How are health-related behaviours influenced by a diagnosis of pre-diabetes? A meta-narrative review
Abstract Background Several countries, including England, have recently introduced lifestyle-focused diabetes prevention programmes. These aim to reduce the risk of individuals with pre-diabetes developing type 2 diabetes. We sought to summarise research on how socio-cultural influences and risk per...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2018-07-01
|
| Series: | BMC Medicine |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12916-018-1107-6 |
| _version_ | 1819263485081550848 |
|---|---|
| author | Eleanor Barry Trisha Greenhalgh Nicholas Fahy |
| author_facet | Eleanor Barry Trisha Greenhalgh Nicholas Fahy |
| author_sort | Eleanor Barry |
| collection | DOAJ |
| description | Abstract Background Several countries, including England, have recently introduced lifestyle-focused diabetes prevention programmes. These aim to reduce the risk of individuals with pre-diabetes developing type 2 diabetes. We sought to summarise research on how socio-cultural influences and risk perception affect people’s behaviour (such as engagement in lifestyle interventions) after being told that they have pre-diabetes. Methods Using the RAMESES standards for meta-narrative systematic reviews, we identified studies from database searches and citation-tracking. Studies were grouped according to underlying theorisations of pre-diabetes. Following a descriptive analysis, the studies were synthesised with reference to Cockerham’s health lifestyle theory. Results In total, 961 titles were scanned, 110 abstracts assessed and 35 full papers reviewed. Of 15 studies included in the final analysis, 11 were based on individual interviews, focus groups or ethnography and five on structured questionnaires or surveys. Three meta-narratives emerged. The first, which we called biomedical, characterised pre-diabetes as the first stage in a recognised pathophysiological illness trajectory and sought to intervene with lifestyle changes to prevent its progression. The second, which we called psychological, focused on the theory-informed study of the knowledge, attitudes and behaviours in people with pre-diabetes. These studies found that participants generally had an accurate perception of their risk of developing diabetes, but this knowledge did not directly lead to behavioural change. Some psychological studies incorporated wider social factors in their theoretical models and sought to address these through action at the individual level. The third meta-narrative we termed social realist. These studies conceptualised pre-diabetes as the product of social determinants of health and they applied sociological theories to explore the interplay between individual agency and societal influences, such as the socio-cultural context and material and economic circumstances. They recommended measures to address these structural influences on lifestyle choices. Conclusions The study of pre-diabetes to date has involved at least three research disciplines (biomedicine, psychology and sociology), which up to now have operated largely independently of one another. Behavioural science and sociology are increasing our understanding of how personal, social, cultural and economic aspects influence health-related behaviours. An interdisciplinary approach with theoretically informed multi-level studies could potentially improve the success of diabetes prevention strategies. Trial registration Prospero Registration Number: CRD42018088609. |
| first_indexed | 2024-12-23T20:14:20Z |
| format | Article |
| id | doaj.art-4051ba66cb14431d8f11431dbb9c1492 |
| institution | Directory Open Access Journal |
| issn | 1741-7015 |
| language | English |
| last_indexed | 2024-12-23T20:14:20Z |
| publishDate | 2018-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medicine |
| spelling | doaj.art-4051ba66cb14431d8f11431dbb9c14922022-12-21T17:32:43ZengBMCBMC Medicine1741-70152018-07-0116111710.1186/s12916-018-1107-6How are health-related behaviours influenced by a diagnosis of pre-diabetes? A meta-narrative reviewEleanor Barry0Trisha Greenhalgh1Nicholas Fahy2Nuffield Department of Primary Care Health Sciences, University of OxfordNuffield Department of Primary Care Health Sciences, University of OxfordNuffield Department of Primary Care Health Sciences, University of OxfordAbstract Background Several countries, including England, have recently introduced lifestyle-focused diabetes prevention programmes. These aim to reduce the risk of individuals with pre-diabetes developing type 2 diabetes. We sought to summarise research on how socio-cultural influences and risk perception affect people’s behaviour (such as engagement in lifestyle interventions) after being told that they have pre-diabetes. Methods Using the RAMESES standards for meta-narrative systematic reviews, we identified studies from database searches and citation-tracking. Studies were grouped according to underlying theorisations of pre-diabetes. Following a descriptive analysis, the studies were synthesised with reference to Cockerham’s health lifestyle theory. Results In total, 961 titles were scanned, 110 abstracts assessed and 35 full papers reviewed. Of 15 studies included in the final analysis, 11 were based on individual interviews, focus groups or ethnography and five on structured questionnaires or surveys. Three meta-narratives emerged. The first, which we called biomedical, characterised pre-diabetes as the first stage in a recognised pathophysiological illness trajectory and sought to intervene with lifestyle changes to prevent its progression. The second, which we called psychological, focused on the theory-informed study of the knowledge, attitudes and behaviours in people with pre-diabetes. These studies found that participants generally had an accurate perception of their risk of developing diabetes, but this knowledge did not directly lead to behavioural change. Some psychological studies incorporated wider social factors in their theoretical models and sought to address these through action at the individual level. The third meta-narrative we termed social realist. These studies conceptualised pre-diabetes as the product of social determinants of health and they applied sociological theories to explore the interplay between individual agency and societal influences, such as the socio-cultural context and material and economic circumstances. They recommended measures to address these structural influences on lifestyle choices. Conclusions The study of pre-diabetes to date has involved at least three research disciplines (biomedicine, psychology and sociology), which up to now have operated largely independently of one another. Behavioural science and sociology are increasing our understanding of how personal, social, cultural and economic aspects influence health-related behaviours. An interdisciplinary approach with theoretically informed multi-level studies could potentially improve the success of diabetes prevention strategies. Trial registration Prospero Registration Number: CRD42018088609.http://link.springer.com/article/10.1186/s12916-018-1107-6Diabetes preventionSocio-cultural influencesRisk perceptionSystematic review |
| spellingShingle | Eleanor Barry Trisha Greenhalgh Nicholas Fahy How are health-related behaviours influenced by a diagnosis of pre-diabetes? A meta-narrative review BMC Medicine Diabetes prevention Socio-cultural influences Risk perception Systematic review |
| title | How are health-related behaviours influenced by a diagnosis of pre-diabetes? A meta-narrative review |
| title_full | How are health-related behaviours influenced by a diagnosis of pre-diabetes? A meta-narrative review |
| title_fullStr | How are health-related behaviours influenced by a diagnosis of pre-diabetes? A meta-narrative review |
| title_full_unstemmed | How are health-related behaviours influenced by a diagnosis of pre-diabetes? A meta-narrative review |
| title_short | How are health-related behaviours influenced by a diagnosis of pre-diabetes? A meta-narrative review |
| title_sort | how are health related behaviours influenced by a diagnosis of pre diabetes a meta narrative review |
| topic | Diabetes prevention Socio-cultural influences Risk perception Systematic review |
| url | http://link.springer.com/article/10.1186/s12916-018-1107-6 |
| work_keys_str_mv | AT eleanorbarry howarehealthrelatedbehavioursinfluencedbyadiagnosisofprediabetesametanarrativereview AT trishagreenhalgh howarehealthrelatedbehavioursinfluencedbyadiagnosisofprediabetesametanarrativereview AT nicholasfahy howarehealthrelatedbehavioursinfluencedbyadiagnosisofprediabetesametanarrativereview |