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Relationships between health literacy, motivation and diet and physical activity in people with type 2 diabetes participating in peer-led support groups

Lookup NU author(s): Professor Gill Rowlands



This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).


AimsTo investigate associations between health literacy (HL) and diet and physical activity, and motivation and diet and physical activity in Danish people with type 2 diabetes.MethodsWe used a cross-sectional design including 194 individuals with type 2 diabetes participating in peer-led support groups provided by the Danish Diabetes Association between January–December 2015. The participants completed a questionnaire at the first meeting including; The Summary of Diabetes Self-Care Activities (SDSCA) measure, The Treatment Self-Regulation Questionnaire (TSRQ) (Self-Determination Theory) measuring type of motivation, and two HL scales: The HLS-EU-Q16, and the Diabetes Health Literacy scale (Ishikawa, H). Data were analyzed using linear regression models adjusting for age, gender, educational level, diabetes duration, motivation and HL.ResultsThe adjusted β (95%CI) showed that autonomous motivation and functional HL were associated with following recommended diet: autonomous motivation; 0.43 (0.06; 0.80) and functional HL; 0.52 (0.02; 1.00). Autonomous motivation was related to following physical activity recommendations; β (95%CI) 0.56 (0.16; 0.96).ConclusionsThis study indicates that, for people with type 2 diabetes, functional HL and autonomous motivation may be important drivers for following diet recommendations, and autonomous motivation may be the most important factor for following recommendations regarding physical activity. These concepts may therefore be highly relevant to address in interventions to people with type 2 diabetes. Different interventions are suggested.

Publication metadata

Author(s): Juul L, Rowlands G, Terkildsen Maindal H

Publication type: Article

Publication status: Published

Journal: Primary Care Diabetes

Year: 2018

Volume: 12

Issue: 4

Pages: 331-337

Print publication date: 01/08/2018

Online publication date: 17/03/2018

Acceptance date: 20/02/2018

Date deposited: 08/05/2018

ISSN (print): 1751-9918

ISSN (electronic): 1878-0210

Publisher: Elsevier


DOI: 10.1016/j.pcd.2018.02.005


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