Joint Display Study for Prediabetes Prevention in Urban Contexts and Behavioral Change of Thailand: A Mixed Methods Study

Background Type 2 diabetes mellitus (T2DM) is usually a lifelong condition that importance for global health problems. The management of prediabetes in the urban contexts is a priority. To examine the effects of nine intervention functions including education, training, environmental restructuring, enablement, restriction, coercion, modelling, incentivisation, and persuasion on self-care behaviors for glycemic control in individuals with prediabetes using a mixed methods approach. Methods A convergent mixed methods design was employed. Quantitative data were collected from 790 individuals with prediabetes using a self-reported questionnaire based on the Behavior Change Wheel (BCW). Multiple linear regression (enter method) was used to assess the relationship between intervention functions and self-care behavior. Qualitative data were gathered via semi-structured interviews with 25 purposively sampled participants and analyzed using thematic analysis. Findings were integrated using a joint display approach guided by Guetterman, Fetters, and Creswell. Results Eight of the nine intervention functions significantly predicted of self-care behavior (p < .01), with the strongest effects observed for enablement (β = .520), education (β = .492), and training (β = .421). Coercion (β = –.003, p = .786) showed no significant association. Thematic analysis revealed convergence with the quantitative findings, highlighting themes such as skill-building, peer and provider support, and motivational narratives. The joint display demonstrated alignment between perceived influences and actual behavior, supporting the need for multicomponent interventions. Conclusions This study highlights the multifactorial nature of self-care behavior change among individuals with prediabetes. Tailored interventions should prioritize enablement, education, and training while avoiding coercive strategies. Nurses are well-positioned to implement theory-based, culturally responsive approaches that reflect patients' real-life capabilities, opportunities, and motivations. Clinical trial number: Not applicable.