Kaupapa Consulting Ltd, Napier, Aotearoa/New Zealand.
School of Nursing and Midwifery, Edith Cowan University, Joondalup, Australia.
Public Health Nutr. 2021 Dec;24(18):6015-6026. doi: 10.1017/S1368980021001968. Epub 2021 May 10.
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.
A qualitative study involving semi-structured, face-to-face interviews with a stratified sample of adults with prediabetes and BMI ≥ 25 kg/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.
Hawke's Bay, Aotearoa/New Zealand, April 2018-March 2020.
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.
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.
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 socio-economic environment.
了解在参与初级保健护士主导的个体化饮食干预的具有糖尿病前期的新西兰多样化人群中，饮食改变的动机、促进因素和挑战。
一项定性研究，对来自更大的基于初级保健的糖尿病前期饮食干预研究的具有糖尿病前期和 BMI≥25kg/m2 的成年人进行分层抽样，进行半结构式、面对面访谈。进行主题分析。社会生态模型指导解释。
新西兰霍克湾，2018 年 4 月至 2020 年 3 月。
58 名年龄在 28-69 岁之间的参与者，其中男女比例相近，有和没有回归正常血糖的新西兰毛利人和非毛利人比例也相近，以及有和没有回归正常血糖的参与者比例也相近。
想要改变饮食的动机是不想进展为糖尿病；想要健康并为他人做出贡献，并得到他人的鼓励。采取和维持改变的促进因素是强烈渴望健康；个人决心和感觉得到支持。挑战是对生活和环境因素的控制受到损害；感到不被他人支持；社交场合；经济限制和与其他健康状况并存。制定自己克服挑战的策略是赋权的，使人们感到有控制感。这些因素在人口统计学和血糖结果组中都相似。
影响饮食改变的因素涉及个人、人际、组织、环境和政策因素。尽管研究结果在各群体中似乎相似，但饮食干预需要针对个人和社会群体中动机、促进因素和挑战的具体表现方式，并根据更广泛的肥胖和社会经济环境进行相应调整。
