The risk, perceived and actual, of developing type 2 diabetes mellitus for mothers of preschool children in urban China

PLoS One. 2019 Sep 27;14(9):e0222839. doi: 10.1371/journal.pone.0222839. eCollection 2019.

Abstract

Background: The perceived risk of developing type 2 diabetes mellitus (T2DM) can motivate individuals to adopt preventive health behaviors. Compared with fathers, mothers of young children often experience unique risk factors for developing T2DM: pregnancy-related weight gain, lifestyle changes related to child care, and the increased incidence of gestational diabetes mellitus. Understanding how actual risk factors affect the perceived risk of developing T2DM can foster effective diabetes prevention interventions for this population. The aims of this study were to describe the risk, perceived and actual, of developing T2DM and to explore the influencing factors of perceived risk for Chinese mothers of preschool children in China.

Methods: A multisite, cross-sectional survey was conducted and included 176 mothers (mean age of 31.19 years old) of preschool children (aged 3-7 years old) from four preschools in Changsha, the capital city of Hunan Province, China. The overall perceived risk of developing T2DM was measured by one item "Your own personal health risk is at almost no risk, slight risk, moderate risk or high risk from diabetes" from the Risk Perception Survey for Developing Diabetes (RPS-DD). PRS-DD and the Chinese version of the Canadian Diabetes Risk Assessment Questionnaire (CHINARISK) were used to assess perceived risk related worry, personal control, optimistic bias, and diabetes risk knowledge and actual risk of T2DM. Mothers also reported their height, weight, and waist circumference followed by the NIH protocol. Pearson correlation and stepwise multivariate linear regression were used to explore how the actual risk factors affected the perceived risk of developing diabetes (RPS-DD)).

Results: Nearly 90% of mothers perceived almost no/slight risk for developing diabetes. Nearly half of the mothers had parents or siblings with diabetes. Roughly 70% of the mothers did not eat five servings of fruits and vegetables per day, and more than 50% did not exercise at least 30 minutes a day. In the five stepwise multivariate linear regression models, young mothers (95% CI .400-1.311) and those with a family history of diabetes (95% CI -0.74- .000) were founded a higher overall perceived risk. Mothers who reported more sedentary time (95% CI -0.029- -0.008) and less physical activity had less personal control (95% CI -0.354- -0.046). Mothers with more sedentary time had more worries about developing T2DM(95% CI 0.008-0.035) . Mothers who were older (95% CI -0.440-0.055) or had more physical activities (95% CI 0.003-0.048) had more optimistic bias of not developing T2DM. Mothers who had a higher education level (95% CI .354-1.422) and a family history of diabetes (95% CI .029-2.231) had more diabetes risk knowledge of developing T2DM.

Conclusion: This study found that Chinese mothers of preschool children in urban areas reported low perceived risk of developing T2DM, although they have actual risk factors. These women did not associate anthropometric, health history, or health behavior factors with the risk of developing T2DM. Anthropometrics and risk factors associated with behavioral risk factors may be the focus of diabetes prevention programs.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Child
  • Child, Preschool
  • China / epidemiology
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Diabetes Mellitus, Type 2 / prevention & control
  • Diabetes Mellitus, Type 2 / psychology
  • Female
  • Humans
  • Incidence
  • Life Style
  • Male
  • Medical History Taking / statistics & numerical data
  • Mothers / psychology*
  • Perception
  • Risk Assessment / methods
  • Risk Factors
  • Urban Population / statistics & numerical data
  • Young Adult

Grants and funding

This work was supported by the Bureau of Education and Cultural Affair, Fulbright U.S. Research Program and University of California, School of Nursing Global Health Nursing Research Grant to J-LC; the China Medical Board (16-256) to GJ and J-LC; the Innovation-Driven Project of Central South University (No.2018CX037) to GJ and Philosophy and Social Science Foundation of Hunan Province (17XBQ111) to JG. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.