title: Regulatory focus and adherence to self-care behaviors among adults with type 2 diabetes.
abstract: The aims of this study were, first, to test the association between regulatory focus of adults with type 2 diabetes and their adherence to two types of self-care behaviors - lifestyle change (e.g. physical activity and diet) and medical care regimens (blood-glucose monitoring, foot care and medication usage). Second, to explore whether a fit between the message framing and patients' regulatory focus would improve their intentions to adhere specifically when the type of behavior fits the patients' regulatory focus as well. A cross-sectional study was conducted among 130 adults with type 2 diabetes who were hospitalized in an academic medical center. The patients completed a set of questionnaires that included their diabetes self-care activities, regulatory focus, self-esteem and demographic, socioeconomic and clinical data. In addition, participants were exposed to either a gain-framed or a loss-framed message, and were then asked to indicate their intention to improve adherence to self-care behaviors. A multivariable linear regression model revealed that promoters reported higher adherence to lifestyle change behaviors than preventers did (B = .60, p = .028). However, no effect of regulatory focus on adherence to medical care regimens was found (B = .46, p = .114). In addition, preventers reported higher intentions to adhere to medical care behaviors when the message framing was congruent with prevention focus (B = 1.16, p = .023). However, promoters did not report higher intentions to adhere to lifestyle behaviors when the message framing was congruent with promotion focus (B = -.16, p = .765). These findings justify the need to develop tailor-made interventions that are adjusted to both patients' regulatory focus and type of health behavior.
authors.affiliation: a Faculty of Health Sciences, Department of Nursing , Ben-Gurion University of the Negev , Beer Sheva , Israel.
authors.forename: Rinat
authors.initials: R
authors.lastname: Avraham
authors.affiliation: b Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Department of Health Systems Management , Ben-Gurion University of the Negev , Beer Sheva , Israel.
authors.forename: Dina
authors.initials: D
authors.lastname: Van Dijk
authors.affiliation: b Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Department of Health Systems Management , Ben-Gurion University of the Negev , Beer Sheva , Israel.
authors.forename: Tzahit
authors.initials: T
authors.lastname: Simon-Tuval
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D004032:Diet; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006801:Humans; D033182:Intention; D007557:Israel; D008019:Life Style; D016014:Linear Models; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D010349:Patient Compliance; D012648:Self Care; D012649:Self Concept; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Type 2 diabetes; adherence; health behaviors; health messages; regulatory focus