A Model for Physical Activity Behavioural Change in Middle Aged and Older People with Type 2 Diabetes

Abstract

Objective: To identify key determinants of increased PA level among adults with T2DM to improve a hierarchical model, based on social cognitive theory (SCT) and Ecological Models. It hypothesises and clarifies how these determinants relate to physical activity which is important to evidencebased PA interventions in middle aged and older people with T2DM. Methods: Full transcript studies in English were searched in the following databases: CINAHL, Medline on OvidSP, PubMed, and PsycINFO. Included articles were selected by following these combined terms: type 2 diabetes, physical activity, exercise, physical inactivity, correlates, barriers, theory, self-efficacy, ecological models. And they (n=124) met the following criteria: 1) T2BD, aged 35 and over; 2) reporting determinants or factors 3) indicated physical activity or exercise as an outcome variable. Additional records identified via bibliographies (n=4), duplicates were removed (n=95), non-full-text articles (n=8) and no-English (n=2) were excluded. Finally, of the 21 articles retrieved from databases (9 of them are reviewed studies), only 12 original articles including qualitative and quantitative study were reviewed. Results: The determinants are divided into four classifications; physical, psychological, social and environmental factors, adapted combined SCT with Ecological Model of physical activity with T2MD in middle aged older adults. Self-efficacy is the core mediators with physical, environmental, and social factors, that fact is the core of SCT. Self-efficacy had an indirective negative influence by physical factors particular regions with physical barriers such as cold weather, low-density land use. Therefore, managing self-efficacy is proposed to effectively change for physical activity. It is hypothesised that improve social supports from family may help people with T2DM increase the physical activity level. Conclusion: Therefore, it is evident from the above that many factors of PA in middle aged and older people with T2DM exist. And self-efficacy is an important determinant with PA. There is a need to clarify whether these variables are determinants and the causality between these variables. Nonetheless, theory-basement approach to studying PA in this population is required based upon this study