Identification of Factors Associated with Glycemic Control Using the PRECEDE- PROCEED Model in Patients with Type 2 Diabetes: A Cross-Sectional Study

Juan Tu,1 Guoxin Lin,1 Feng Zhu,1 Feipeng Xu,1 Yuan Gao,2 Qiulan Gan,1 Yali Chen,1 Xiaofang Hu,3 Rui Tang41Department of Endocrinology, The First Hospital of Putian City, Putian, Fujian, People’s Republic of China; 2The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China; Nursing School of Nanchang University, Nanchang, Jiangxi, People’s Republic of China; 3Health Science Center, Hunan Normal University, Changsha, Hunan, People’s Republic of China; 4School of Basic Medical Sciences, Southwest Medical University, Luzhou, Sichuan, People’s Republic of ChinaCorrespondence: Rui Tang, School of Basic Medical Sciences, Southwest Medical University, Luzhou, Sichuan, 646000, People’s Republic of China, Email 2396258206@qq.com Xiaofang Hu, Hunan Normal University Health Science Center, No. 371 Tongzipo Road, Yue-Lu District, Changsha, Hunan, 410013, People’s Republic of China, Email hxf20179@163.comObjective: This study aimed to identify the predisposing, enabling, and reinforcing factors associated with glycemic control in patients with type 2 diabetes mellitus, and to provide preliminary evidence for developing continuity management programs across hospital and community settings.Methods: A cross-sectional survey design was used. Based on the PRECEDE-PROCEED planning model, 220 patients with type 2 diabetes were assessed using a general information questionnaire, the Chronic Disease Management Self-Efficacy Scale, the Type 2 Diabetes Self-Management Behavior Scale, and the Social Support Rating Scale. Data were analyzed using the chi-square test, Spearman correlation analysis, and multiple linear regression analysis.Results: The average age of patients with type 2 diabetes was 57.90 (SD=14.28), and the average course of disease was 8.76 (SD=7.52). Overall, 25% of patients achieved the glycemic control target of HbA1c < 7%. Age, disease duration, smoking history, self-efficacy, self-management behavior, and social support were significantly associated with HbA1c and jointly accounted for 44.4% of its variance.Conclusion: The rate of adequate glycemic control among patients with type 2 diabetes mellitus remains suboptimal. Within the PRECEDE-PROCEED framework, self-efficacy may represent a predisposing factor, self-management behaviors an enabling factor, and social support both an enabling and reinforcing factor affecting glycemic control. These findings indicate that future continuity management programs should integrate tailored interventions targeting self-efficacy enhancement, self-management behavior improvement, and social support reinforcement. The incorporation of intelligent terminal technologies may further support personalized diabetes management and improve long-term glycemic outcomes.Keywords: type 2 diabetes mellitus, glycemic control, PRECEDE-PROCEED model, influencing factors