Paper Title
Facilitators and Barriers of Modifiable Behaviours that Reduce the Risk of Developing Type 2 Diabetes in Adulthood: An Integrative Review

Background: The risk of developing type 2 diabetes (T2DM) is significantly increased by various modifiable factors, such as obesity, unhealthy diet and sedentary lifestyle. This implies that T2DM can be partially prevented and its progression and complications can be minimised by altering these modifiable risk factors, particularly among the adult population. Aim: The main aim of this review was to identify barriers and facilitators of modifiable behaviours for reducing the risk of developing T2DM. Methods: An integrative review was undertaken. A computerised systematic search for relevant studies was performed on Cumulative Literature Index of Nursing and Allied Health Literature (CINAHL), MEDLINE and Sociological Abstracts. Thematic synthesis was performed to analyse the included studies. Results: Following critical appraisal a total of 19 studies, six quantitative and 13 qualitative, were reviewed. Three main themes concerning modifiable behaviours were identified from the studies: physical activity, diet and smoking. The review identified numerous internal and external factors affecting for these modifiable behaviours, which were classified and synthesised under two main themes: (1) barriers to and (2) facilitators of modifiable behaviours. Four subthemes were identified and discussed as barrier to modifiable behaviours, including (i) personal factors, such as health and emotional issues; (ii) social factors, such as lack of social support; (iii) informational factors, such as inadequate knowledge and awareness and (iv) environmental factors, such as climate and individual settings. Conversely, three subthemes were identified as facilitators for modifiable behaviour, including (i) personal factors, such as motivation; (ii) social factors, such as adequate social support and (iii) informational factors, such as adequate knowledge and awareness. Conclusion: Numerous factors can facilitate or bar adult engagement in modifiable behaviours that reduce the risk of developing T2DM. Strategies to enhance modifiable behaviours should focus on education and counselling, enhancing individual self-efficacy and promoting social support. Keywords - Modifiable Behaviours, Lifestyle Intervention, Physical Activity, Diet, Diabetes Prevention, Diabetes Mellitus, Smoking.