Identifying Barriers and Facilitators to Diet and Physical Activity Behaviour Change in Type 2 Diabetes Using a Design Probe Methodology
Open accessAbstract
Treatment of Type 2 Diabetes (T2D) typically involves pharmacological methods and adjunct behavioural modifications, focused on changing diet and physical activity (PA) behaviours. Changing diet and physical activity behaviours is complex and any behavioural intervention in T2D, to be successful, must use an appropriate suite of behaviour change techniques (BCTs). In this study, we sought to understand the perceived barriers and facilitators to diet and PA behaviour change in persons with T2D, with a view to creating artefacts to facilitate the required behaviour changes. The Design Probe was chosen as the most appropriate design research instrument to capture the required data, as it enabled participants to reflect and self-document, over an extended period of time, on their daily lived experiences and, following this reflection, to identify their barriers and facilitators to diet and PA behaviour change. Design Probes were sent to 21 participants and 13 were fully completed. A reflective thematic analysis was carried out on the data, which identified themes of food environment, mental health, work schedule, planning, social support, cravings, economic circumstances and energy associated with diet behaviour. Similar themes were identified for PA as well as themes of physical health, weather, motivation and the physical environment.
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[35] conducted semi-structured interviews with British Pakistani participants, identifying how intergenerational dietary norms impacted diabetes self-management.
“[35] conducted semi-structured interviews with British Pakistani participants, identifying how intergenerational dietary norms impacted diabetes self-management.”
From Methodological Approaches in Studying Type-2 Diabetes-Related Health Behaviors—A Systematic Review (2025) · cites this paper as [35]
The Methods (§2.1, page unavailable) say participants were recruited in Galway, Ireland, and §2.3 describes daily self-documentation using a design probe, not semi-structured interviews. The Results (§3) analyze those probes; the paper does not identify its participants as British Pakistani or report an analysis of intergenerational dietary norms. (LLM, conf=0.90)
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Experimental — accuracy not yet measured[32,35] examined how generational dietary norms, family dynamics, and food beliefs shaped self-management in specific communities.
“For example, [32,35] examined how generational dietary norms, family dynamics, and food beliefs shaped selfmanagement in specific communities.”
From Methodological Approaches in Studying Type-2 Diabetes-Related Health Behaviors—A Systematic Review (2025) · cites this paper as [35]
The Results (Social Support; page unavailable) examine how family and friends influence healthy eating, supporting the family-dynamics portion of the claim. The Discussion (page unavailable) says cultural issues were not reported as a theme in this study; our copy does not establish that it examined generational dietary norms or food beliefs in specific communities. (LLM, conf=0.88)
Experimental — accuracy not yet measuredCultural values and family roles played an important part in behavior.
“Cultural values and family roles played an important part in behavior, as shown in qualitative studies by [32,35].”
From Methodological Approaches in Studying Type-2 Diabetes-Related Health Behaviors—A Systematic Review (2025) · cites this paper as [35]
The Results (Social Support; page unavailable) identify family support and interactions as influences on healthy behaviours, supporting the family-related part of the claim. The Discussion (page unavailable) says cultural issues were not reported in this study, so it does not support the claim that cultural values played an important part. (LLM, conf=0.88)
Experimental — accuracy not yet measuredIncorporating cultural beliefs, gender roles, and social structures in behavioral assessments is valuable for intervention design and interpretation.
“Research by [35] and [32] highlighted the importance of incorporating cultural beliefs, gender roles, and social structures in behavioral assessments, emphasizing the value of cultural context in intervention design and interpretation.”
From Methodological Approaches in Studying Type-2 Diabetes-Related Health Behaviors—A Systematic Review (2025) · cites this paper as [35]
The Methods (§2.4) and Discussion (§4.2) describe assessing participants’ lived context to inform intervention design, and the Results identify family and friends as influences on behaviour. But the Discussion says cultural issues and gender-specific factors were not reported as themes in this study, so it does not support the claim’s emphasis on cultural beliefs and gender roles. (LLM, conf=0.86)
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Li, C., Leung, D. Y. P., Sit, J. W. H., Li, X., Wu, Y., Yang, M., Gao, C., & Rong, H. (2016) · Patient Preference and Adherence · doi:10.2147/ppa.s94275 · Cited by 32 · see citing works
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Visiting eWorkers' Homes - Three Stories for Designing eWork Homes and Furniture
Virtanen, K., Mattelmäki, T., & Heinonen, S. (2004) · Cited by 4 · see citing works
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2 of the 97 references couldn’t be matched to a known paper.
