Saw Swee Hock School of Public Health, National University of Singapore, and National University Health System, Singapore, Singapore.
Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore.
BMC Public Health. 2022 Aug 20;22(1):1582. doi: 10.1186/s12889-022-14020-z.
Therapeutic lifestyle changes can reduce individual risk of type 2 diabetes (T2D) by up to 58%. In Singapore, rates of preventive practices were low, despite a high level of knowledge and awareness of T2D risk and prevention. The study explored the context of the discrepancy between knowledge and practices in T2D prevention among adults undiagnosed with the condition.
In-depth interviews with 41 adults explored lay beliefs of T2D and the sources of these perceptions, subjective interpretation of how T2D may impact lives, and perceived costs and benefits of practising preventative behaviours. Purposive sampling was used to maximise the variability of participants in demographic characteristics. Thematic analysis was conducted to identify themes related to the domains of inquiry.
Participants' risk perceptions were influenced by familial, social, and cultural contexts of the representation and management of T2D conditions. The adverse effects of T2D were often narrated in food culture. The cost of adopting a healthy diet was perceived at a high cost of life pleasure derived from food consumption and social interactions. Inconveniences, loss of social functions, dependency and distress were the themes related to T2D management. Participants' motivation to preventive practices, such as exercise and weight loss, were influenced by short-term observable benefits.
T2D risk communication needs to be addressed in emotionally impactful and interpersonally salient ways to increase the urgency to adopt preventative behaviours. Shifting perceived benefits from long-term disease prevention to short-term observable wellbeing could reduce the response cost of healthy eating.
生活方式的治疗性改变可以将个体患 2 型糖尿病（T2D）的风险降低多达 58%。在新加坡，尽管人们对 T2D 的风险和预防有很高的了解和认识，但预防措施的实施率仍然很低。本研究探讨了在未确诊为 T2D 的成年人中，知识与 T2D 预防实践之间存在差异的背景。
对 41 名成年人进行了深入访谈，探讨了他们对 T2D 的一般看法以及这些看法的来源、他们对 T2D 可能如何影响生活的主观理解，以及他们对实施预防行为的成本和收益的看法。采用目的抽样法，使参与者在人口统计学特征方面的变异性最大化。对主题进行了分析，以确定与研究领域相关的主题。
参与者的风险感知受到 T2D 状况的代表性和管理的家族、社会和文化背景的影响。T2D 的不良影响常常在食物文化中被描述。采用健康饮食的成本被认为是生活乐趣的高成本，这种乐趣来自于食物消费和社交互动。与 T2D 管理相关的主题包括不便、丧失社会功能、依赖和痛苦。参与者对预防措施（如锻炼和减肥）的动机受到短期可观察到的好处的影响。
需要以情感上有影响力和人际上有意义的方式来进行 T2D 风险沟通，以增加人们采取预防措施的紧迫性。将感知到的收益从长期疾病预防转移到短期可观察到的健康状况改善，可以降低健康饮食的反应成本。
