Perceived severity and benefits show a preliminary conditional association with kidney-protective behaviors in type 2 diabetes with early kidney function decline: an exploratory health belief model analysis.

Authors

Chorphaka Fakkaew, Sarunya Koositamongkol, Sarinrut Sriprasong, Wiwat Chancharoenthana

Published in

Renal failure. Volume 48. Issue 1. Pages 2717464. Epub Oct 15, 2026.

Abstract

Diabetic kidney disease (DKD) is a leading cause of chronic kidney disease (CKD) and end-stage kidney disease, and early-stage CKD represents a critical window to slow progression through self-management behaviors. The Health Belief Model (HBM) posits that perceived severity, benefits, barriers, and self-efficacy shape health behaviors; however, whether these constructs operate independently or interact in adults with type 2 diabetes and early kidney function decline remains unclear. This cross-sectional study examined four selected HBM constructs-perceived severity, perceived benefits, perceived barriers, and self-efficacy-both individually and through their interaction, as predictors of self-reported kidney-protective health behaviors, assessed simultaneously via questionnaires, among 123 adults with type 2 diabetes and early-stage CKD or at high risk for CKD (eGFR 45-89 mL/min/1.73m²; G3a, n = 26; G2 without albuminuria confirmation, n = 97) at a tertiary hospital in Bangkok. The four HBM constructs did not independently predict behaviors (F = 2.161, p = 0.078). Simple slopes analysis revealed that perceived severity was significantly associated with health behaviors at high perceived benefits (+1 SD: slope = 0.187, p = 0.041) but not at low levels (-1 SD: p = 0.524). These preliminary, hypothesis-generating findings suggest a potential conditional association between perceived severity and perceived benefits; however, the interaction term did not reach statistical significance (p = 0.289). Educational strategies targeting both disease severity awareness and self-management benefits may warrant further investigation. Longitudinal and adequately powered studies are needed to confirm these interaction patterns and establish directionality.

PMID:
42876250
Bibliographic data and abstract were imported from PubMed on 15 Oct 2026.

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