open access

Vol 10, No 3 (2021)
Research paper
Published online: 2021-03-03
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Pre-diabetic women’s understanding of the role of diet in preventing diabetes using the PEN-3 cultural model

Mostafa Alimehr, Samira Malayen, Zahra Karimipour, Kobra Doostifar, Fereshteh Sohrabi Vafa, Maryam Nikbina
DOI: 10.5603/DK.a2021.0023
·
Clinical Diabetology 2021;10(3):261-269.

open access

Vol 10, No 3 (2021)
Original articles (submitted)
Published online: 2021-03-03

Abstract

Background. Pre-diabetes is one of the most widespread
epidemics in the world. Pre-diabetics are the
most susceptible to diabetes. The prevalence of prediabetes
status is higher than that of diabetes. Lifestyle
modification at this stage may delay the onset of type
2 diabetes for ten years. The present study aims at determining
the Dezful pre-diabetic women’s experiences
of diabetic preventive eating behaviors.

Methods. The present study employed a directed qualitative
content analysis (DQlCA) conducted in Dezful in
2020. The experiences of 41 pre-diabetic women aged
30–65 years and 9 health care providers (physicians,
nutritionists, public health experts) were explained
using the in-depth interviewing technique on the factors
affecting diabetes preventive behaviors, including
nutritional behaviors and physical activities, based on
the constructions of the PEN-3 model. The participants
were selected from Dezful health centers. Analysis of
the qualitative data was done via a directed qualitative
content analysis (DQlCA). Data validity was estimated
by assessing acceptability, reliability, adaptability, and
transferability.

Results. the most appropriate and accessible way to
promote diabetes prevention behaviors in pre-diabetics
is to hold training classes with a health promotion
approach implemented by health care providers.

Conclusion. Pre-diabetic women have a variety of beliefs
and habits influenced by awareness, food culture,
and temporal and spatial constraints. By identifying the
positive and negative beliefs affecting diet, researchers
who want to promote the nutritional behavior of
pre-diabetic women should correct and eliminate negative
and inhibitory beliefs by targeting these beliefs,
emphasizing positive and motivating beliefs. They also
should use the mentioned points in their educational
interventions.

Abstract

Background. Pre-diabetes is one of the most widespread
epidemics in the world. Pre-diabetics are the
most susceptible to diabetes. The prevalence of prediabetes
status is higher than that of diabetes. Lifestyle
modification at this stage may delay the onset of type
2 diabetes for ten years. The present study aims at determining
the Dezful pre-diabetic women’s experiences
of diabetic preventive eating behaviors.

Methods. The present study employed a directed qualitative
content analysis (DQlCA) conducted in Dezful in
2020. The experiences of 41 pre-diabetic women aged
30–65 years and 9 health care providers (physicians,
nutritionists, public health experts) were explained
using the in-depth interviewing technique on the factors
affecting diabetes preventive behaviors, including
nutritional behaviors and physical activities, based on
the constructions of the PEN-3 model. The participants
were selected from Dezful health centers. Analysis of
the qualitative data was done via a directed qualitative
content analysis (DQlCA). Data validity was estimated
by assessing acceptability, reliability, adaptability, and
transferability.

Results. the most appropriate and accessible way to
promote diabetes prevention behaviors in pre-diabetics
is to hold training classes with a health promotion
approach implemented by health care providers.

Conclusion. Pre-diabetic women have a variety of beliefs
and habits influenced by awareness, food culture,
and temporal and spatial constraints. By identifying the
positive and negative beliefs affecting diet, researchers
who want to promote the nutritional behavior of
pre-diabetic women should correct and eliminate negative
and inhibitory beliefs by targeting these beliefs,
emphasizing positive and motivating beliefs. They also
should use the mentioned points in their educational
interventions.

Get Citation

Keywords

PEN-3 cultural model, pre-diabetic, education, perceptual factors, enablers

About this article
Title

Pre-diabetic women’s understanding of the role of diet in preventing diabetes using the PEN-3 cultural model

Journal

Clinical Diabetology

Issue

Vol 10, No 3 (2021)

Article type

Research paper

Pages

261-269

Published online

2021-03-03

DOI

10.5603/DK.a2021.0023

Bibliographic record

Clinical Diabetology 2021;10(3):261-269.

Keywords

PEN-3 cultural model
pre-diabetic
education
perceptual factors
enablers

Authors

Mostafa Alimehr
Samira Malayen
Zahra Karimipour
Kobra Doostifar
Fereshteh Sohrabi Vafa
Maryam Nikbina

