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.

Purpose: 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.