title: Does self-efficacy mediate the cross-sectional relationship between perceived quality of health care and self-management of diabetes? Results from Diabetes MILES - Australia.
abstract: Quality of health care (QoC) and self-efficacy may affect self-management of diabetes, but such effects are not well understood. We examined the indirect role of diabetes-specific self-efficacy (DSE) and generalised self-efficacy (GSE) in mediating the cross-sectional relationship between self-reported QoC and diabetes self-management.
  
  
  
  Diabetes MILES-Australia was a national survey of 3,338 adults with diabetes. We analysed data from 1,624 respondents (age: M = 52.1, SD = 13.9) with type 1 (T1D; n = 680) or type 2 diabetes (T2D; n = 944), who responded to a version of the survey containing key measures.
  
  
  
  self-reported healthy eating, physical activity, self-monitoring of blood glucose frequency, HbA1c, medication/insulin adherence.
  
  
  
  We used Preacher and Hayes' bootstrapping method, controlling for age, gender and diabetes duration, to test mediation of DSE and GSE on the relationship of QoC with each self-management variable. We found statistically significant but trivial mediation effects of DSE and of GSE on most, but not all, variables (all effect sizes < .06).
  
  
  
  Support for mediation was weak, suggesting that relationships amongst these variables are small and that future research might explore other aspects of self-management in diabetes.
authors.affiliation: a School of Psychology , The University of Queensland , St Lucia , Australia.
authors.forename: Hannah
authors.initials: H
authors.lastname: Tregea
authors.affiliation: a School of Psychology , The University of Queensland , St Lucia , Australia.
authors.forename: Christina
authors.initials: C
authors.lastname: Lee
authors.affiliation: b The Australian Centre for Behavioural Research in Diabetes , Melbourne , Australia.|c School of Psychology , Deakin University , Burwood , Australia.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Browne
authors.affiliation: d Center of Research on Psychology in Somatic diseases (CoRPS) , Tilburg University , Tilburg , The Netherlands.
authors.forename: Frans
authors.initials: F
authors.lastname: Pouwer
authors.affiliation: b The Australian Centre for Behavioural Research in Diabetes , Melbourne , Australia.|c School of Psychology , Deakin University , Burwood , Australia.|e AHP Research , Essex , UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Speight
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D001315:Australia; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011787:Quality of Health Care; D012648:Self Care / Q000523:psychology*; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Australia; diabetes; population; quality of care; self-efficacy; self-management