Date of Award

Summer 8-2020

Document Type


Degree Name

Doctor of Philosophy (PhD)


Health Services Research


Health Services Research

Committee Director

Qi Zhang

Committee Member

Shelley Mishoe

Committee Member

Praveen K. Durgampudi


The prevalence of diabetes and poor glycemic control in Saudi Arabia has increased that contributed to the growing number of deaths in Saudi Arabia. It is known that type 2 diabetes (T2DM) can be prevented but there is a lack information about the magnitude of the of diabetes at national level as well as the risk factors for physical activity (PA), self-monitoring of blood glucose (SMBG), and poor glycemic. Thus, through utilizing Health promotion model (HPM), the aims are to examine the personal factors, cognitive-perceptual, and behavioral determinants of three outcomes; physical activity, SMBG, and poor glycemic control. A secondary data (Saudi health interview survey-2013) was used with two sample sizes for examining PA and SMBG (808 participants who reported to have T2DM and were 18 year or older) and poor glycemic control (391 participants who reported to have T2DM and had data about their blood glucose level) outcomes. Bivariate and multivariate logistic regression were conducted to address the research questions at alpha level of 0.05.

The results showed that the prevalence of physical activity, SMBG, and poor glycemic control, were 9.1%, 55.4%, and 34%, respectively. Younger age (Adjusted odds ratio [AOR] = 2.84), and higher education (AOR = 3.14) were associated with PA, while health professional support for treatment (HPST) was inversely associated with PA (AOR = 0.35). Factors associated with SMBG were obesity (Adjusted prevalence ratio [APR] = 1.20), middle (APR = 1.30) and higher (APR =1.49) education, while shorter diabetes duration (AOR = 0.78 for < 5 years and 0.78 for 5-9 years) and Eastern region (AOR = 0.66) were inversely associated with SMBG. For poor glycemic control, the only predictor was Eastern region (AOR = 1.55) compared to the Central region. Further analysis showed that region of residence, education, diabetes duration, and age were prominent predictors of all cognitive-perceptual and behavioral outcomes. The study suggested individualizing plan of care for diabetic patients due to disparity in the personal factors. The study supported the urgent change in the healthcare system to adapt healthcare professional team-based care. Finally, longitudinal studies at both national and regional levels are needed to determine the causal relationship focusing on both personal and psychological factors.