title: Socioeconomic status and psychosocial mechanisms of lifestyle change in a type 2 diabetes prevention trial.
abstract: 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.
authors.affiliation: Department of Lifestyle and Participation, National Institute for Health and Welfare, Helsinki, Finland. nelli.hankonen@thl.fi
authors.forename: Nelli
authors.initials: N
authors.lastname: Hankonen
authors.forename: Pilvikki
authors.initials: P
authors.lastname: Absetz
authors.forename: Ari
authors.initials: A
authors.lastname: Haukkala
authors.forename: Antti
authors.initials: A
authors.lastname: Uutela
mesh_terms: 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