Predicting intentions and behaviours in populations with or at-risk of diabetes: A systematic review

AbstractPurposeTo systematically review the Theory of Planned Behaviour studies predicting self-care intentions and behaviours in populations with and at-risk of diabetes.MethodsA systematic review using six electronic databases was conducted in 2013. A standardised protocol was used for appraisal. Studies eligibility included a measure of behaviour for healthy eating, physical activity, glucose monitoring, medication use (ii) the TPB variables (iii) the TPB tested in populations with diabetes or at-risk.ResultsSixteen studies were appraised for testing the utility of the TPB. Studies included cross-sectional (n=7); prospective (n=5) and randomised control trials (n=4). Intention (18%–76%) was the most predictive construct for all behaviours. Explained variance for intentions was similar across cross-sectional (28–76%); prospective (28–73%); and RCT studies (18–63%). RCTs (18–43%) provided slightly stronger evidence for predicting behaviour.ConclusionsFew studies tested predictability of the TPB in populations with or at-risk of diabetes. This review highlighted differences in the predictive utility of the TPB suggesting that the model is behaviour and population specific. Findings on key determinants of specific behaviours contribute to a better understanding of mechanisms of behaviour change and are useful in designing targeted behavioural interventions for different diabetes populations

Indian students at QUT: Expectations and experiences

India currently ranks among the top source countries for the Australian education industry and therefore, a better understanding of the concerns and challenges confronted by Indian students is essential. This study was undertaken to assess the needs and expectations of Indian students enrolled at Queensland University of Technology (QUT) that would inform the formulation of strategies to provide superior service to the current and future cohorts of students coming from India. Data collection was undertaken through surveys and focus group meetings. The findings reveal the acute need for more effective dissemination of information prior to the students commencing their programs on both academic and non-academic aspects of university life as well as the resources and support available at QUT. Usage of English in an academic setting, career related services, accommodation, and networking opportunities were identified as some of the key areas of concern by the participants

Relationships and sexual health promotion project for QUT international students

International students may experience a variety of sexual health problems which include unplanned pregnancies, abortions and sexually transmitted diseases. These are often because of limited knowledge of sexual health matters and lack of sexual health education and/or access to health services in their home country. A study was undertaken to identify the concerns of international students and how to provide culturally appropriate promotion of sexual health for international students at Queensland University of Technology (QUT). The project included consultations with stakeholders, interviews with key informants, an online survey and focus group discussions with international students. The project found that sexual health is a concern for international students, particularly in developing relationships and when becoming sexually active in Australia, and there is a perceived lack of access to health services and insufficient knowledge on sexual health matters. Preferred methods of dissemination of sexual health information included use of student mentors, web-based online resources, brochures and confidential on-line advice

Evaluating the QUT Homestay Program : lessons learnt in providing quality services to international students

The QUT Homestay Program is an essential part of the university’s commitment to meet the accommodation needs of international students. Despite the importance of this style of accommodation, there is very little research addressing issues related to homestay arrangements. The program at Queensland University of Technology (QUT) was evaluated in 2002 to develop a continuous improvement framework to ensure provision of quality homestay services to international students. This paper presents an overview of the evaluation and key lessons learnt in providing quality homestay services to international students. It will cover social and cross-cultural issues faced by providers and international students in the homestay environment, the homestay support needs, program information, policies, procedures and code of practice governing the program

Socio-cultural context of managing type 2 diabetes in Australian Pacific Islander women living in Queensland

This thesis examined diabetes self-management of Australian Pacific Island (API) women with type 2 diabetes living in Queensland using a community-based participatory action research and culturally informed Talanoa methodology. Fundamentally process and action - oriented, the study aimed to understand self-management change behaviours within the broader API community that included social, cultural and environmental contexts. The findings will contribute to the development and design of culturally appropriate and tailored strategies of diabetes self-management for Pacific communities

Socio-cultural factors influencing self-management of Australian Pacific Islander women with type 2 diabetes

