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Self-efficacy, Self-regulation, and Barriers to Dietitian-led Nutrition Counseling: Qualitative Interviews with Adults with Diabetes in the United Arab Emirates

Habiba I. Ali,Amal I Al Harbi,Maitha Alnahdi,Mahra S Alshamsi,Mariam R. Aldhaheri,Shamma M Al Meqbaali,Meera A Aldahmani,Bolaji Ilesanmi-Oyelere,A. A. Al Dhaheri,Leila Cheikh Ismail,Lily Stojanovska,N. Kalupahana

Published 2025 in Journal of Primary Care & Community Health

ABSTRACT

Background: Despite the critical role of dietitians in supporting diabetes management through nutrition education, attendance at dietetics consultations remains suboptimal. Although the Arab Gulf Region has one of the highest prevalence rates of diabetes globally, there is a lack of research investigating the barriers and facilitators influencing both diabetes management and participation in dietetics consultations in this region. This study explored patients’ perspectives on diabetes nutrition management within the framework of self-regulation and self-efficacy constructs of the Social Cognitive Theory (SCT) and their suggestions for improving patient attendance in dietitian-led nutrition counseling sessions. Methods: Audio recordings of semi-structured interviews with 44 adults attending a diabetes clinic in the United Arab Emirates (UAE) were transcribed in Arabic, translated into English, and thematically analyzed to examine the participants’ self-management strategies, self-efficacy beliefs, and suggestions for improving attendance at dietitian-led nutrition counseling sessions. Results: Five themes emerged: barriers to diabetes self-management, diabetes self-management practices, high self-efficacy, low self-efficacy, and suggestions for improving attendance at dietitian nutrition counseling. Barriers included time constraints, scheduling issues, socio-cultural factors, health status, and nutrition counseling quality. Confidence levels varied, with some patients requiring reminders or additional information. Suggested improvements included coordinated appointments, reminders, remote sessions, and enhancing the quality of nutrition counseling. Conclusion: Addressing personal, social, and visit scheduling barriers may improve attendance and support effective diabetes management.

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