Introduction
Diabetes in China
Integrated treatment and prevention
Theoretical framework
Methods
Study design and participants
Questionnaire design
Construct questionnaire items
Form an initial questionnaire
Data collection
Measures
Behavioral attitude (BA, 6 items)
Subjective norms (SN, 6 items)
Perceived behavioral control (PBC, 6 items)
Behavioral intention (BI, 6 items)
Actual behavior (AB, 17 items)
Data analysis
Latent Variables | Item | Std. | S.E. | C.R. | P | SMC | CR | AVE | Factor Correlation | ||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
BA | SN | PBC | BI | Be | |||||||||
BA | BA1 | 0.827 | 0.684 | 0.920 | 0.659 | 0.812 | |||||||
BA2 | 0.832 | 0.072 | 14.659 | *** | 0.692 | ||||||||
BA3 | 0.770 | 0.071 | 13.225 | *** | 0.593 | ||||||||
BA4 | 0.840 | 0.069 | 14.907 | *** | 0.706 | ||||||||
BA5 | 0.806 | 0.072 | 14.029 | *** | 0.650 | ||||||||
BA6 | 0.793 | 0.077 | 13.622 | *** | 0.629 | ||||||||
SN | SN1 | 0.760 | 0.578 | 0.901 | 0.604 | 0.297 | 0.777 | ||||||
SN2 | 0.795 | 0.094 | 12.046 | *** | 0.632 | ||||||||
SN3 | 0.802 | 0.092 | 12.184 | *** | 0.643 | ||||||||
SN4 | 0.735 | 0.089 | 11.005 | *** | 0.540 | ||||||||
SN5 | 0.815 | 0.090 | 12.477 | *** | 0.664 | ||||||||
SN6 | 0.753 | 0.097 | 11.364 | *** | 0.567 | ||||||||
PBC | PBC1 | 0.795 | 0.632 | 0.902 | 0.605 | 0.402 | 0.301 | 0.778 | |||||
PBC2 | 0.744 | 0.080 | 11.854 | *** | 0.554 | ||||||||
PBC3 | 0.802 | 0.078 | 12.929 | *** | 0.643 | ||||||||
PBC4 | 0.762 | 0.080 | 12.162 | *** | 0.581 | ||||||||
PBC5 | 0.829 | 0.090 | 13.532 | *** | 0.687 | ||||||||
PBC6 | 0.729 | 0.087 | 11.469 | *** | 0.531 | ||||||||
BI | BI1 | 0.800 | 0.640 | 0.920 | 0.659 | 0.440 | 0.404 | 0.497 | 0.812 | ||||
BI2 | 0.855 | 0.075 | 14.515 | *** | 0.731 | ||||||||
BI3 | 0.790 | 0.072 | 13.044 | *** | 0.624 | ||||||||
BI4 | 0.766 | 0.076 | 12.434 | *** | 0.587 | ||||||||
BI5 | 0.822 | 0.082 | 13.668 | *** | 0.676 | ||||||||
BI6 | 0.834 | 0.076 | 14.112 | *** | 0.696 | ||||||||
Be | Be1 | 0.855 | 0.731 | 0.949 | 0.729 | 0.675 | 0.569 | 0.681 | 0.633 | 0.854 | |||
Be2 | 0.849 | 0.044 | 16.646 | *** | 0.721 | ||||||||
Be3 | 0.905 | 0.059 | 18.759 | *** | 0.819 | ||||||||
Be4 | 0.738 | 0.026 | 13.253 | *** | 0.545 | ||||||||
Be5 | 0.895 | 0.059 | 18.332 | *** | 0.801 | ||||||||
Be6 | 0.894 | 0.059 | 18.274 | *** | 0.799 | ||||||||
Be7 | 0.827 | 0.044 | 15.887 | *** | 0.684 |
Results
Characteristics of participants
Variables | |
---|---|
Sociodemographic data | |
Age, years (mean ± SD*) | 72.50 ± 5.69 |
Gender, N (%) | |
Male | 121 (28.1) |
Female | 309 (71.9) |
Education level, N (%) | |
University and above | 5 (1.2) |
Senior high school/technical secondary school | 19 (4.4) |
Junior high school | 73 (17.0) |
Primary school | 149 (34.7) |
