A Mixed Methods Approach to Investigate Risk Perception of Developing Diabetes in Vietnamese Americans with Prediabetes

Abstract

Background: Vietnamese Americans (VnA) are at high risk of prediabetes and type 2 diabetes mellitus (T2DM). VnA are initially diagnosed at an earlier mean age and have higher T2DM prevalence compared to Non-Hispanic Whites, despite having lower mean body mass index. VnA may not perceive their risk of T2DM, which may affect their risk-reducing behaviors. There is a paucity of literature regarding the risk perception of developing T2DM in general and even more so for VnA, supporting the need for this study. Purpose: A fixed complementarity (QUAL+quant) mixed method design with a data transformation variant was used to comprehensively describe the perceived risk of developing T2DM among VnA adults with prediabetes. Methods: A non-random, multiple purposive sampling scheme was used to obtain a sample size of 10 VnA adults with prediabetes in the southwestern United States. Data collection techniques included individual, semi-structured interviews and quantitative questionnaires. Qualitative descriptive, quantitative descriptive, and data transformation techniques were used for data analyses. Findings: The two risk perception domains emerging from the qualitative data were risk factors and disease severity. The main risk factors of T2DM noted by participants were eating habits (including the cultural influences on eating habits), sedentary lifestyle, and family history of T2DM. The mean composite Risk Perception Survey for Developing Diabetes score was 2.15 (SD=0.31) with mean scores of 3.30 and 3.10, respectively for the personal control and worry subscales. The meta-inference concluded that most VnA in this sample have a low perceived T2DM risk with divergence noted only with one participant. Conclusions: VnA with prediabetes perceive they are at low risk for T2DM. Strategies to promote accurate risk perception for T2DM risk that is more congruent to actual risk may be needed to supplement T2DM prevention efforts. With high levels of perceived personal control and worry, this population that may be amenable to T2DM prevention interventions.