Abstract
BackgroundSelf-care is a crucial component of diabetes management. But comprehensive behavior change frameworks are needed to provide guidance for the design, implementation, and evaluation of diabetes self-care programs in diverse populations. We tested the Information–Motivation–Behavioral Skills (IMB) model in a sample of Chinese adults with Type 2 diabetes.MethodsA cross-sectional study of 222 Chinese adults with type 2 diabetes was conducted in a primary care center. We collected information on demographics, provider-patient communication (knowledge), social support (motivation), self-efficacy (behavioral skills), and diabetes self-care (behavior). The values of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were also obtained. Measured variable path analyses were used to the IMB framework.ResultsProvider-patient communication (β = 0.12, p = .037), and social support (β = 0.19, p = .007) and self-efficacy (β = 0.41, p < .001) were independent, direct predictors of diabetes self-care behavior. Diabetes self-care behaviors had a direct effect on TC/HDL-C (β = −0.31, p < .001) and LDL-C/HDL-C (β = −0.30, p < .001).ConclusionsConsistent with the IMB model, having better provider-patient communication, having social support, and having higher self-efficacy was associated with performing diabetes self-care behaviors; and these behaviors were directly linked to lipid control. The findings indicate that diabetes education programs should including strategies enhancing patients’ knowledge, motivation and behavioral skills to effect behavior change.
Highlights
Self-care is a crucial component of diabetes management
The Information–Motivation–Behavioral Skills (IMB) model of health behavior change [21,22] was used to conceptualize the determinants of diabetes self-care behavior and lipid ratios in a sample of Chinese adults with T2DM
The current study explored the relationship between diabetes self-care behaviors and lipid ratios because lipid ratios are more sensitive in reflecting the morbidity and severity of Cardiovascular disease (CVD) than individual lipid level[4,5,6,7].the finding indicated that diabetes self-care behaviors were negatively associated with total cholesterol (TC)/high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C)/HDL-C
Summary
Self-care is a crucial component of diabetes management. But comprehensive behavior change frameworks are needed to provide guidance for the design, implementation, and evaluation of diabetes self-care programs in diverse populations. The world prevalence of diabetes among adults (aged 20– 79 years) was 6.4% in 2010, and will increase to 7.7% by 2030. Self-care behaviors influence glycemic control [8,9,10] and lipid levels [11,12] These behaviors include monitoring for signs/symptoms of the disease, managing diet, exercising, testing blood glucose, taking medications, inspecting feet for early indications of compromised circulation, stopping smoking, and controlling alcohol consumption [13,14]. While self-care is crucial in diabetes management, few patients engage in the full set of selfcare behaviors at recommended levels [15,16]. Because most patients with chronic diseases, including diabetes, receive health care at primary care centers, it is important that primary care providers understand how to encourage self-care behaviors and improve health outcomes
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