Cross-cultural analysis of motivational determinants among people at risk of or with type two diabetes

Ondertitel:a translational study of self-determination theory

Type 2 diabetes (T2D) belongs to the world’s biggest killers and is a leading cause of disability. The burden of T2D is increasing rapidly, not least in Sub-Saharan Africa, and disadvantaged populations are disproportionally affected. A healthy lifestyle such as engaging in regular physical activity and a healthy diet are key in the prevention and management of T2D, but are a challenge to implement. Understanding motivational determinants of health behavior is essential to guide implementation, but evidence is lacking for disadvantaged populations and people living in low- and middle-income countries. The aim of this study is to confirm the validity of Self-determination Theory in maintaining a healthy diet and regular physical activity among disadvantaged populations with, or at risk of diabetes. Using structural equation modeling, we assessed the validity of a motivational process model across a rural Ugandan sample and disadvantaged samples with high proportions of immigrants in urban South Africa and Sweden. Associations between motivational constructs and behavioral outcomes were consistent with the hypothesized Self-determination theory process model for both lifestyle behaviors. Proxy measures of perceived competence and perceived relatedness were associated with autonomous motivation for both behaviors. Findings suggested that different types of motivation regulate different domains and intensities of physical activity. We also found that it was possible to compare motivational constructs across settings, but the motivational process model was not consistent across settings. Our findings support the use of Self-determination Theory for the implementation of a healthy lifestyle among disadvantaged populations. Our findings are relevant for health promotion at public health level, for health workers, but also for people living with type two diabetes themselves and their significant others. We recommend future research to focus on the role of perceived autonomy and to address the methodological challenges of our studies, including the cross-sectional design, the sampling strategy and the quality of the measures.

Jaar van publicatie:2022

Trefwoorden:Doctoral thesis

Toegankelijkheid:Open