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Journal of Peking University (Health Sciences) ›› 2026, Vol. 58 ›› Issue (3): 600-605. doi: 10.19723/j.issn.1671-167X.2026.03.021

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Health education preferences in patients with type 2 diabetes mellitus based on Big Five personality traits

Siyan YUAN1, Hewei MIN1, Ping CHEN1, Yibo WU1, Hongxia CUI2, Xuxi ZHANG1, Xinying SUN1,*()   

  1. 1. Department of Social Medicine and Health Education, Peking University School of Public Health, Beijing 100191, China
    2. Dongcheng Hospital of Dongying City, Dongying 257091, Shandong, China
  • Received:2026-02-26 Online:2026-06-18 Published:2026-04-28
  • Contact: Xinying SUN
  • Supported by:
    the National Natural Science Foundation of China(72174008)

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Abstract:

Objective: To explore differences in the Big Five personality traits among patients with type 2 diabetes mellitus (T2DM) in relation to demographic characteristics and health education preferences and to provide evidence for personalized health education strategies. Methods: In September 2023, a cluster sampling method was used to recruit patients with T2DM from seven community health service centers in Shandong Province, China. Data were collected using a questionnaire survey. The 10-item Big Five Inventory (BFI-10) and a self-developed health education preference questionnaire were used for the assessment. Latent profile analysis (LPA) was conducted to identify personality classifications among the patients. Chi-square tests were applied to compare differences in health education preferences across personality groups, and stratified binary Logistic regression analysis was performed to examine the association between personality classification and health education preferences. Results: A total of 612 patients were included and categorized into three personality groups: Regular-balanced type (69.8%), introverted-sensitive type (6.4%), and proactive-adaptive type (23.8%). In the univariate analysis, the proportion of patients in the proactive-adaptive group who preferred peer patients as health education providers was significantly lower than that in other personality groups (χ2=6.123, P=0.047). In contrast, patients in the introverted-sensitive group showed a significantly higher preference for health education content that included psychological support than other personality groups (χ2=8.566, P=0.014). In the Logistic regression analysis, using the regular-balanced type as the reference group, proactive-adaptive patients were less likely to prefer peer patients with diabetes as health education providers (OR=0.491, 95%CI: 0.279-0.866, P=0.014). Regarding health education content, proactive-adaptive patients demonstrated a lower preference for research-frontier information (OR=0.565, 95%CI: 0.376-0.848, P=0.006). In terms of educational delivery settings, introverted-sensitive patients were less likely to prefer mobile applications as a means of receiving health education (OR=0.374, 95%CI: 0.165-0.848, P=0.019). When the proactive-adaptive type as the reference group, introverted-sensitive patients showed a significantly higher preference for psychological support content (OR=2.122, 95%CI: 1.029-4.380, P=0.042). Conclusion: Personality traits exhibit substantial heterogeneity among patients with T2DM, and different personality classifications are associated with distinct health education preferences. Personality traits may serve as an important reference for developing individualized health education strategies; however, their effectiveness in improving intervention outcomes requires further validation through future studies.

Key words: Diabetes mellitus, type 2, Personality, Health education, Patient preference, Latent profile analysis

CLC Number: 

  • R193

Table 1

Latent profile analysis results"

K AIC BIC aBIC Entropy LMRT BLRT Proportions for the profiles
1 11 688.399 11 732.567 11 700.819
2 11 593.412 11 664.080 11 613.283 0.804 ＜0.001 ＜0.001 0.801/0.199
3 11 564.251 11 661.419 11 591.573 0.856 0.023 ＜0.001 0.698/0.064/0.239
4 11 554.242 11 677.911 11 589.016 0.691 0.153 ＜0.001 0.484/0.224/0.229/0.064
5 11 523.564 11 673.733 11 565.790 0.821 0.572 0.040 0.036/0.127/0.641/0.065/0.131

Table 2

Personality trait scores by personality profile in patients with T2DM"

Items Regular-balanced (n=427) Introverted-sensitive (n=39) Proactive-adaptive (n=146)
Extraversion 6.05±0.67 3.64±0.63 8.85±0.85
Agreeableness 7.66±1.41 7.44±1.60 7.84±1.40
Openness 5.90±1.63 5.90±1.65 6.10±1.70
Neuroticism 4.80±1.89 5.67±1.44 4.33±1.78
Conscientiousness 7.21±1.66 7.15±1.76 8.11±1.50

Table 3

Comparison of health education preferences by personality profile in patients with T2DM"

Items Regular-balanced (n=427) Introverted-sensitive (n=39) Proactive-adaptive (n=146) χ2 P
Preferred educator
  Peers No 338 (79.2) 32 (82.1) 129 (88.4) 6.123 0.047
Yes 89 (20.8) 7 (17.9) 17 (11.6)
Preferred format
  One-on-one No 198 (46.4) 14 (35.9) 64 (43.8) 1.706 0.426
Yes 229 (53.6) 25 (64.1) 82 (56.2)
  Health lecture No 176 (41.2) 17 (43.6) 68 (46.6) 1.292 0.524
Yes 251 (58.8) 22 (56.4) 78 (53.4)
  Group discussion No 337 (78.9) 31 (79.5) 124 (84.9) 2.514 0.285
Yes 90 (21.1) 8 (20.5) 22 (15.1)
Preferred content
  Diabetes knowledge No 25 (5.9) 5 (12.8) 5 (3.4) 5.088 0.079
Yes 402 (94.1) 34 (87.2) 141 (96.6)
  Psychological support No 249 (58.3) 21 (53.8) 104 (71.2) 8.566 0.014
Yes 178 (41.7) 18 (46.2) 42 (28.8)
Preferred location
  Phone/WeChat No 301 (70.5) 23 (59.0) 96 (65.8) 2.937 0.230
Yes 126 (29.5) 16 (41.0) 50 (34.2)
  Application No 260 (60.9) 31 (79.5) 87 (59.6) 5.618 0.060
Yes 167 (39.1) 8 (20.5) 59 (40.4)

Table 4

Logistic regression results for health education preferences in patients with T2DM"

Items β P OR 95%CI
Preferred educator (vs. regular-balanced)
  Peers Introverted-sensitive -0.251 0.571 0.778 0.327-1.852
Proactive-adaptive -0.711 0.014 0.491 0.279-0.866
Preferred content (vs. regular-balanced)
  Research frontiers Introverted-sensitive 0.182 0.589 1.199 0.621-2.316
Proactive-adaptive -0.571 0.006 0.565 0.376-0.848
  Diabetes knowledge Introverted-sensitive -1.006 0.061 0.366 0.127-1.049
Proactive-adaptive 0.417 0.411 1.518 0.562-4.103
Preferred location (vs. regular-balanced)
  Application Introverted-sensitive -0.983 0.019 0.374 0.165-0.848
Proactive-adaptive 0.060 0.767 1.062 0.715-1.576
Preferred content (vs. proactive-adaptive)
  Psychological support Regular-balanced 0.571 0.006 1.770 1.179-2.658
Introverted-sensitive 0.753 0.042 2.122 1.029-4.380
  Diabetes knowledge Regular-balanced -0.417 0.411 0.659 0.244-1.781
Introverted-sensitive -1.423 0.035 0.241 0.064-0.903
Preferred location (vs. proactive-adaptive)
  Application Regular-balanced -0.060 0.767 0.942 0.635-1.398
Introverted-sensitive -1.043 0.018 0.352 0.149-0.836
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