References (28)
  1. Moradi A, Morovati HR, Teimourpour A, et al. Determine the prevalence of gestational diabetes in Ardakan and its related factors. MethodsX. 2019; 6: 409–416.
  2. Olfatifar M, Karami M, Shokri P, et al. Prevalence of chronic complications and related risk factors of diabetes in patients referred to the diabetes center of hamedan Province. Scientific Journal of Hamedan Nursing and Midwifery Faculty. 2017; 25(2): 69–74.
  3. Moradi A, Alavi SM, Salimi M, et al. The effect of short message service (SMS) on knowledge and preventive behaviors of diabetic foot ulcer in patients with diabetes type 2. Diabetes Metab Syndr. 2019; 13(2): 1255–1260.
  4. Shabibi P, Mansourian M, Abedzadeh M, et al. The status of self-care behaviors in patients with type 2 diabetes in the city of Ilam in 2014. journal of ilam university of medical sciences. 2016; 24(2): 63–71.
  5. Jalilian H, Pezeshki MZ, Torkzadeh L, et al. Health care seeking behaviors in type 2 diabetic patients in East Azerbaijan. Clinical Diabetology. 2020; 8(6): 292–302.
  6. Nikbina M, Mameneh M, Bakaeian M, et al. Effectiveness of nutrition education and counseling on metabolic control parameters of diabetes mellitus type 2 patients in primary health care centers. Clinical Diabetology. 2020; 9(5): 293–299.
  7. Hafez Griauzde D, Saslow L, Patterson K, et al. Mixed methods pilot study of a low-carbohydrate diabetes prevention programme among adults with pre-diabetes in the USA. BMJ Open. 2020; 10(1): e033397.
  8. Hu FB. Globalization of diabetes: the role of diet, lifestyle, and genes. Diabetes Care. 2011; 34(6): 1249–1257.
  9. Peyman N, Ezzati Ra, Taghipour A, et al. Effectiveness of education by PEN-3 cultural model on improve feeding behaviors in adolescent girls with obesity and over weight in Razan city (Hamadan)-2010. Horizon Med Sci. 2013; 18(5): 254–260.
  10. Shahbazi H, Ghofranipour F, Amiri P, et al. Factors affecting self-care performance in adolescents with type i diabetes according to the PEN-3 cultural model. Int J Endocrinol Metab. 2018; 16(4): e62582.
  11. Moghaddam ES, Shahnazi H, Hassanzadeh A. Predictive power of PEN-3 model constructs in breast cancer screening behaviors among teachers: a cross- sectional study in Central Iran. Eur J Breast Health. 2019; 15(2): 105–110.
  12. Yick A, Oomen‐Early J. Using the PEN‐3 model to plan culturally competent domestic violence intervention and prevention services in Chinese American and immigrant communities. Health Education. 2009; 109(2): 125–139.
  13. , et al Bartholomew LK, Parcel GS, Kok G, et al. Planning health promotion programs: anintervention mapping approach. Jossey-Bass 2006.
  14. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004; 24(2): 105–112.
  15. Sirati Ni, Ebadi A, et al. Fallahi Khoshknab M, Consequences of living with Posttraumatic Stress Disorder: A Qualitative Study. Journal of Qualitative Research in Health Sciences. 2012; 1(2): 92–101.
  16. Hosseyni Esfahani F, Jazayeri A, Mirmiran P, et al. Dietary patterns and their association with socio-demographic and lifestyle factors among Thehrani adults: Tehran Lipid and Glucose Study. Journal of School of Public Health and Institute of Public Health Research. 2008; 6(1): 23–36.
  17. BeLue R, Diaw M, Ndao F, et al. A cultural lens to understanding daily experiences with type 2 diabetes self-management among clinic patients in M'bour, Senegal. Int Q Community Health Educ. 2012; 33(4): 329–347.
  18. Keshani P, Farvid MS. Perceived benefits and barriers regarding high fiber food intake in type 2 diabetes patients-a qualitative study. Iranian Journal of Nutrition Sciences & Food Technology. 2012; 7(1): 11–22.
  19. Ramezani Te, Amiri P, Paikari N, et al. Metabolism. Women’s perception regarding to healthy nutrition inhibitors: a qualitative research in tehran lipid and glucose study (TLGS). Iranian Journal of Endocrinology and Metabolism. 2011; 13(1): 48–57.
  20. Sabzmakan L, Jafarabadi MA, Nikpajouh A, et al. Determinants of physical activity among patients with cardiovascular metabolic risk factors based on the educational factors of PRECEDE model: a mixed method study. ranian Journal of Health Education and Health Promotion. 2016; 4(1): 5–19.
  21. Sabzmakan L, Mazloomy Mahmoodabad S, Ali Morowatisharifabad M, et al. Patients, Experiences with Cardiovascular Disease Risk Factors and Healthcare Providers of Determinants of the Nutritional Behavior: A Qualitative Directed Content Analysis. Iranian Journal of Endocrinology and Metabolism. 2013; 15(3): 292–302.
  22. Schwarzer R. Modeling health behavior change: how to predict and modify the adoption and maintenance of health behaviors. Applied Psychology. 2008; 57(1): 1–29.
  23. Mousavizadeh S, Ashktorab T, Ahmadi F, et al. Evaluation of barriers to adherence to therapy in patients with diabetes. J Diabetes Nurs. 2016; 4(3): 94–108.
  24. Lewis CP, Newell JN. Patients' perspectives of care for type 2 diabetes in Bangladesh -a qualitative study. BMC Public Health. 2014; 14: 737.
  25. Zalak K, Kazemi Haki B, Matlabi H. Obstacles to self-care from the viewpoint of type II diabetic patients and guidelines to remove them. Jorjani Biomed J. 2012; 0(1): 30–37.
  26. Farahmand M, Tehrani FR, Amiri P, et al. Barriers to healthy nutrition: perceptions and experiences of Iranian women. BMC Public Health. 2012; 12: 1064.
  27. James DCS. Factors influencing food choices, dietary intake, and nutrition-related attitudes among African Americans: application of a culturally sensitive model. Ethn Health. 2004; 9(4): 349–367.
  28. Shea S, Stein AD, Basch CE, et al. Independent associations of educational attainment and ethnicity with behavioral risk factors for cardiovascular disease. Am J Epidemiol. 1991; 134(6): 567–582.

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