Factors influencing the likelihood of dietary compliance amongst people with diabetes

Factors influencing the likelihood of dietary compliance amongst people with diabetes

Diabetes is one of the greatest health pandemics to impact the global health system and despite concerted efforts by governments to manage and control it there is little respite from its rapid progression. At this point there is no known cure for diabetes, however many of its negative health impacts can be controlled or prevented through formal therapy, dietary modification and exercise. Of these, dietary modification is considered an important first step for positive diabetes management and therapy outcomes.

Unfortunately, despite this knowledge and support provided by the health system to better manage dietary lifestyles, many people with diabetes are unable to carry out dietary modification regimens. Factors such as individual cognition; environmental factors; and biological factors (Nam et al. 2011; Schiøtz 2012) have been found to influence dietary behaviour among people with diabetes. Of these, cognitive factors are considered to be the major driving force influencing health behaviours (Bandura 1986; Frewer et al. 1996). The present study through literature review has found cognitively driven factors such as self-efficacy, food risk perception, food related lifestyles and usage of social support groups as key drivers found to influence the likelihood of dietary compliance amongst people with diabetes. However, up to date there are still inconclusive results from studies testing these factors (Nam et al. 2011; Schiøtz 2012), therefore the present study has attempted to close these research gaps by empirically testing these constructs in the present model.

The analysis in this study was conducted in three Phases: I, II and III i.e. Analysis I, II and III, to which 3 models were tested and presented as Alternative Model 1, 2 and 3 respectively. The results for all three phases reveal that self-efficacy is a key factor to influence both social support usage and dietary compliance. Phases I and II revealed no significant mediation relationship between the usage of social support and the cognitive constructs in the model and dietary compliance which contradicts literature (Antonovsky 1974; Thoits 1985). Phase III was conducted to re-examine the Social Support Groups Usage construct and to test its role as a key driver in the model. Phase III showed a strong relationship between social support usage and the constructs of self-efficacy, food risk perception and food related lifestyles. Mixed outcomes were also found in some causal relationships in all three models from this study which supports literature (Bandura 1986; Frewer et al. 1996; Grunert, Brunsø & Bisp 1993), in that cognitive factors are multi-dimensional, situational and guided by a range of factors.

Using a social marketing framework, the findings of this study are translated into likely useful recommendations for the health system and relevant diabetes support groups in Australia. A constant challenge for those working within the social marketing domain is understanding the motivations that drive food choice behaviour, this understanding is essential for the creation of effective message strategies to generate dietary behaviour modification (Luca & Suggs 2013). Therefore, by understanding the factors that influence dietary compliance amongst people with diabetes, this study will not only have impact for those working in the health care sector but it will also extend current literature in social marketing in support of health care marketing.