Perceptions and Intentions to Prevent Diabetes Among At-Risk Individuals: A Qualitative Study Using the Theory of Planned Behaviour

Abstract

Aim: To explore the perceptions and factors that influence intentions to prevent diabetes among at-risk individuals.

Design: A descriptive qualitative study design was used. The Consolidated criteria for Reporting Qualitative Research (COREQ) checklist guided the presentation of findings.

Methods: Nine focus groups, including 47 individuals at risk of diabetes from the community in Singapore, were interviewed from April 2023 to January 2024. The semi-structured guide was developed on the basis of the theory of planned behaviour and validated by two content experts. Focus group interviews were audio-recorded, transcribed verbatim and analysed using Hsieh and Shannon's content analysis.

Results: Six main categories emerged from the data analysis. Individual's perceptions of diabetes were associated with excessive sugar, and prediabetes a warning sign of impending diabetes. Participants were knowledgeable about the risk factors of diabetes but needed more actionable information. They also perceived that more awareness of diabetes is necessary. Participants' attitudes towards diabetes were individualistic, dependent on their sense of vulnerability and individual personalities. The subjective norms that influenced their behaviours were socio-cultural in nature. The main barriers impeding diabetes prevention were their commitment and responsibilities to family and work, accessibility to healthier lifestyle practices and internal struggles with the tediousness of diabetes prevention behaviours.

Conclusion: To improve intentions to engage in diabetes prevention, a diabetes prevention programme needs to be hosted on a culturally appropriate mHealth platform for groups of like-minded individuals at risk of diabetes and their family and friends.

Implications for nurses: Nurses possess the necessary skills and experience to develop and deliver diabetes prevention programmes, create awareness of existing government initiatives and resources, and improve chronic disease management in the clinical setting.

Patient or public contribution: Members of the public assisted in recruitment. They also engaged in focus group discussions and provided the insights necessary for this study.

Keywords: diabetes; healthy lifestyle; nursing; prediabetes; prevention; qualitative study.