Development of a health behavior model for females with a history of gestational diabetes to promote healthy dietary habits and glucose tolerance testing

Abstract

This study aims to develop a health behavior model for females with a history of gestational diabetes mellitus (GDM) to promote healthy dietary habits and glucose tolerance testing by identifying factors affecting the health behaviors of this population based on the framework of the Theory of Planned Behavior. A questionnaire survey was administered to females with a history of GDM who were raising infants, and 58 responses were analyzed. An exploratory factor analysis using Promax rotation?was conducted to determine the factor structure of the influencing factors of each health behavior. Next, a structural analysis of covariance was conducted using each factor extracted from the factor analysis and "behavioral intention" and "behavior" as observed variables. The analyses identified six factors affecting health behaviors. Of these the following four factors affected “behavioral intentions” of healthy dietary habits: Having spare time in daily life, finding positive implications for healthy dietary habits, family understanding of postpartum healthcare, and feelings of ease about eating; also, feeling of ease about eating and “behavioral intentions” affect “behaviors.” For the factors affecting taking periodic glucose tolerance tests, four factors were identified, and of these the following three affected “behavioral intentions”: awareness of the necessity of taking the test, psychological burden of taking the test, and finding positive implications for taking the test. The “behavioral intentions” affected “behaviors.” These models yielded adequate goodness-of-fit indices, suggesting that interventions focusing on the factors affecting their respective health behaviors may contribute to the promotion of health behaviors. Key words: gestational diabetes mellitus, health behavior, dietary habits, glucose tolerance testing.