Self-efficacy, problem solving, and social-environmental support are associated with diabetes self-management behaviors.
OBJECTIVE
To evaluate associations between psychosocial and social-environmental variables and diabetes self-management, and diabetes control.


METHODS
Baseline data from a type 2 diabetes self-management randomized trial with 463 adults having elevated BMI (M = 34.8 kg/m(2)) were used to investigate relations among demographic, psychosocial, and social-environmental variables; dietary, exercise, and medication-taking behaviors; and biologic outcomes.


RESULTS
Self-efficacy, problem solving, and social-environmental support were independently associated with diet and exercise, increasing the variance accounted for by 23 and 19%, respectively. Only diet contributed to explained variance in BMI (beta = -0.17, P = 0.0003) and self-rated health status (beta = 0.25, P < 0.0001); and only medication-taking behaviors contributed to lipid ratio (total-to-HDL) (beta = -0.20, P = 0.0001) and A1C (beta = -0.21, P < 0.0001).


CONCLUSIONS
Interventions should focus on enhancing self-efficacy, problem solving, and social-environmental support to improve self-management of diabetes.
Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado, USA. diane.king@kp.org
Diane K
DK
King
Russell E
RE
Glasgow
Deborah J
DJ
Toobert
Lisa A
LA
Strycker
Paul A
PA
Estabrooks
Diego
D
Osuna
Andrew J
AJ
Faber
D003920:Diabetes Mellitus / Q000178:diet therapy / Q000523:psychology* / Q000628:therapy; D015444:Exercise / Q000502:physiology; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D011340:Problem Solving; D012648:Self Care / Q000523:psychology*; D020377:Self Efficacy; D012944:Social Support