Beyond Individual Responsibility: A Qualitative Study of Capability, Motivation, and Opportunity for Self-Management in Early-Onset Type 2 Diabetes

PURPOSE: The purpose of the study was to explore daily experiences of age-specific unmet needs among adults with early-onset type 2 diabetes across the care trajectory. METHODS: A qualitative descriptive design was used. Participants were recruited from university-affiliated endocrinology clinics and online diabetes communities and via self-referral in Korea. Thirty-five adults (54.3% men) with early-onset type 2 diabetes were included. Interviews (40-90 minutes) were conducted between June 2023 and February 2024 in person (n = 12) or via video calls (n = 23). Interviews were audio-recorded, transcribed verbatim, and analyzed using qualitative content analysis with investigator triangulation. RESULTS: Findings were synthesized using the capability, opportunities, and motivation-behavior model. Capability developed cumulatively through repeated trial-and-error attempts and vicarious experiences, strengthening over time. Opportunity reflected a health care context characterized by early diabetes detection but less focus on prevention and follow-up treatment. Motivation, shaped by illness perceptions, health care provider support, and evolving self-identity, facilitated the link between capability and opportunity. CONCLUSIONS: This study identified age-specific educational and support needs among individuals with early-onset type 2 diabetes. Optimal care requires multifaceted strategies, including person-centered coaching, provider training, age-specific education content, supportive services and environments, and tailored public health messaging, to promote self-management. Interdisciplinary collaboration is essential for implementation.