Department of Health Promotion & Behavioral Sciences, The University of Texas Health Science Center Houston (UTHealth Houston) School of Public Health, Trinity Towers, 2777 N Stemmons Fwy, Ste 8400, TX, 75207, Dallas, USA.
UTHealth Houston School of Public Health, Center for Health Promotion & Prevention Research, 7000 Fannin Street, Houston, TX, 77030, USA.
J Gen Intern Med. 2023 Jun;38(8):1928-1954. doi: 10.1007/s11606-023-08164-w. Epub 2023 Apr 10.
This systematic review describes approaches to measuring perceived risk of developing type 2 diabetes among individuals without diagnoses and describes the use of theories, models, and frameworks in studies assessing perceived risk. While a systematic review has synthesized perceived risk of complications among individuals with diabetes, no reviews have systematically assessed how perceived risk is measured among those without a diagnosis.
Medline, PubMed, PsycINFO, and CINAHAL databases were searched for studies conducted through October 2022 with measures of perceived risk among adults ≥ 18 years without a diabetes diagnosis. Extracted data included study characteristics, measures, and health behavior theories, models, or frameworks used.
Eighty-six studies met inclusion criteria. Six examined perceived risk scales' psychometric properties. Eighty measured perceived risk using (1) a single item; (2) a composite score from multiple items or subconstructs; and (3) multiple subconstructs but no composite score. Studies used items measuring "comparative risk," "absolute or lifetime risk," and "perceived risk" without defining how each differed. Sixty-four studies used cross-sectional designs. Twenty-eight studies mentioned use of health behavior theories in study design or selection of measures.
There was heterogeneity in how studies operationalized perceived risk; only one third of studies referenced a theory, model, or framework as guiding design or scale and item selection. Use of perceived lifetime risk, absolute risk, or comparative risk limits comparisons across studies. Consideration of context, target population, and how data are utilized is important when selecting measures; we present a series of questions to ask when selecting measures for use in research and clinical settings. This review is the first to categorize how perceived risk is measured in the diabetes prevention domain; most literature focuses on perceived risk among those with diabetes diagnoses. Limitations include exclusion of non-English and gray literature and single reviewer screening and data extraction.
本系统评价描述了用于测量无诊断个体发生 2 型糖尿病风险感知的方法，并描述了在评估风险感知的研究中使用理论、模型和框架的情况。虽然有一项系统评价综合了糖尿病患者并发症风险感知，但没有综述系统地评估了无诊断个体的风险感知是如何测量的。
检索了 Medline、PubMed、PsycINFO 和 CINAHAL 数据库，以获取截至 2022 年 10 月期间开展的、针对≥18 岁无糖尿病诊断成年人的风险感知测量研究。提取的数据包括研究特征、测量方法以及使用的健康行为理论、模型或框架。
86 项研究符合纳入标准。6 项研究检验了风险感知量表的心理测量特性。80 项研究使用以下方法测量了风险感知：（1）单个项目；（2）多个项目或亚结构的综合得分；以及（3）多个亚结构但没有综合得分。研究使用了衡量“相对风险”、“绝对风险或终身风险”和“感知风险”的项目，但没有定义每个项目之间的差异。64 项研究采用了横断面设计。28 项研究在研究设计或测量方法的选择中提到了使用健康行为理论。
研究如何操作感知风险存在异质性；只有三分之一的研究参考了理论、模型或框架，以指导设计或量表和项目选择。使用感知终生风险、绝对风险或相对风险限制了研究之间的比较。在选择测量方法时，考虑背景、目标人群以及如何利用数据非常重要；我们提出了一系列问题，以供在研究和临床环境中选择测量方法时参考。本综述是首次对糖尿病预防领域感知风险的测量方法进行分类；大多数文献都集中于糖尿病诊断患者的风险感知。本研究的局限性包括排除非英语和灰色文献以及仅由一名审查员进行筛查和数据提取。