Illiteracy | 184 (42.8) |
Marriage, N (%) | |
Single # | 101 (23.5) |
Non-single | 329 (76.5) |
Occupation, N (%) | |
Employed | 23 (5.3) |
Unemployed | 407 (94.7) |
Monthly income, RMB, N (%) | |
< 3000 | 415 (96.7) |
3000 ~ 5000 | 8 (1.9) |
5000 ~ 8000 | 5 (1.2) |
>=10,000 | 1 (0.2) |
Health insurance, N (%) | |
State medicine | 1 (0.2) |
Urban employee basic medical insurance | 6 (1.4) |
Urban-Rural Resident Basic Medical Insurance | 370 (86.0) |
Commercial insurance | 1 (0.2) |
Other | 2 (0.5) |
None♄ | 50 (11.6) |
Clinical data | |
Disease course¢, years, (mean ± SD) | 10.67 ± 7.26 |
Body mass index ♆, kg/m2, N (%) | |
< 18.5 | 4 (0.9) |
18.5 ~ 24.0 | 131 (30.5) |
24.0 ~ 28.0 | 215 (50.0) |
>=28.0 | 80 (18.6) |
Family history ¤, N (%) | |
Yes | 133 (30.9) |
No | 297 (69.1) |
Treatment strategies, N (%) | |
Diet and exercise | 3 (0.7) |
Oral hypoglycemic agents | 218 (50.7) |
Insulin monotherapy | 153 (35.6) |
Insulin combined with oral hypoglycemic agents | 56 (13.0) |
Exploratory factor analysis
Item | Factor | ||||
---|---|---|---|---|---|
1 | 2 | 3 | 4 | 5 | |
BA1 | 0.757 | ||||
BA2 | 0.780 | ||||
BA3 | 0.760 | ||||
BA4 | 0.800 | ||||
BA5 | 0.760 | ||||
BA6 | 0.792 | ||||
SN1 | 0.805 | ||||
SN2 | 0.789 | ||||
SN3 | 0.742 | ||||
SN4 | 0.796 | ||||
SN5 | 0.737 | ||||
SN6 | 0.799 | ||||
PBC1 | 0.725 | ||||
PBC2 | 0.802 | ||||
PBC3 | 0.792 | ||||
PBC4 | 0.786 | ||||
PBC5 | 0.759 | ||||
PBC6 | 0.805 | ||||
BI1 | 0.780 | ||||
BI2 | 0.718 | ||||
BI3 | 0.715 | ||||
BI4 | 0.797 | ||||
BI5 | 0.741 | ||||
BI6 | 0.765 | ||||
AB1 | 0.634 | ||||
AB2 | 0.625 | ||||
AB3 | 0.642 | ||||
AB4 | 0.682 | ||||
AB5 | 0.632 | ||||
AB6 | 0.614 | ||||
AB7 | 0.758 | ||||
AB8 | 0.667 | ||||
AB9 | 0.675 | ||||
AB10 | 0.622 | ||||
AB11 | 0.694 | ||||
AB12 | 0.653 | ||||
AB13 | 0.678 | ||||
AB14 | 0.739 | ||||
AB15 | 0.649 | ||||
AB16 | 0.713 | ||||
AB17 | 0.706 | ||||
Eigenvalue | 9.207 | 4.542 | 4.540 | 4.519 | 4.414 |
Variance (%) | 22.455 | 11.079 | 11.074 | 11.021 | 10.766 |
Accumulative variance (%) | 22.455 | 33.534 | 44.608 | 55.629 | 66.395 |
Confirmatory factor analysis
Fitness Index | CMIN/DF | GFI | AGFI | RMSEA | SRMR | NFI | CFI |
---|---|---|---|---|---|---|---|
Critical Value | < 3 | > 0.90 | > 0.90 | < 0.08 | < 0.08 | > 0.90 | > 0.90 |
Value of CFA Model | 1.092 | 0.886 | 0.867 | 0.020 | 0.037 | 0.915 | 0.992 |
Value of Final Model | 1.431 | 0.921 | 0.908 | 0.032 | 0.071 | 0.940 | 0.981 |
Structural equation model
Model Paths | Std. | S.E. | C.R. | P | ||
---|---|---|---|---|---|---|
BA | → | BI | 0.289 | 0.049 | 5.827 | *** |
SN | → | BI | 0.314 | 0.049 | 6.516 | *** |
PBC | → | BI | 0.261 | 0.052 | 5.263 | *** |
BI | → | Be | 0.452 | 0.123 | 9.947 | *** |
PBC | → | Be | 0.452 | 0.129 | 9.852 | *** |