Relationship between self-efficacy and physical activity among patients with type 2 diabetes

Department of Medical Humanities & Social Sciences, Florida State University College of Medicine, 1115 W. Call St., Tallahassee, FL 32306, USA.
Journal of Behavioral Medicine (Impact Factor: 3.1). 02/2009; 32(3):270-7. DOI: 10.1007/s10865-009-9200-0
Source: PubMed


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.

15 Reads
  • Source
    • "Importantly, there is robust evidence that self-efficacy is a prerequisite for successful behavior change throughout a variety of health-related domains, including physical activity (e.g., Holden, 1991; Rovniak et al., 2002; Sharma and Sargent, 2005; Gwaltney et al., 2009). Moreover, several recent studies have shown that self-efficacy mediates the effects of health promotion interventions on objectively assessed physical activity (e.g., Burke et al., 2008; Dutton et al., 2009; Darker et al., 2010). Thus, our results tentatively suggest that, although the augmented intervention was not related with elevated levels of physical activity, it might have increased the likelihood of the participants to become more active in the long run, because they were more confident to do so. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Sedentarism is a serious health concern in industrialized countries throughout the world. We examined whether a text message-based intervention, targeted at increasing daily levels of physical activity, would be more effective than a standard psychoeducational intervention and a control condition. Sixty-three individuals (43 women) with a mean age of 23.7 years participated in the study. They were randomly assigned to a psychoeducational standard intervention; an augmented intervention with additional short text messages sent to the mobile phones to remind participants of their action plans, and a control condition. Objectively assessed physical activity and self-efficacy were assessed pre- and post-intervention. Participants in the control condition showed a significant decline in physical activity from pre-assessment to post-assessment, whereas participants in both intervention arms exhibited a slight increase. Moreover, the augmented intervention resulted in a marginally significant increase in self-efficacy, whereas the standard intervention resulted in a significant decrease. The findings suggest that short text messages reminding individuals of their action plans are not more effective than an intervention without text messages, although there seems to be a beneficial effect on self-efficacy, which might facilitate behavior change in the long-term. Challenging aspects of the research design (e.g., reactivity of the assessment protocol) are discussed and suggestions for future research are highlighted.
    Frontiers in Psychology 08/2012; 3:270. DOI:10.3389/fpsyg.2012.00270 · 2.80 Impact Factor
  • Source
    • "Self-efficacy for exercise/physical activity (exercise self-efficacy) is believed to influence physical activity behaviour [22-24]. In people with T2DM a high level of exercise self-efficacy is thought to be predictive of exercise initiation and maintenance over time [25], and is thought to mediate the relationship between an exercise intervention and physical activity [26]. Also, an increased level of exercise self-efficacy makes it more likely that participants indeed use strategies to improve their physical activity levels [27]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Sufficient exercise is important for people with Type 2 Diabetes Mellitus (T2DM), as it can prevent future health problems. Despite, it is estimated that only 30-40% of people with T2DM are sufficiently active. One of the psychosocial constructs that is believed to influence physical activity behaviour, is exercise self-efficacy. The goal of this study is to evaluate a patient-tailored exercise intervention for people with T2DM that takes exercise self-efficacy into account. This study is conducted as a non-randomized controlled clinical trial. Patients are eligible when they are diagnosed with T2DM, exercise less than advised in the ADA guideline of 150 min/week of moderate-intensity aerobic physical activity, have an BMI >25 and are between 18 and 80 years old. Recruitment takes place at a Primary care organization of general practitioners and practice nurses in the south of the Netherlands.Participants are allocated to three groups: An advice intervention -for participants with a high exercise self-efficacy score- in which participants receive a patient-tailored exercise intervention, an intensive intervention -for participants with a low exercise self-efficacy score- in which participants receive a patient-tailored exercise intervention accomplished by a group based intervention, and a control group in which participants receive regular Dutch diabetes care. The primary outcome measure of this study is physical activity. Secondary outcome measures are health status, (symptoms of) depression, exercise self-efficacy, Body Mass Index (BMI), blood pressure and glycemic control. We aimed to design an intervention that can be implemented in Primary care, but also to design an easy accessible program. This study is innovative as it is -to our best knowledge- the first study that takes level of exercise self-efficacy of people with T2DM into account by means of giving extra support to those with the lowest exercise self-efficacy. If the program succeeds in increasing the amount of physical activity it can be implemented in regular primary care. Dutch Trial Register NTR2734.
    BMC Public Health 05/2012; 12(1):331. DOI:10.1186/1471-2458-12-331 · 2.26 Impact Factor
  • Source
    • "Sigurdardottir (2005) states that self-efficacy is a powerful predictor of a person's perceived self-care. Studies of patients with type 2 diabetes demonstrated that greater selfefficacy predicted better nutrition and medication management, more frequent self-monitoring of blood glucose and enhanced physical activity (Dutton et al., 2009; King et al., 2010). While higher levels of self-efficacy have been seen as an indicator of better diabetes control, lower levels have been seen as an indicator of worse diabetes control (Glasgow, Tooberth, & Gilette, 2001). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Purpose The purpose of this study was to determine hypoglycemia fear and self-efficacy levels of patients receiving insulin and the factors affecting these levels. Method In total, 345 diabetic patients who met the inclusion criteria participated in this descriptive, correlational study. Patients were invited to participate in the study during their regular visits to the diabetes outpatient clinic of Istanbul University, Istanbul Medicine Faculty. Data were collected using a patient-information form as well as the Hypoglycemia Fear Survey and Confidence in Diabetes Self-care Scale. Results It was found that patients who had type 1 diabetes, received intensive insulin therapy and experienced more frequent and severe hypoglycemia had more hypoglycemia worry and fear. It was also determined that patients who had type 1 diabetes and received intensive insulin therapy had higher self-efficacy levels than patients who had type 2 diabetes and received conventional therapy. Conclusion The effects of experiences of frequent and severe hypoglycemia in patients with diabetes emphasize the need for programs that support diabetes-specific self-efficacy and also guide and teach hypoglycemia prevention.
    Asian Nursing Research 12/2011; 5(4):222–228. DOI:10.1016/j.anr.2011.12.001 · 1.00 Impact Factor
Show more