Motivational, volitional and multiple goal predictors of walking in people with type 2 diabetes

Abstract

BackgroundType 2 diabetes is a major public health problem. Effective diabetes self-management involves people engaging in multiple health behaviours, including physical activity. Walking is an effective, accessible and inexpensive form of physical activity, yet many people with Type 2 diabetes do not meet recommended levels. The present study aimed to: 1) identify demographic, motivational and volitional factors predictive of walking in people with Type 2 diabetes mellitus, and 2) test whether accounting for the perceived impact of other goal pursuits (goal facilitation and goal conflict) improved the prediction of walking. MethodsA theory-based cross-sectional study using the Health Action Process Approach was conducted in adults with Type 2 diabetes across Scotland. Assuming a 50% response rate 1000 questionnaires were mailed to achieve the target sample size (N = 500). Demographic information was collected, and intentional (outcome expectations, social support, risk perceptions), motivational (intention, self-efficacy), volitional (action planning, action control) and multiple goal (goal conflict, goal facilitation) factors were assessed as predictors of physical activity in general and walking specifically. ResultsThe final sample comprised 411 respondents. The majority (60%) were non-adherent to physical activity recommendations. Of 411 respondents, 356 provided walking data. Body Mass Index and age were the only demographic and anthropometric factors predictive of walking (overall R2 = 0.04). When motivational factors were added, intention and self-efficacy added to the prediction (overall R2 = 0.07). When volitional factors were added, only action control was predictive of walking (overall R2 = 0.08). Finally, goal facilitation explained an additional 7% variance in walking when added to the model (final overall R2 = 0.15). ConclusionThere was low adherence with physical activity recommendations in general and walking in particular. When testing predictors of motivational, volitional and competing goal constructs together, action control and goal facilitation emerged as predictors of walking. Future research should consider how walking can be embedded synergistically alongside other goal pursuits and how action control may help to ensure that they are pursued.