Knowledge, Attitudes, and Reported Practices Regarding Prediabetes Among Hypertensive Patients With Abdominal Obesity: A Cross‐Sectional Structural Equation Modeling Analysis

BACKGROUND: We assessed prediabetes-related knowledge, attitudes, and reported practices among adults with hypertension and abdominal obesity and examined whether their associations were compatible with a hypothesized KAP structure. METHODS: This cross-sectional questionnaire survey included 446 adults recruited from April to June 2025. A revision-stage coding audit corrected P5 scoring. Because P4 and P6 had near-zero, nonsignificant loadings, the primary practice construct comprised P1, P2, P3, and P5; full-item models were retained as sensitivity analyses. Spearman correlations and structural equation modeling (SEM) were used. RESULTS: Mean knowledge, attitude, and four-item practice scores were 8.90 ± 2.14, 37.31 ± 3.68, and 10.75 ± 2.38. Correlations were 0.160 for knowledge-attitude, 0.173 for knowledge-practice, and 0.146 for attitude-practice (all p ≤ 0.002). The primary SEM showed acceptable fit (CMIN/DF = 2.127, RMSEA = 0.050, CFI = 0.925). Knowledge was associated with attitude (β = 0.160, p = 0.012), and attitude with practice (β = 0.281, p = 0.004); the direct knowledge-practice path was nonsignificant (β = 0.069, p = 0.402). The model-based indirect association was 0.045 (95% CI 0.016-0.091; p = 0.004). Practice showed weak convergent reliability (AVE = 0.199; CR = 0.464), and attitude responses had marked ceiling effects. CONCLUSIONS: The findings suggest modest cross-sectional associations among KAP domains and are compatible with the hypothesized structure but do not establish temporal ordering or mediation. Longitudinal studies using validated instruments and objective glycemic assessment are needed.