Socioeconomic Status and Psychosocial Mechanisms of Lifestyle Change in a Type 2 Diabetes Prevention Trial

Little is known about psychosocial mechanisms that may underlie differences in lifestyle change between socioeconomic groups. The purpose of this study is to examine how educational level influences middle-aged participants' (N = 385) psychosocial responses to the GOAL Lifestyle Implementation Trial. The measurements of self-efficacy and planning for healthy lifestyle were conducted pre-intervention (T1) and post-intervention (T2, 3 months), and measurements of exercise and healthy eating as outcomes at T1 and at 12 months (T3). Psychosocial determinants at T1 and their T1-T2 changes were mostly similar, irrespective of educational levels. Exercise barriers self-efficacy was enhanced slightly less (p = 0.08) among the low-SES. T2 levels as well as pre-post-intervention changes in exercise self-efficacy predicted 12-month changes in exercise, and T2 diet coping planning predicted changes in dietary fat intake. The associations were similar across all SES groups. Enhancing self-efficacy and planning is similarly effective among intervention participants regardless of education level.