BackgroundType 2 diabetes disproportionately affects ethnically and culturally diverse communities in Australia and is a major public health challenge for Australian Pacific Islander (API) communities residing in Queensland. APIs in Queensland face health inequalities, such that they are two to four times more likely to be hospitalised or die from preventative chronic conditions compared to the general Queensland population. API women are also four times more at risk of developing diabetes and diabetes-related mortality and co-morbidities. Despite a higher burden of diabetes mortality and morbidity, very little is known about the socio-cultural factors influencing self-management of API women with type 2 diabetes living in Queensland, which has the largest Pacific Islander diaspora, outside of New Zealand. AimsThe objective of this study was to identify socio-cultural, lifestyle and diabetes-related factors influencing self-care behaviours of API women with type 2 diabetes. This study also examined the relationship between socio-cultural, demographics, lifestyle, diabetes- related factors and self-care behaviours.MethodsA self-reported cross-sectional survey was used for health data collection from 148 API women with type 2 diabetes in Queensland. The dependent variable was self-care behaviours which was collected using the Summary of Diabetes Self-Care Activity (SDSCA) and independent variables included socio-demographics, lifestyle and health and diabetes-related factors. Descriptive and multiple linear regression methods were used to identify factors influencing self-management in API women with type 2 diabetes. ResultsThe API women with type 2 diabetes generally had low levels of self-management behaviour (SDSCA mean score= 19.8 ± 6.6), engaging on average two to three days per week in diabetes self-care activities. Taking medication (4.9 ± 3.0) and self-monitoring blood glucose (3.9 ± 1.5) were the most frequent self-reported behaviours. Eating foods that were low in fat and/or processed carbohydrates (2.5 ± 2.2), physical activity (2.5 ± 2.2) and foot care (2.6 ± 2.7), were the least reported self-care behaviours.Socio-cultural factors including age, ethnicity, BMI, low physical activity, diabetes knowledge, membership with Diabetes Queensland and self-reported HbA1c (knowledge of) were significant determinants of diabetes self-care. Older women (aged 55 years and over) were more likely to report better self-management. There were significant variations among the ethnic groups, whereby Tongan, Solomon and i-Kiribati API women were less likely to seek support from health professionals and API women from i-Kiribati and Tongan background were less likely to adhere to heathy eating behaviours.DiscussionThis is the first Australian study for Pacific Islander women with diabetes in Queensland with the largest Pacific population. This study highlighted important socio-cultural factors including age, ethnicity, physical activity, knowledge of Glycosylated haemoglobin (HbA1c) values, diabetes knowledge, and membership with Diabetes Queensland, as important determinants of self-management for API women with type 2 diabetes. The study allows one to look at diabetes health from the cultural lens. It also provides a platform to further examine other social determinants of health specifically to diabetes self-management within the Australian Pacific community context.<br/

Predictors of Self-Care For Australian Pacific Women With Type 2 Diabetes (MOPP 1-03)

BACKGROUND Type 2 diabetes is a major public health challenge for Australian Pacific Islander (API) residing in Queensland, with largest Pacific diaspora, outside of New Zealand. API women are four times at increased risk of diabetes-related mortality and co-morbidities compared to general Queensland population. Despite a higher burden, very little is known about the socio-cultural factors influencing self-management of API women with type 2 diabetes. This community-based participatory action research study investigated the socio-cultural, lifestyle and diabetes-related factors influencing self-care behaviours of API women with type 2 diabetes.METHODSA self-reported cross-sectional survey collected data from 148 API women with type 2 diabetes. Dependent variable was self-care behaviour, collected using Summary of Diabetes Self-Care Activity (SDSCA). Independent variables included socio-demographics, lifestyle and health and diabetes-related factors. Descriptive and multiple linear regression modelling identified factors influencing self-care behaviours.RESULTSAPI women displayed low levels of self-management (SDSCA score= 19.8 ± 6.6), engaging on average two to three days per week in diabetes self-care. Taking medication (4.9 ± 3.0) and self-monitoring blood glucose (3.9 ± 1.5) were most frequently reported self-care. Eating foods low in fat and/or processed carbohydrates (2.5 ± 2.2), physical activity (2.5 ± 2.2) and foot care (2.6 ± 2.7), were least reported self-care behaviours.Socio-cultural factors including age, ethnicity, BMI, low physical activity, diabetes knowledge, membership with Diabetes Queensland and self-reported HbA1c (knowledge of) were significant determinants of diabetes self-care. Older women (aged 55 years and over) reported better self-management. There were variations among the ethnic groups. Tongan, Solomon and i-Kiribati API women were less likely to seek support from health professionals and i-Kiribati and Tongan women were less likely to adhere to heathy eating behaviours.CONCLUSIONSThis study highlighted important socio-cultural factors influencing diabetes self-care behaviours of API women. There were also variations between ethnic groups with self-management. KEY WORDS Self-care behaviours, Socio-cultural determinants, Type 2 diabetes, Australian Pacific Islander women<br/

