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

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Abstract

Introduction

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.

Methods

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.

Results

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.

Discussion

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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References

  • American Diabetes Association, National Institute of Diabetes. (2003). Digestive and kidney diseases: The prevention or delay of type 2 diabetes (Position Statement). Diabetes Care, 26, S62–S69. doi:10.2337/diacare.26.2007.S62.

    Article  Google Scholar 

  • Bandura, A. (1986). Social foundations of thought and action: A Social Cognitive Theory. Englewood Cliffs, NJ: Prentice Hall.

    Google Scholar 

  • Bandura, A. (1998). Health promotion from the perspective of social-cognitive theory. Psychology & Health, 13, 623–649. doi:10.1080/08870449808407422.

    Article  Google Scholar 

  • Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182. doi:10.1037/0022-3514.51.6.1173.

    Article  PubMed  Google Scholar 

  • Blair, S. N., Haskell, W. L., Ho, P., Paffenbarger, R. S., Vranizan, K. M., Farquhar, J. W., et al. (1985). Assessment of habitual physical activity by a seven-day recall in a community survey and controlled experiments. American Journal of Epidemiology, 122, 794–804.

    PubMed  Google Scholar 

  • Blanchard, C. M., Fortier, M., Sweet, S., O’Sullivan, T., Hogg, W., Reid, R. W., et al. (2007). Explaining physical activity levels from a self-efficacy perspective: The physical activity counseling trial. Annals of Behavioral Medicine, 34, 323–328. doi:10.1007/BF02874557.

    Article  PubMed  Google Scholar 

  • Boule, N. G., Haddad, E., Kenny, G. P., Wells, G. A., & Sigal, R. J. (2001). Effects of exercise on glycemic control and body mass in type 2 diabetes mellitus: A meta-analysis of controlled clinical trials. Journal of the American Medical Association, 286, 1218–1227. doi:10.1001/jama.286.10.1218.

    Article  PubMed  Google Scholar 

  • Calfas, K. J., Long, B. J., Sallis, J. F., Wooten, W. J., Pratt, M., & Patrick, K. (1996). A controlled trial of physician counseling to promote the adoption of physical activity. Preventive Medicine, 25, 225–233. doi:10.1006/pmed.1996.0050.

    Article  PubMed  Google Scholar 

  • Cardinal, B. J., & Sachs, M. L. (1996). Effects of mail-mediated, stage-matched exercise behavior change strategies on female adults’ leisure-time exercise behavior. The Journal of Sports Medicine and Physical Fitness, 36, 100–107.

    PubMed  Google Scholar 

  • Clark, M., Hampson, S. E., Avery, L., & Simpson, R. (2004). Effects of a brief tailored intervention on the process and predictors of lifestyle behaviour change in patients with type 2 diabetes. Psychology Health and Medicine, 9, 440–449. doi:10.1080/13548500412331292250.

    Article  Google Scholar 

  • Conn, V. S., Hafdahl, A. R., Mehr, D. R., LeMaster, J. W., Brown, S. A., & Nielson, P. J. (2007). Metabolic effects of interventions to increase exercise in adults with type 2 diabetes. Diabetologia, 50, 913–921. doi:10.1007/s00125-007-0625-0.

    Article  PubMed  Google Scholar 

  • Delahanty, L. M., Conroy, M. B., & Nathan, D. M. (2006). Psychological predictors of physical activity in Diabetes Prevention Program. Journal of the American Dietetic Association, 106, 698–705. doi:10.1016/j.jada.2006.02.011.

    Article  PubMed  Google Scholar 

  • Dishman, R. K., Motl, R. W., Saunders, R., Felton, G., Ward, D. S., Dowda, M., et al. (2004). Self-efficacy partially mediates the effect of a school-based physical activity intervention among adolescent girls. Preventive Medicine, 38, 628–636. doi:10.1016/j.ypmed.2003.12.007.

    Article  PubMed  Google Scholar 

  • Dunn, A. L., Marcus, B. H., Kampert, J. B., Garcia, M. E., Kohl, H. W., & Blair, S. N. (1999). Comparison of lifestyle and structured interventions to increase physical activity and cardiorespiratory fitness: A randomized trial. Journal of the American Medical Association, 281, 327–334. doi:10.1001/jama.281.4.327.

    Article  PubMed  Google Scholar 

  • Dunn, A. L., Trivedi, M. H., Kampert, J. B., Clark, C. G., & Chambliss, H. O. (2005). Exercise treatment for depression: Efficacy and dose response. American Journal of Preventive Medicine, 28, 1–8. doi:10.1016/j.amepre.2004.09.003.

    Article  PubMed  Google Scholar 

  • Efron, B., & Tibshirani, R. J. (1993). An introduction to the bootstrap. Boca Raton, FL: Chapman & Hall/CRC.

    Google Scholar 

  • Grace, S. L., Barry-Bianchi, S., Stewart, D. E., Rukholm, E., & Nolan, R. P. (2006). Physical activity behavior, motivational readiness and self-efficacy among Ontarians with cardiovascular disease and diabetes. Journal of Behavioral Medicine, 30, 21–29. doi:10.1007/s10865-006-9080-5.

    Article  PubMed  Google Scholar 

  • Kim, C., McEwen, L. N., Kieffer, E. C., Herman, W. H., & Piette, J. D. (2008). Self-efficacy, social support, and associations with physical activity and body mass index among women with histories of gestational diabetes mellitus. The Diabetes Educator, 34, 719–728. doi:10.1177/0145721708321005.

