Barriers and Enablers to Maintaining Behaviour Changes Following a Lifestyle Intervention for Adults With Type 2 Diabetes

Abstract

Aim To explore short-term barriers and enablers to maintaining behaviour changes in adults with type 2 diabetes who had completed a lifestyle behaviour change program. Methods Focus groups with 44 participants identified barriers and enablers at the end-of-program (n = 8 groups: anticipated); and, 1-month post-program (n = 6 groups: experienced). Thematic inductive analysis was undertaken independently by two authors, discussed, then deductively grouped according to the Capability (physical, psychological), Opportunity (physical, social), Motivation (automatic, reflective) – Behaviour (COM-B) model. Results Nine barriers were identified: two anticipated, one experienced, and six common to both timepoints. Key barriers related to physical capability (health ability), physical opportunity (difficulty accessing and using resources), social opportunity (unwillingness to invest in social networks), and reflective motivation (lack of internal drive). Eleven enablers were identified: all across both timepoints. Key enablers related to psychological capability (knowledge), physical opportunity (access and use of program resources), social opportunity (sense of belonging and safety within the program), automatic motivation (beliefs and awareness around perceived risk; monitoring of progress), and reflective motivation (committed to change). Discussion Findings suggest diabetes management programs should enable ongoing access to their resources. Investing in mechanisms to scaffold program graduates into suitable community-based activities may also be beneficial.