Queensland Pasifika Women's Health Forum

Queensland University of Technology (QUT) played a major role in the Pasifika Women’s Health Forum held at the Chermside-Kedron Community (Uniting) Church on Friday 29 August 2014. Ms Heena Akbar, a Pacific Islander PhD student in the Faculty of Health, coordinated this second community forum in partnership with Diabetes Queensland and with other members of the Pasifika Women’s Alliance Inc. (PWA), a community organisation whose aims include improving the health and wellbeing of the women from Pacific Island communities in Queensland

Exploring type-2 diabetes self-management of Australian Pacific Islander women: a Talanoa perspective

Whilst type 2 diabetes is a growing health problem for Australian Pacific Island (API) communities in Queensland, very little is known about self-management. The purpose of this study was to develop a socio-cultural construct of self-management (self-care) for Australian Pacific Island women living with type 2 diabetes

Identifying Predictors of Self-Care Intentions And Behaviours of Australian Pacific Islander Women With Type 2 Diabetes (PP5-06)

BACKGROUND Type 2 diabetes disproportionately affects ethnically diverse communities in Australia, particularly Australian Pacific Islanders (API) residing in Queensland, which has the largest Pacific diaspora, outside of New Zealand. APIs are two to four times more likely to be hospitalised or die from preventable diabetes-related conditions compared to the general population. However, self-care behaviours of API women with type 2 diabetes is not well understood. Using theory of planned behaviour (TPB), this community-based participatory action research study investigated the intentions and behavioural determinants of self-management of API women with type 2 diabetes.METHODSA self-reported cross-sectional TPB survey measured the predictors of intentions and behaviours across five self-care activities: ‘healthy eating’, ‘physical activity’, ‘taking medication’, ‘self-monitoring of blood glucose’, and ‘health professional support’. Multiple hierarchical regression was used and included attitudes, social support, perceived behavioural control, intentions and behaviours as variables.RESULTS148 API women with type 2 diabetes was surveyed. Mean age was 53 years. Majority were born in the Pacific nations, namely, Fiji, Samoa, Tonga, PNG, New Zealand, Solomon and Cook Islands, Kiribati, Tuvalu and Vanuatu. API women displayed positive intentions toward self-management but had low self-care behaviours. A wide range of variance explained for intentions ( 50% - 75%) and behaviors (3% - 30%) across all self-care activities. The explained variance for intentions were taking medication (75%), self-monitoring of blood glucose (68%), physical activity (61%), professional health support (58%) and eating healthily (50%). For behaviours, explained variance included self-monitoring of blood glucose (30%), professional health support (22%), taking medication (19%), healthy eating (13%) and physical activity (3%). Attitude was the strongest predictor for intentions. Intention was the strongest predictor for behaviours across all self-care activities. CONCLUSIONSThe TPB predicted differently across the self-care activities with significant variations across ethnicity suggesting there are differences in self-care behaviours between ethnic groups.Key words Self-management intentions and behaviours, Theory of planned behaviour, Type 2 diabetes, Australian Pacific Islander women<br/