Applying behavioral models to dietary education of elderly diabetic patients

This study investigated the impact of psychosocial variables on diabetes-related behavior using a questionnaire based on the Health Belief Model and the Theory of Planned Behavior (TOPB). Forty-eight elderly male diabetic patients were surveyed to determine the influence of attitudes and beliefs on dietary adherence. Mean fasting blood sugar (FBS) (171 mg/dl) demonstrated a lack of metabolic control and suggested a need for improved education. Subjects taking insulin perceived significantly greater barriers to control than did those on oral agents or diet alone (p < .05). Subjects with FBS fluctuations of 50 mg/dl or more perceived significantly fewer (p < .05) barriers than those with more stable FBS. These results indicate that interventions for older men should identify barriers to control and include practical ways to overcome them. Intention to eat foods such as pie, cake, or doughnuts was strongly related to subjective norm, attitude towards dietary adherence, and perceived control (R² = 0.69, F = 31.60, p < .001). In addition, regression analysis to predict adherence behavior from TOPB accounted for a significant proportion of the variance (R² = 0.37, F = 4.44, p < .01). This regression model suggests that educators who effect a change in attitudes may also change behavioral intentions and dietary adherence behavior.