title: Self-efficacy impacts self-care and HbA1c in young adults with Type I diabetes.
abstract: OBJECTIVE
  The present study examined self-efficacy and self-esteem as basic aspects of the self that influence self-care and physiological outcomes among young adults with Type I diabetes. The two aims of this study were 1) to examine the cross-sectional and longitudinal role of the self-variables as they predict self-care and HbA1c and 2) to test whether self-care mediates the association between the self variables and HbA1c using cross-sectional and longitudinal data.
  
  
  METHODS
  One hundred ten participants were recruited from a regional diabetes outpatient clinic. Inclusion criteria were age (18-35 years) and duration of diabetes (>1 year before recruitment). Participants were 61% female and 88% white. In addition, the sample had an average annual income between $24,999 and $34,999, and 85% had completed some or all of college. The average duration of diabetes was 15 years.
  
  
  RESULTS
  Using multiple regression analyses we found that, compared with self-esteem, self-efficacy was a better predictor of all aspects of self-care and HbA1c in cross-sectional analyses, in addition to diet and exercise self-care, and a better predictor of HbA1c in longitudinal analyses. The data also supported the cross-sectional and longitudinal mediational model in which better self-care helped account for the association between greater self-efficacy and better HbA1c.
  
  
  CONCLUSIONS
  Self-efficacy is an important factor for management of self-care practices and physiological outcomes among young adults with Type I diabetes, and self-care may be an important mechanism by which self-efficacy influences HbA1c levels.
authors.affiliation: Denver Veterans Affairs Medical Center, Denver, CO 80220, USA. catharine.johnston@med.va.gov
authors.forename: Catharine H
authors.initials: CH
authors.lastname: Johnston-Brooks
authors.forename: Megan A
authors.initials: MA
authors.lastname: Lewis
authors.forename: Satish
authors.initials: S
authors.lastname: Garg
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism* / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D008297:Male; D012648:Self Care; D012649:Self Concept; D020377:Self Efficacy; D011795:Surveys and Questionnaires
chemical_list: D006442:Glycated Hemoglobin