Bridging Mind, Body, and Behavior : Psychosocial and Clinical Predictors of Lifestyle Modification Adherence Among Patients With Type 2 Diabetes in Urban Cameroon : A Cross Sectional Study in Yaounde Central Hospital

Abstract Background and Objectives : Type 2 diabetes (T2D) usually consider as a health issue specific to economically prosperous societies, is rising at a critical and significant rate in sub-Saharan Africa, particularly in urban areas undergoing rapid nutritional and epidemiological transitions. Adopting appropriate lifestyle habits is the cornerstone of preventing and managing this the disease. This study aims to analyze the psychosocial and clinical predictors of adherence to lifestyle modifications among T2D patients in urban area in Cameroon. Methods : To achieve our goal a cross-sectional, correlational approach involving an active cohort of 351 patients followed over six months was conducted using the Diabetes Obstacles Questionnaire (DOQ) as a tool. Fisher's exact test, the Pearson's chi-square test, and multinomial logistic regression were performed using CS Pro 8.0 and R software. Logistic regression analyses controlling for age, sex, marital status, montly incomes, and educational attainment were carried out to identify the outcome variable of aherence with a statistical significance threshold of p < 5%. Results : 58% of women and 42% men filled the DOQ, with a mean age of 53.29 years (±10.06), and sex ratio of 0.72. A negative correlation was observed between economic and dietary barriers (r = -0.608), environmental and urban barriers (r = -0.413) ; social and cultural barriers (r = -0.291). The psychosocial and clinical predictors identified were self-efficacy (adjusted OR = 2.141; 95% CI: 1.097–4.179; p = 0.026); economic and environmental barriers (adjusted OR = 0.330; 95% CI: 0.231–0.471; p = 0.001); environmental/urban barriers (adjusted OR = 0.669; 95% CI: 0.468–0.956; p = 0.027); and the patients' level of knowledge regarding the disease (adjusted OR = 1.409; 95% CI: 1.011–1.963; p = 0.043). Conclusions : Current findings support the hypothesis that adherence to therapeutic recommendations among people living with T2D in sub-Saharan Africa (SSA) depends on a synergy of actions: therapy and behavioral conditioning, with an emphasis on self-efficacy reinforced by financial support through the extension of universal health coverage to all chronic diseases, the creation of supportive environments (involving social support networks, stable ergonomic conditions, and sports facilities), and the continuous updating of their knowledge.