA. 2001;286:1195-1200.
2.
2. American Diabetes Association. Facts and figures. The dangerous toll of diabetes, 2000. Available at: www.diabetes.org/ada/facts.asp. Accessed January 2002.
3.
3. Boyle JP. Honeycutt AA, Venkat Narayan KM, et al. Projection of diabetes burden through 2050: impact of changing demography and disease prevalence in the US. Diabetes Care. 2001;24: 1936-1940.
4.
4. American Diabetes Association. Economic consequences of diabetes mellitus in the US in 1997. Diabetes Care. 1998;21: 296-309.
5.
5. Centers for Disease Control. Behavioral risk factor surveillance system. Available at: www.cdc.gov/nccdphp/brfss. Accessed March 2002.
6.
6. Federal Interagency Forum on Aging-Related Statistics. Older Americans 2000: key indicators of well-being. Available at: www.agingstats.gov/chartbook2000/population.Html. Accessed February 2002.
7.
7. Centers for Disease Control, National Center for Chronic Disease Prevention and Health Promotion. National diabetes fact sheet, 2000. Available at: www.cdcgov/diabetes/pubs/facts98.htm. Accessed January 2002.
8.
8. Diabetes Research Working Group. Conquering Diabetes: A Strategic Plan for the 21 st Century. Bethesda, Md: National Institutes of Health; 1999. NIH publication 99-4398.
9.
9. Pasternak RC, Grundy SM, Levy D, Thompson PD, and Task Force 3. Spectrum of risk factors for coronary heart disease. J Am Coll Cardiol. 1996; 27:978-978.
10.
10. Norris SL, Engelgau MM, Venkat Natayan KM. Effectiveness of self-management training in type 2 diabetes: a systematic review of randomized control trials. Diabetes Care. 2001;24:561-587.
11.
11. Centers for Disease Control. Strategies for reducing morbidity and mortality from diabetes through health-care system interventions and diabetes self-management education in community settings. MMWR Morb Mortal Wkly Rep.2001; 50(RR-16).
12.
12. US Department of Health and Human Services. Healthy People 2010. 2nd ed.Washington, DC: US Government Printing Office; 2000. Available at: www.health.gov/healthypeople/. Accessed March 2002.
14. Testa MA, Simonson DC. Health economic benefits and quality of life during improved glycemic control in patients with type 2 diabetes mellitus: a randomized, controlled, double-blind trial. JAMA. 1998; 280:1490-1496.
15.
15. Franz MIJ, Bantle JP, Beebe CA, et al. Evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications (technical review). Diabetes Care. 2002; 25:148-198.
16.
16. American Diabetes Association. Evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications (position statement). Diabetes Care. 2002; 25:S50-S60.
17.
17. Rainey CJ, Mayo RM, Haley-Zitlin V, Kemper KA, Cason KL. Nutritional beliefs, attitudes and practices of elderly, rural, southern women. J Nutr Elder. 2000;20:3-27.
18.
l8. Holcomb CA. Positive influence of age and education on food consumption and nutrient intakes of older women living alone. J Am Diet Assoc. 1995;95:1381-1386.
19.
19. Fischer CA, Crocket SJ, Heller KE, Skauge LH. Nutrition knowledge, attitudes and practices of older and younger elderly in rural areas. J Am Diet Assoc. 1991;91:1398-1401.
20.
20. Ho EE, Lee FC, Meyskens FL. An exploratory study of attitudes, beliefs and practices related to the interim dietary guidelines for reducing cancer in the elderly. J Nutr Elder. 1991;10:31-49.
21.
21. Crockett SJ, Heller KE, Merkel JM. Assessing Beliefs of Older Rural Americans About Nutrition Education: Use of the Focus Group Approach. Fargo, North Dakota: Dept of Food and Nutrition, Extension Services, Nutrition Education for Rural Seniors, North Dakota State University, and Veteran's Administration Hospital; 1990;90: 563-567.
23. Kreuger RA. Focus Groups: A Practical Guide for Applied Research. 2nd ed.Thousand Oaks, Calif: Sage Publications; 1994.
24.
24. Bandura A.Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev.1977;84:191-215.
25.
25. Gorsuch RL. Assessing spiritual variables in Alcoholics Anonymous research. In: McCrady BS, Miller WR, eds. Research on Alcoholics Anonymous: Opportunities and Alternatives. New Brunswick, NJ: Alcohol Research Documentation, Inc., Publications Division, Rutgers Center of Alcohol Studies; 1993.
26.
26. National Heart, Lung, and Blood Institute, National Institutes of Health. The practical guide: identification, evaluation, and treatment of overweight and obesity in adults. Available at: www.nhlbi.nih.gov/guidelines/obesity/practgde.htm. Accessed March 2002.