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Barriers and Motivators to Weight Loss in People With Obesity
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Cavallo, F. R., & Toumazou, C. (2023) · PLOS Digital Health · doi:10.1371/journal.pdig.0000333 · Cited by 12 · see citing works
Physical inactivity and barriers to physical activity among Type-2 diabetics in Kumasi, Ghana
Taylor, L. K., Nyakotey, D. A., & Kwarteng, A. (2023) · African Health Sciences · doi:10.4314/ahs.v23i3.38 · Cited by 11 · see citing works
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Design of a Planner-Based Intervention to Facilitate Diet Behaviour Change in Type 2 Diabetes
Cradock, K. A., Quinlan, L. R., Finucane, F. M., Gainforth, H. L., Ginis, K. A. M., Sanders, E., & OLaighin, G. M. (2022) · Sensors · doi:10.3390/s22072795 · Cited by 7 · see citing works
Self-citationA Practical Guide on Behaviour Change Support for Self-Managing Chronic Disease
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Polhuis, K. C. M. M. (2023) · doi:10.18174/631882 · Cited by 2 · see citing works
Methodological Approaches in Studying Type-2 Diabetes-Related Health Behaviors—A Systematic Review
Khandoker, F., & Grigsby, T. J. (2025) · Applied Sciences · doi:10.3390/app151910567 · Cited by 2 · see citing works
Chen, P., van Riemsdijk, M. B., Heylen, D., Jonker, C. M., & Tielman, M. L. (2025) · Behaviour and Information Technology · doi:10.1080/0144929x.2025.2483793 · Cited by 2 · see citing works
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Cranney, L., McGill, B., Clare, P., & Bauman, A. (2022) · Preventive Medicine · doi:10.1016/j.ypmed.2022.107004 · Cited by 2 · see citing works
Implementing Behaviour Change Strategies
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Exercise Barriers Among Females With Type 2 Diabetes: Exploring Age-Related Differences
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- Authors
- Cradock, K. A., Quinlan, L. R., Finucane, F. M., Gainforth, H. L., Martin Ginis, K. A., Barros, A. C. D., Sanders, E. B. N., & ÓLaighin, G.
- Affiliations
- Ollscoil na Gaillimhe – University of Galway (IE)
- Science Foundation Ireland (IE)
- Health Research Board (IE)
- University of British Columbia (CA)
- School of Health and Exercise Sciences, Faculty of Health and Social Development, The University of British Columbia, Kelowna, BC V1V 1V7, Canada
- Fraunhofer Portugal Research (PT)
- The Ohio State University (US)
- Electrical & Electronic Engineering, School of Engineering, National University of Ireland Galway, Galway, Ireland
- Corresponding author
- Quinlan, Leo R.
- ORCID
- Venue
- Journal of Personalized Medicine
- Publisher
- MDPI AG
- Published
- 2021-01-26
- Volume
- 11
- Issue
- 2
- Pages
- 72
- ISSN
- 2075-4426 (ISSN-L)
- PMC
- PMC7911111
- OpenAlex
- W3122455703
- Cited by
- 32
- References
- 97
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 4 · 2023: 10 · 2022: 6
- FWCI
- 3.73
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of Personalized Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- cIRcle (University of British Columbia) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Publikationsdatenbank der Fraunhofer-Gesellschaft (Fraunhofer-Gesellschaft) (submittedVersion, other-oa)
- Fraunhofer-Publica (Fraunhofer-Gesellschaft) (submittedVersion)
- Open Collections
- Funders
- Irish Research Council for Science, Engineering and Technology (GOIPG/2013/873)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- type 2 diabetes, exercise behavior change, barriers and facilitators, design probes, behaviour change techniques, food environment, social support, craving, work schedules, motivation, self-reflection
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