Factors Related to Health Behaviors Among Adults With Prediabetes: A Systematic Review And Meta-Analysis

Background: Prediabetes is a critical stage in the progression to type 2 diabetes, where preventive lifestyle changes can be most effective. However, many adults with prediabetes do not adhere to recommended health behaviors such as physical activity, healthy dietary practices, and medication adherence. This study aimed to synthesize existing evidence on the factors influencing health behaviors among adults with prediabetes. Methods: A systematic review and meta-analysis of observational studies was conducted using the PRISMA 2020 framework. A comprehensive search was performed across PubMed, Scopus, ScienceDirect, ProQuest, and Google Scholar. Eligible studies were published in English and focused on determinants of health behaviors in adults with prediabetes. Results: Fourteen (14) studies met the inclusion criteria. Factors influencing health behaviors were grouped into three categories: (1) sociodemographic and health-related factors (e.g., age, gender, education, body weight), (2) cognitive and perceptual factors (e.g., self-efficacy, perceived benefits and barriers, knowledge, health literacy), and (3) motivational and social factors (e.g., types of motivation, attitudes, cues to action, social support). Meta-analysis demonstrated that higher self-efficacy and greater knowledge were significantly associated with healthier behaviors, although heterogeneity was high for self-efficacy (I² >75%). Limitations included the small number of eligible studies and methodological variability. Conclusion: This review concludes that cognitive and motivational factors play a central role in shaping health behaviors. Tailored, patient-centered interventions focusing on these factors are essential for diabetes prevention. Interventions that strengthen self-efficacy, such as skills-based training and behavioral counseling are recommended to promote sustainable lifestyle change and support diabetes prevention.