title: Understanding perceived risk of type 2 diabetes in healthy middle-aged adults: a cross-sectional study of associations with modelled risk, clinical risk factors, and psychological factors.
abstract: OBJECTIVE
  To determine the perceived risk of type 2 diabetes in a sample of healthy middle-aged adults and examine the association between perceived risk and modelled risk, clinical risk factors, and psychological factors theorised to be antecedents of behaviour change.
  
  
  METHODS
  An exploratory, cross-sectional analysis of perceived risk of type 2 diabetes (framed according to time and in comparison with peers) was conducted using baseline data collected from 569 participants of the Diabetes Risk Communication Trial (Cambridgeshire, UK). Type 2 diabetes risk factors were measured during a health assessment and the Framingham Offspring Diabetes Risk Score was used to model risk. Questionnaires assessed psychological factors including anxiety, diabetes-related worry, behavioural intentions, and other theory-based antecedents of behaviour change. Multivariable regression analyses were used to examine associations between perceived risk and potential correlates.
  
  
  RESULTS
  Participants with a high perceived risk were at higher risk according to the Framingham Offspring Diabetes Risk Score (p<0.001). Higher perceived risk was observed in those with a higher body fat percentage, lower self-rated health, higher diabetes-related worry, and lower self-efficacy for adhering to governmental recommendations for physical activity (all p<0.001). The framing of perceived risk according to time and in comparison with peers did not influence these results.
  
  
  CONCLUSIONS
  High perceived risk of type 2 diabetes is associated with higher risk of developing the disease, and a decreased likelihood of engagement in risk-reducing health behaviours. Risk communication interventions should target high-risk individuals with messages about the effectiveness of prevention strategies.
authors.affiliation: MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Box 285, Addenbrooke's Hospital, Hills Road, Cambridge CB2 0QQ, United Kingdom.
authors.forename: Job G
authors.initials: JG
authors.lastname: Godino
authors.affiliation: MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Box 285, Addenbrooke's Hospital, Hills Road, Cambridge CB2 0QQ, United Kingdom.
authors.forename: Esther M F
authors.initials: EM
authors.lastname: van Sluijs
authors.affiliation: Behavioural Science Group, Institute of Public Health, University of Cambridge, Forvie Site, Robinson Way, Cambridge CB2 0SR, United Kingdom.
authors.forename: Stephen
authors.initials: S
authors.lastname: Sutton
authors.affiliation: MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Box 285, Addenbrooke's Hospital, Hills Road, Cambridge CB2 0QQ, United Kingdom. Electronic address: simon.griffin@mrc-epid.cam.ac.uk.
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Griffin
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control / Q000523:psychology; D015438:Health Behavior; D010353:Patient Education as Topic; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D020377:Self Efficacy; D011795:Surveys and Questionnaires
keywords: Modelled risk; Perceived risk; Prevention; Psychology; Risk communication; Type 2 diabetes