Examining determinants of self management behaviors in patients with diabetes: an application of the Theoretical Model of Effortful Decision Making and Enactment.
OBJECTIVE
This study examined determinants of self-monitoring of blood glucose (SMBG) in patients with diabetes based on a theoretical model. The model focuses on two equally important components of the decision process within a single framework: (1) making a decision and (2) enacting the decision.


METHODS
Diabetes patients with HbA1c >7% and requiring insulin therapy were recruited from a southeastern Michigan healthcare system. Responses were elicited using a mail-in questionnaire. SMBG was measured using a two-week diary and two recall measures. The applicability of the theoretical model as it relates to SMBG was tested using structural equation modeling (SEM).


RESULTS
The SEM analysis demonstrated that goal desire is an antecedent to goal intentions and that implementation desire and implementation intentions mediate the path between goal intentions and SMBG. Further, implementation intentions are a significant predictor of SMBG.


CONCLUSIONS
Consistent with the theoretical model, results indicated that implementation desire and implementation intentions mediate the relationship between strength of goal intention and performing specific behaviors to achieve the goal.


CONCLUSIONS
It is evident that in order to be more effective, educational programs or interventions should consider incorporating implementation and action plans to help patients translate decisions and intentions into behavior.
HEOR, Bristol-Myers Squibb, Co., Plainsboro, NJ 08536, USA. anaghan@umich.edu
Anagha
A
Nadkarni
Suzan N
SN
Kucukarslan
Richard P
RP
Bagozzi
J Frank
JF
Yates
Steven R
SR
Erickson
D015190:Blood Glucose Self-Monitoring; D016009:Chi-Square Distribution; D003657:Decision Making; D003920:Diabetes Mellitus / Q000097:blood / Q000628:therapy*; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D008824:Michigan; D008875:Middle Aged; D008962:Models, Theoretical; D012648:Self Care; D011795:Surveys and Questionnaires
D007004:Hypoglycemic Agents; D007328:Insulin