Precision Diabetes Education and Support Considering Patients’ Behavioral and Psychological Phenotype: A Q-Methodology Study

Abstract

Background: The prevalence of type 2 diabetes is growing, and diabetes burden is increasing. Precision health in diabetes education and support employs different intervention strategies, depending on an individual’s viewpoint on diabetes and self-management behaviors, to improve patients’ treatment adherence, clinical outcomes, and quality of life. Objective: To classify the behavioral and psychological phenotypes of self-management behaviors in adults taking oral glucose–lowering medications to develop a theory-driven, person-centered group intervention applicable to busy clinical settings. Methods: Q-methodology was used. From January to August 2020, 73 participants (48 male, 25 female) were invited to do Q-sorting with 33 statements. The principal component technique, followed by varimax rotation, was used for factor analysis. The Summary of Diabetes Self-Care Activity questionnaire and HbA1c in the past 6 months were included to obtain comprehensive understanding. Results: Fifty-one sorts (35 male, 16 female) loaded on 1 of 4 factors: factor A ( n = 18): Needing emotional support with enhancing problem-solving skills group; factor B ( n = 15): Self-help group; factor C ( n = 6): Needing personalized coaching group; and factor D ( n = 12): Needing basic diabetes education group. Conclusions: Each factor demonstrated a different need for diabetes education and support. Younger participants (factor D) had the poorest diabetes self-management behaviors and required basic diabetes education. Further research is warranted to develop a screening tool to classify the typologies and adopt the findings in a busy clinical setting.