The Joint Annual Scientific Meetings of the Endocrine Society of Australia and the Society for Reproductive Biology 2018

Characterising baseline motivation and engagement in healthy lifestyle behaviours in participants in the testosterone for type 2 diabetes prevention in men (T4DM) Study (#274)

Tarryn Sohn 1 2 , Yi Xian Chan 1 2 , Gary Wittert 3 , Mathis Grossmann 4 , Warrick J. Inder 5 , David Jesudason 3 , Mark Ng Tang Fui 4 , Karen Bracken 6 , Bu B Yeap 1 2
  1. Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Western Australia, Australia
  2. School of Medicine, University of Western Australia, Perth, Western Australia, Australia
  3. Freemasons Foundation Centre for Men's Health, School of Medicine , University of Adelaide , Adelaide , South Australia , Australia
  4. Department of Medicine, Austin Health, University of Melbourne , Melbourne, Victoria , Australia
  5. Department of Diabetes and Endocrinology, Princess Alexandra Hospital , Brisbane , Queensland , Australia
  6. NHMRC Clinical Trials Centre, University of Sydney , Sydney, New South Wales, Australia

Background: Beneficial lifestyle changes are difficult to implement in overweight men at risk of diabetes. The impact of motivation on facilitating engagement in healthy lifestyle behaviours is incompletely understood.

Aim: Characterisation of a questionnaire to characterise levels of motivation and willingness to change, in relation to healthy lifestyle behaviours.

Participants: 605 of 1,007 men 50-74 years with waist ≥95cm, testosterone ≤14nmol/L, and impaired glucose tolerance (IGT)/newly diagnosed type 2 diabetes enrolled in T4DM (ACTRN12612000287831), randomised to testosterone vs placebo for two years with background lifestyle intervention.

Methods: Dedicated questionnaire administered at randomisation comprising motivation and behavioural domains. Relevant items were compared with SF12 and Physical Activity questionnaires.

Results: On scale 1 (low)-10 (high), motivation was rated (median) 8 and willingness to change 8. Over a 14-day period, men reported engagement in healthy activities on (median) 5 days, moderate physical activities 6 days, vigorous physical activities 2 days and quality time with friends/family 9 days. Overall effort to engage in these activities was rated 3/10.

Self-rated physical health (median score 7/10) correlated with quality of life by SF12 score (r=-0.57, p=<0.001). Self-reported engagement in moderate and vigorous physical activity correlated with corresponding Physical Activity questionnaire responses (r=0.60, p=<0.001; r=0.47, p=<0.001 respectively). Motivation correlated strongly with willingness to change (r=0.75, p=<0.001) but only modestly with engagement in healthy behaviours (r=0.15, p=0.001).

Baseline testosterone did not correlate with motivation (p>0.05) but was positively correlated with engagement in vigorous physical activity (difference 0.07 nmol/L/day, p=0.025).

Conclusions: Men participating in T4DM with IGT/newly diagnosed diabetes self-report high motivation and willingness to change, but moderate engagement with healthy lifestyle behaviours. Key elements from the motivation and behavioural questionnaire correlated strongly with similar questions from validated instruments. Further research is needed to translate motivation into improved engagement in healthy lifestyle behaviours in men at risk of diabetes.