Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
PLoS One. 2022 Oct 6;17(10):e0275576. doi: 10.1371/journal.pone.0275576. eCollection 2022.
Lifestyle interventions focusing on diet and physical activity for the prevention and management of type 2 diabetes have been found effective. Acceptance of the intervention is crucial. The Theoretical Framework of Acceptability (TFA) developed by Sekhon et al. (2017) describes the multiple facets of acceptance: Affective attitude, burden, perceived effectiveness, ethicality, intervention coherence, opportunity costs and self-efficacy. The aims of this study were to develop and assess the psychometric properties of a measurement scale for acceptance of a telephone-facilitated health coaching intervention, based on the TFA; and to determine the acceptability of the intervention among participants living with diabetes or having a high risk of diabetes in socioeconomically disadvantaged areas in Stockholm.
This study was nested in the implementation trial SMART2D (Self-management approach and reciprocal learning for type 2 diabetes). The intervention consisted of nine telephone-facilitated health coaching sessions delivered individually over a 6-month period. The acceptability of the intervention was assessed using a questionnaire consisting of 19 Likert scale questions developed using Sekhon's TFA. Exploratory factor analysis (EFA) was performed.
Ratings from 49 participants (19 with type 2 diabetes and 30 at high risk of developing diabetes) in ages 38-65 were analyzed. The EFA on the acceptability scale revealed three factors with acceptable reliabilities: affective attitude (alpha 0.90), coherence and understanding (alpha 0.77), perceived burden (alpha 0.85), explaining 82% of the variance. Positive affect and coherence had high median scores and small variance. Median score for perceived burden was low, but with significant variance due to younger individuals and those at high risk reporting higher burden.
The telephone-facilitated health coaching intervention was perceived as acceptable by the study population using a questionnaire based on Sekhon's TFA, with a wider variation in perceived burden seen among high risk and younger participants.
针对 2 型糖尿病的预防和管理，以饮食和身体活动为重点的生活方式干预已被证明是有效的。接受干预至关重要。Sekhon 等人（2017 年）提出的可接受性理论框架（TFA）描述了接受的多个方面：情感态度、负担、感知效果、道德、干预一致性、机会成本和自我效能。本研究的目的是基于 TFA 开发和评估用于测量电话促进健康辅导干预可接受性的测量量表的心理测量特性；并确定在斯德哥尔摩社会经济弱势地区患有糖尿病或有患糖尿病高风险的参与者对该干预措施的可接受性。
本研究嵌套在实施试验 SMART2D（2 型糖尿病的自我管理方法和相互学习）中。该干预措施包括在 6 个月期间通过 9 次电话进行的个人健康辅导。使用 Sekhon 的 TFA 开发的 19 个李克特量表问题的问卷评估干预的可接受性。进行了探索性因素分析（EFA）。
分析了年龄在 38-65 岁之间的 49 名参与者（19 名 2 型糖尿病患者和 30 名有患糖尿病高风险的患者）的评分。可接受性量表的 EFA 显示出三个具有可接受信度的因素：情感态度（α 0.90）、一致性和理解（α 0.77）、感知负担（α 0.85），解释了 82%的方差。积极的情感和一致性得分较高，方差较小。感知负担的中位数得分较低，但由于年轻个体和高风险个体报告的负担较高，方差较大。
使用基于 Sekhon 的 TFA 的问卷，研究人群认为电话促进健康辅导干预是可接受的，在高风险和年轻参与者中，感知负担的差异较大。
