Relationship between self-efficacy and physical activity among patients with type 2 diabetes
ABSTRACT While previous studies indicate a significant relationship between self-efficacy and physical activity, less research has focused on this relationship among patients with type 2 diabetes. The purpose of this investigation was to examine whether self-efficacy mediated the relationship between participation in a 1-month, print-based physical activity intervention and improvements in activity levels.
Participants (N = 85; mean age = 57; 73% Caucasian; 69% female) were recruited from a community diabetes center. The intervention was individually-tailored based on theoretical constructs, including self-efficacy.
After controlling for age, baseline activity, and baseline self-efficacy, the tailored intervention was associated with significant improvements in physical activity, 95% CI [23.01, 271.68] as well as self-efficacy, CI [0.02, 3.48]. There was an indirect effect of treatment on physical activity through self-efficacy, CI [0.77, 73.11], and the direct effect of treatment on physical activity was no longer significant, CI [-7.33, 253.40], after the influences of self-efficacy change were accounted for in the model.
Results supported a mediation effect, such that the treatment effect on physical activity was completely mediated by changes in self-efficacy. Although replication is needed, results support the theoretical rationale for targeting self-efficacy to promote physical activity among patients with type 2 diabetes.
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ABSTRACT: Physical activity (PA) is a relevant component of the treatment of Type 2 diabetes mellitus (T2DM). However, to prevent its related morbidities, PA requires an immediate and lasting change of lifestyle. Exercise self-efficacy and body satisfaction were used in a sample of older adults with T2DM, classified in different stages of change, to predict levels of PA. Results show that exercise self-efficacy increases linearly from precontemplation to maintenance stage, while body satisfaction shows an inverted U shape. However, only stages of change, other than exercise self-efficacy, add a significant and noticeable contribution to prediction of levels of PA. This evidence claims a tailored approach to PA in older adults with T2DM and advises behavioural health interventions based on exercise self-efficacy.04/2014; 2(1). DOI:10.1080/21642850.2014.924858
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ABSTRACT: The high recurrence rate of chronic venous leg ulcers has a significant impact on an individual's quality of life and healthcare costs. This study aimed to identify risk and protective factors for recurrence of venous leg ulcers using a theoretical approach by applying a framework of self and family management of chronic conditions to underpin the study. Secondary analysis of combined data collected from three previous prospective longitudinal studies. The contributing studies' participants were recruited from two metropolitan hospital outpatient wound clinics and three community-based wound clinics. Data were available on a sample of 250 adults, with a leg ulcer of primarily venous aetiology, who were followed after ulcer healing for a median follow-up time of 17 months after healing (range: 3-36 months). Data from the three studies were combined. The original participant data were collected through medical records and self-reported questionnaires upon healing and every 3 months thereafter. A Cox proportion-hazards regression analysis was undertaken to determine the influential factors on leg ulcer recurrence based on the proposed conceptual framework. The median time to recurrence was 42 weeks (95% CI 31.9-52.0), with an incidence of 22% (54 of 250 participants) recurrence within three months of healing, 39% (91 of 235 participants) for those who were followed for six months, 57% (111 of 193) by 12 months, 73% (53 of 72) by two years and 78% (41 of 52) of those who were followed up for three years. A Cox proportional-hazards regression model revealed that the risk factors for recurrence included a history of deep vein thrombosis (HR 1.7, 95% CI 1.07-2.67, p=0.024), history of multiple previous leg ulcers (HR 4.4, 95% CI 1.84-10.5, p=0.001), and longer duration (in weeks) of previous ulcer (HR 1.01, 95% CI 1.003-1.01, p<0.001); while the protective factors were elevating legs for at least 30min per day (HR 0.33, 95% CI 0.19-0.56, p<0.001), higher levels of self-efficacy (HR 0.95, 95% CI 0.92-0.99, p=0.016), and walking around for at least 3h/day (HR 0.66, 95% CI 0.44-0.98, p=0.040). Results from this study provide a comprehensive examination of risk and protective factors associated with leg ulcer recurrence based on the chronic disease self and family management framework. These results in turn provide essential steps towards developing and testing interventions to promote optimal prevention strategies for venous leg ulcer recurrence. Copyright © 2015 Elsevier Ltd. All rights reserved.International journal of nursing studies 03/2015; 52(6). DOI:10.1016/j.ijnurstu.2015.02.016 · 2.25 Impact Factor
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ABSTRACT: More than 60% of cancer-related deaths in the United States are attributable to tobacco use, poor nutrition, and physical inactivity, and these risk factors tend to cluster together. Thus, strategies for cancer risk reduction would benefit from addressing multiple health risk behaviors. We adapted an evidence-based intervention grounded in social cognitive theory and principles of motivational interviewing originally developed for smoking cessation to also address physical activity and fruit/vegetable consumption among Latinos exhibiting multiple health risk behaviors. Literature reviews, focus groups, expert consultation, pretesting, and pilot testing were used to inform adaptation decisions. We identified common mechanisms underlying change in smoking, physical activity, and diet used as treatment targets; identified practical models of patient-centered cross-cultural service provision; and identified that family preferences and support as particularly strong concerns among the priority population. Adaptations made to the original intervention are described. The current study is a practical example of how an intervention can be adapted to maximize relevance and acceptability and also maintain the core elements of the original evidence-based intervention. The intervention has significant potential to influence cancer prevention efforts among Latinos in the United States and is being evaluated in a sample of 400 Latino overweight/obese smokers. © 2014 Society for Public Health Education.Health Education & Behavior 12/2014; 42(1). DOI:10.1177/1090198114560019 · 1.54 Impact Factor