Socioeconomic status and psychosocial mechanisms of lifestyle change in a type 2 diabetes prevention trial.
BACKGROUND
Little is known about psychosocial mechanisms that may underlie differences in lifestyle change between socioeconomic groups.


OBJECTIVE
The purpose of this study is to examine how educational level influences middle-aged participants' (N = 385) psychosocial responses to the GOAL Lifestyle Implementation Trial.


METHODS
The measurements of self-efficacy and planning for healthy lifestyle were conducted pre-intervention (T1) and post-intervention (T2, 3 months), and measurements of exercise and healthy eating as outcomes at T1 and at 12 months (T3).


RESULTS
Psychosocial determinants at T1 and their T1-T2 changes were mostly similar, irrespective of educational levels. Exercise barriers self-efficacy was enhanced slightly less (p = 0.08) among the low-SES. T2 levels as well as pre-post-intervention changes in exercise self-efficacy predicted 12-month changes in exercise, and T2 diet coping planning predicted changes in dietary fat intake. The associations were similar across all SES groups.


CONCLUSIONS
Enhancing self-efficacy and planning is similarly effective among intervention participants regardless of education level.
Hankonen
Nelli
N
Department of Lifestyle and Participation, National Institute for Health and Welfare, Helsinki, Finland. nelli.hankonen@thl.fi
Absetz
Pilvikki
P
Haukkala
Ari
A
Uutela
Antti
A
D000368:Aged; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control / Q000523:psychology*; D004435:Eating / Q000523:psychology; D015444:Exercise / Q000523:psychology; D005247:Feeding Behavior; D005260:Female; D015438:Health Behavior; D006266:Health Education; D006293:Health Promotion; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D012307:Risk Factors; D020377:Self Efficacy; D012923:Social Class; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires