Table 4.

Sample quotes for subthemes

Subtheme	Sample quotes
Motivators: Determination to not get diabetes	Fear of losing my limbs. Fear of not having a healthy old age. Fear of being dependent on others because of my health. Looking at what my sister looks like and thinking, ‘I don’t want to be there.’ (PIP02: Māori Female, PD) I’d seen what the old man went through and I don’t want to go through that again; didn’t want to go through what he went through. From a guy that did a shitload of gardening, was always active fishing and everything else, to a guy sitting in a wheelchair wishing he wasn’t alive. It’s just like, don’t want that. (PIP36: NZE male, NG)
Motivators: Wanting to be healthy and to contribute to others	You just want to participate; just want to be available for them when the kids have got things on. That usefulness you know; there’s still a role to do…. I didn’t really want to lose any value in any of that. So I just need to be healthier. (PIP38: Māori female, PD) So it’s the future of new grandchildren; I want them to meet me. My mother only met my eldest daughter, she didn’t meet the other two. That inspires me to take care of my journey. (PIP52: Māori Female, NG)
Motivators: Encouragement of others	I think it’s little things that my mother in-law and my mother have said, “You need to take this seriously, because you don’t want to become a diabetic.” (PIP11: NZE Female, PD) (My nurse’s) approach to it. She told me about it and she didn’t push it. She encouraged me. (PIP01: NZE Female, NG)
Facilitators: Strong desire to be healthy for self and others	Feeling a bit healthier. When I was doing up my shoelaces I’d be puffing before, where now I’m not. I’m lying on my stomach when I sleep. I notice those changes that have come. So, I’m wanting to continue that on. (PIP20: NZE Male, NG) I’m trying to put things right so I can be around till my grandkids are teenagers, so they can remember me. Not, when they’re only two or three and ‘This is a photo of your granddad.’ I want them to grow up so they can visualise me in their minds.” (PIP09- Māori Male, PD)
Facilitators: Personal determination	It’s my responsibility, this prediabetes, it’s not theirs. So we go out, they eat what they want, friends and family. It’s my responsibility. I can’t be passing things over to people, because at the end of the day I’m the one who has to do it. (PIP52: Māori Female, NG) Definitely, because it’s all a mindset eh, I believe. Because once your mind’s right you make better decisions. (PIP12: Māori Male, PD)
Facilitators: Feeling supported	‘Cause she’s (wife) my biggest support and probably my best critic that I listen to… She’s always telling the kids, “Look after your father. You know, not to give him too much sweet stuff.” (PIP09; Māori Male, PD) (My nurse) has given me some good tips… I think she’s doing her best to help me so I owe it to her, and myself, to just make more of an effort and be more aware of what I’m doing really. (PIP3: NZE Female, PD) Probably the appointments every month at the doctors. Again, routine, appointments. I think it’s every month I go there. They weigh and measure and do blood sugars (PIP11: NZE Female, PD)
Challenges: Compromised control of life and environment	Just after, [my wife] went to hospital and I was struggling with that; up to the hospital every day, every day, every day. From January last year to November, I lost five kgs, and then in a month I put on seven kgs because of eating on the run - home from work, up to the hospital, oh, bugger it, I’ll have some takeaways tonight. Then friends invite you around for tea and there’s enough food there to sink a battleship, so I eat it all because, “This is a good feed tonight.” (PIP28: Māori Male, NG) TV advertisements and stuff…You know, that’s everywhere - fast food, milkshakes, like advertisements for food. I think I’m bombarded with it… You can’t go to the supermarket without being bombarded (PIP42: NZE Male, NG)
Challenges: Feeling unsupported by others	Because he’s (partner) not very good at cooking so he would always buy takeaways. I said, “Can you not buy pizza?” Then he’d buy it and go, “Oh I forgot. Sorry I forgot.” Lots of, “I forgot.” Then he would buy something and, “Here I bought this for you.” “You know I’m not allowed that.” “Yeah I forgot.” He’ll feel disappointed because I didn’t eat it. So there was a little bit of not trying to hurt his feelings. (PIP08: Māori Female, NG) Because the grandkids like takeaways, which is not necessarily a good thing, and being there of course I was helping eat their tea (PIP24: NZE Male, PD)
Challenges: Social occasions	We have patients bringing food in all the time – cakes, slices and cookies – and it’s so easy to just go in there and have it every single day (PIP01: NZE Female, NG) Probably just when you’re at the marae. You know, a lot of fatty meat and a lot of sweet stuff… It’s the socialising that captures you into what’s there to be offered on the table…. ‘Cause the food is nice, it’s rich, and it’s inviting. And I think, catching up with friends; you sit down, you talk, you eat. (PIP09; Māori Male, PD)
Challenges: Financial issues	Plus you haven’t got the money to buy it, too, that’s another thing…. Like they say eat more fish, eat more chicken, but it’s what you can afford. Fish ain’t the cheapest things (PIP57: Māori Male, NG) Cause my husband and I, we’re on a very tight budget and it’s not every day we have all the treats. We like to have every day meals and stuff. So, we’re very restricted (PIP04: Māori Female, PD)
Challenges: Impact of other health issues	I went to the Sleep Clinic and got diagnosed with really bad sleep apnoea - really bad… I was just so tired. It was too easy to just do easy prepare meals. (PIP26: NZE Female, PD) I just let everything go after I had that [hip joint replacement] op. Then I went, ‘Huh, you let it go too far. Oh, you better wake up now.’ (Laughter) Interviewer: So when did you decide you needed to stop and wake up? When they said, ‘You’ve got diabetes,’ practically. (PIP46: Māori Female, Diabetes)
Challenges: Meeting the challenges	Often I’ll just say if someone’s there and it’s afternoon teatime ‘Oh no I had a late lunch thanks.” Just so I’m not saying, “I don’t want this.” (PIP13: NZE Female, NG) I would eat their (kids’) food. So, what I do now is I actually feed myself first. I know that sounds crazy (laughter)… So, I eat my dinner early, like 4·30 to 5·00 and then it’s time for their dinner when it’s ready, about 6·00… so I’m not tempted to eat their food. (PIP17: NZE Female, PD)

NZE, NZ European; PD, Persistent prediabetes post 6 month intervention; NG, Normoglycaemia post 6 month intervention.