Date on Master's Thesis/Doctoral Dissertation

8-2024

Document Type

Doctoral Dissertation

Degree Name

Ph. D.

Department

Psychological and Brain Sciences

Degree Program

Clinical Psychology, PhD

Committee Chair

Stetson, Barbara

Committee Member

Mekawi, Yara

Committee Member

Zahorik, Pavel

Committee Member

LaJoie, Scott

Author's Keywords

self-determination theory; fatalism; diabetes; risk perception

Abstract

Introduction: Rising rates of diabetes in the U.S. indicate an urgent need to explore and understand factors that elucidate individual diabetes risk. Research of fatalism, the belief that events are predetermined, suggests that fatalistic beliefs influence, shape, and potentially determine health behavior and decision-making. The Theory of Self-Determination posits the importance of motivation and competence in health behavior outcomes. The present study aimed to expand fatalism research by examining associations among fatalism and diabetes-related beliefs and knowledge, including perceived risk and risk knowledge, within the Self-Determination theoretical framework. Methods: Participants were 130 adults aged 26 to 64 without diabetes at risk for development of type 2 diabetes by virtue of a positive first-degree family diabetes history (Mage = 39.74, 55.4% female, 62.8% non-Hispanic White), recruited from the online research platform, Prolific. Participants completed an online questionnaire assessing demographics, personal diabetes risk, health characteristics, and fatalism. Data were analyzed using descriptive statistics, correlations, independent samples t-tests, and hierarchical regressions. Post-hoc analyses examined associations among key study variables and objective diabetes risk. Results: Fatalism was positively associated with diabetes risk perception (r = .244, p < .001) and negatively associated with autonomous motivation (r = -.364, p < .01), perceived competence (r = -.395, p < .01), self-rated health status (r = -.326, p < .01). Hierarchical regression analyses revealed the Self-Determination Theory constructs explained an additional 12.3% of variance in fatalism above and beyond age, sex, diabetes risk knowledge, diabetes risk perception, and overall diabetes risk. Fatalism was not significantly associated with education attainment. Post-hoc analyses revealed group differences in fatalism by BMI category and level of food insecurity. Conclusions: Findings highlight the importance of perceived competence and autonomous motivation in fatalistic health beliefs among adults at risk for type 2 diabetes. Future fatalism research would be enhanced by further validation of the Fatalism Scale across various populations and domains. Studies examining socioeconomic correlates of fatalism, beyond race/ethnicity membership, are needed to better understand relationships among fatalism and associated health outcomes. Healthcare providers of individuals with a biological family history of diabetes, poor self-rated health, and food insecurity should consider the role of fatalism in prevention and treatment of diabetes. Interventions aimed at improving diabetes risk factor knowledge may aid in the promotion of healthful behaviors and overall reduction of fatalistic beliefs.

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