Dietary Adherence Attitude and Behavior across Social Context among Hong Kong Chinese Adults with Type II Diabetes

Type II Diabetes is a chronic disease that affects 10% of the population in Hong Kong, and dietary adherence is an important self--care issue with implications for prognosis and well--being. The purpose of this study was to assess both environmental and socio--cultural barriers to dietary adherence in Hong Kong Chinese adults with Type II Diabetes. It was hypothesized that adherence attitude and behavior vary across social contexts (location, occasion, and social relational role). Twenty--five Hong Kong adults with Type II Diabetes were recruited for a within-subject (repeated measures) survey. All social contextual variables (location, occasion, and social relational role) were found to be significantly related to dietary adherence attitude and behavior. The overall effects for location indicated a significantly more positive attitude toward dietary adherence as well as greater dietary adherence when dining at home than at a restaurant. The overall effects for occasion indicated a significantly more positive attitude toward dietary adherence and greater dietary adherence when dining on a typical day than on a festive occasion. The overall effects for social relational role showed a significant difference in attitude toward dietary adherence and in dietary adherence when dining alone and with people with different social relational roles. Participants reported the least positive attitude and least adherence to dietary guidance when dining alone, but when dining with others, adherence toward dietary restriction improved as social relational intimacy with dining companions increased. The interactions among the three independent variables (social relational role, location, and occasion) were not statistically significant. The attitude towards dietary restrictions varied from `feel slightly bad' to `feel good,' all within the mid--range to upper mid--range of the scale. The results suggest that self--control and social support may play important roles in patients' dietary adherences issues. Further research is needed into the identification and modification of variables affecting diabetic patients' dietary adherence. Limitations to the current study were discussed, along with suggestions for patients, family members and physicians.