Self-efficacy and diabetes prevention in overweight South Asians with pre-diabetes

• Authors: Catherine E. Cioffi, Emory University; Harish Ranjani, Madras Diabetes Research Foundation; Lisa R Staimez, Emory University; Ranjit Mohan Anjana, Madras Diabetes Research Foundation; Viswanathan Mohan, Madras Diabetes Research Foundation; Mary Beth Weber, Emory University
• Journal Title: BMJ Open Diabetes Research and Care
• Volume: Volume 6, Number 1
• Publisher: BMJ Publishing Group: Open Access | 2018-10-01
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1136/bmjdrc-2018-000561
• Subjects: Health Sciences, Nutrition; Health Sciences, Health Care Management

Abstract

Objective We evaluated the effects of a diabetes prevention itervention on self-efficacy (SE) and the associations between SE and diabetes-related outcomes among overweight Asian Indian adults with pre-diabetes in a randomized controlled translational trial (the Diabetes Community Lifestyle Improvement Program, D-CLIP). Research design and methods Data were obtained from 550 adults who were randomized to a diabetes prevention program or standard of care. Dietary and exercise-related SEs were measured at baseline, core intervention completion (4months), and annually until the end of follow-up (3 years or diabetes diagnosis). Mixed-effects regressions described changes in SE over time by treatment group. Among treatment participants, multivariable-adjusted models described associations of SE at baseline and intervention completion with diabetes incidence and other secondary outcomes (weight, waist circumference (WC), exercise, and energy intake). Results From baseline to 4months, dietary (β=10.3, p=0.04) and exercise (β=0.49, p=0.04) SE increased significantly in the treatment arm only; however, this increase from baseline was no longer significant at later time points. Among treatment participants, there was no association of dietary or exercise SE with diabetes incidence, but baseline exercise SE was independently associated with improved weight, WC, and exercise at 4months (p<0.05). Change in exercise SE from baseline to intervention completion also predicted increased exercise at 4, 12, and 24 months (p<0.05). Conclusions Exposure to D-CLIP resulted in improved SE at treatment completion, but this effect was not sustained over longer follow-up. Several short-term and long-term secondary outcomes, but not diabetes risk, were significantly associated with exercise SE, suggesting this psychosocial trait may facilitate success in achieving certain health goals. Trial registration number NCT01283308.