Factors associated with perceived need to increase physical activity levels among adults at high risk of type 2 diabetes. A cross-sectional analysis within community-based diabetes prevention project FIN-D2D

Background: Increased physical activity is a cornerstone of type 2 diabetes prevention. Perception of a need to change is considered essential in behaviour change process. However, existing literature on perceived need to change health behaviour is limited. In order to broaden the understanding of diabetes prevention by increased physical activity levels (PAL), we assessed factors associated with perceiving a need to increase PAL among adults at high risk of diabetes. Methods: Opportunistic screening was used within a primary-care based lifestyle intervention covering 10 149 men and women with high risk of type 2 diabetes. Data were obtained from preintervention baseline visits. The explored determinants were demographic, anthropometric/clinical, behavioural and psychosocial characteristics, along with four categories of PAL awareness. Logistic regression was used in analysis. Results: 74% of men (n=2 577) and 76% of women (n=4 551) perceived a need to increase their PAL. Participants most likely to perceive this need were inactive, had a larger waist circumference, rated their PAL as insufficient, and were at the contemplation stage of change. The likelihood was also greater among women with less education and less perceived fitness. PAL overestimators were less likely to perceive the need to increase their PAL than realistic inactive participants. Smoking, hypertension, dyslipidemia, and family history of diabetes were not associated with this need perception. Despite education in women, demographic factors did not determine participants’ perceived need to increase PAL. Conclusion: Subjective rather than objective health factors appear to determine the perception of a need to increase PAL among adults at high risk of diabetes. Client perceptions need to be evaluated in health counselling in order to facilitate a change in PAL. Practical descriptions of the associations between metabolic risk factors, PAL, and diabetes are needed to make the risk factors concrete for at-risk individuals.