Proximal and distal influences on dietary change among a diverse group with prediabetes participating in a pragmatic, primary care nurse-led intervention: A qualitative study
Document Type
Journal Article
Publication Title
Public Health Nutrition
Publisher
Cambridge University Press
School
School of Nursing and Midwifery
RAS ID
36002
Funders
Health Research Council of New Zealand
Abstract
Objective: To understand motivators, facilitators and challenges to dietary change amongst a diverse sample of New Zealanders with prediabetes participating in a primary care nurse-led individualised dietary intervention. Design: A qualitative study involving semi-structured, face-to-face interviews with a stratified sample of adults with prediabetes and body mass index ≥ 25kg/m2, purposefully selected from a larger 2-year primary care-based prediabetes dietary intervention study. Thematic analysis was undertaken. A socio-ecological model guided interpretation. Setting: Hawke's Bay, Aotearoa/New Zealand, April 2018-March 2020. Participants: Fifty-eight people aged 28-69 years, with similar numbers of men and women, indigenous Māori and non-Māori, and those who had and had not regressed to normoglycaemia at 6-months. Results: Motivators for wanting to make dietary changes were determination not to progress to diabetes; wanting to be healthy and contribute to others; and encouragement by others. Facilitators for adopting and maintaining changes were a strong desire to be healthy; personal determination; and feeling supported. Challenges were compromised control over life and environmental factors; feeling unsupported by others; social occasions; financial constraints; and living with other health conditions. Developing their own strategies to overcome challenges was empowering, enabling a sense of control. These factors were similar across demographic and glycaemic outcome groups. Conclusions: Influences on dietary change involved personal, interpersonal, organisational, environmental, and policy factors. Although findings appeared similar across groups, dietary interventions need to address the specific ways motivators, facilitators and challenges manifest for individuals and social groups, and be tailored accordingly within the context of the wider obesogenic and socioeconomic environment.
DOI
10.1017/S1368980021001968
Access Rights
subscription content
Comments
Abel, S. L., Whitehead, L. C., Tipene-Leach, D. C., & Coppell, K. J. (2021). Proximal and distal influences on dietary change among a diverse group with prediabetes participating in a pragmatic, primary care nurse-led intervention: A qualitative study. Public Health Nutrition, 24(18), 6015-6026. https://doi.org/10.1017/S1368980021001968