    Article  PubMed  Google Scholar 

  • Kirk, A. F., Mutrie, N., Macintyre, P. D., & Fisher, M. B. (2004). Promoting and maintaining physical activity in people with type 2 diabetes. American Journal of Preventive Medicine, 27, 289–296. doi:10.1016/j.amepre.2004.07.009.

    Article  PubMed  Google Scholar 

  • Lewis, B. S., & Lynch, W. D. (1993). The effect of physician advice on exercise behavior. Preventive Medicine, 22, 110–121. doi:10.1006/pmed.1993.1008.

    Article  PubMed  Google Scholar 

  • Liberopoulos, E. N., Mikhailidis, D. P., & Elisaf, M. S. (2005). Diagnosis and management of the metabolic syndrome in obesity. Obesity Reviews, 6, 283–296. doi:10.1111/j.1467-789X.2005.00221.x.

    Article  PubMed  Google Scholar 

  • MacKinnon, D. P., Lockwood, C. M., Hoffman, J. M., West, S. G., & Sheets, V. (2002). A comparison of methods to tests significance of the mediated effect. Psychological Methods, 7, 83–104. doi:10.1037/1082-989X.7.1.83.

    Article  PubMed  Google Scholar 

  • Marcus, B. H., Selby, V. C., Niaura, R. S., & Rossi, J. S. (1992). Self-efficacy and the stages of exercise behavior change. Research Quarterly for Exercise and Sport, 63, 60–66.

    PubMed  Google Scholar 

  • Marcus, B. H., Bock, B. C., Pinto, B. M., Forsyth, L. H., Roberts, M. B., & Traficante, R. M. (1998). Efficacy of an individualized, motivationally-tailored physical activity intervention. Annals of Behavioral Medicine, 20, 174–180. doi:10.1007/BF02884958.

    Article  PubMed  Google Scholar 

  • Marcus, B. H., Lewis, B. A., Williams, D. M., Dunsiger, S. I., Jakicic, J. M., Whiteley, J. A., et al. (2007). Step into motion: A randomized trial examining the relative efficacy of internet vs. print-based physical activity interventions. Contemporary Clinical Trials, 28, 737–747. doi:10.1016/j.cct.2007.04.003.

    Article  PubMed  Google Scholar 

  • Morrato, E. H., Hill, J. O., Wyatt, H. R., Ghushchyan, V., & Sullivan, P. W. (2007). Physical activity in U.S. adults with diabetes and at risk for developing diabetes, 2003. Diabetes Care, 30, 203–209. doi:10.2337/dc06-1128.

    Article  PubMed  Google Scholar 

  • Morris, K. S., McAuley, E., & Motl, R. W. (2008). Self-efficacy and environmental correlates of physical activity among older women and women with multiple sclerosis. Health Education Research, 23, 744–752. doi:10.1093/her/cym067.

    Article  PubMed  Google Scholar 

  • Napolitano, M. A., & Marcus, B. H. (2002). Targeting and tailoring physical activity information using print and information technologies. Exercise and Sport Sciences Reviews, 30, 122–128. doi:10.1097/00003677-200207000-00006.

    Article  PubMed  Google Scholar 

  • Napolitano, M. A., Papandonatos, G. D., Lewis, B. A., Whiteley, J. A., Williams, D. M., King, A. C., et al. (2008). Mediators of physical activity behavior change: A multivariate approach. Health Psychology, 27, 409–418. doi:10.1037/0278-6133.27.4.409.

    Article  PubMed  Google Scholar 

  • Nelson, K. M., McFarland, L., & Reiber, G. (2007). Factors influencing disease self-management among veterans with diabetes and poor glycemic control. Journal of General Internal Medicine, 22, 442–447. doi:10.1007/s11606-006-0053-8.

    Article  PubMed  Google Scholar 

  • Peyrot, M. F. (2001). Theory in behavioral diabetes research. Diabetes Care, 24, 1703–1705. doi:10.2337/diacare.24.10.1703.

    Article  PubMed  Google Scholar 

  • Pham, D., Fortin, F., & Thibaudeau, M. (1996). The role of the health belief model in amputees’ self-evaluation of adherence to diabetes self-care behaviors. The Diabetes Educator, 22, 126–132. doi:10.1177/014572179602200205.

    Article  PubMed  Google Scholar 

  • Plotnikoff, R. C., Brez, S., & Hotz, S. B. (2000). Exercise behavior in a community sample with diabetes: Understanding the determinants of exercise behavioral change. The Diabetes Educator, 26, 450–459. doi:10.1177/014572170002600312.

    Article  PubMed  Google Scholar 

  • Plotnikoff, R. C., Brez, S., & Brunet, S. (2003). Are exercise social-cognitive factors and behaviors different for adults with diabetes? A randomized community sample. Psychology Health and Medicine, 8, 465–471. doi:10.1080/1354850310001604577.

    Article  Google Scholar 

  • Preacher, K. J., & Hayes, A. F. (2004). SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behavior Research Methods, Instruments, & Computers, 36, 717–731.

    Google Scholar 

  • Prochaska, J. O., & DiClemente, C. C. (1983). Stages and processes of self-change in smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology, 5, 390–395. doi:10.1037/0022-006X.51.3.390.

    Article  Google Scholar 

  • Prodaniuk, T. R., Plotnikoff, R. C., Spence, J. C., & Wilson, P. M. (2006). The influence of self-efficacy and outcome expectations on the relationship between perceived environment and physical activity in the workplace. The International Journal of Behavioral Nutrition and Physical Activity, 1, 7–18. doi:10.1186/1479-5868-1-7.

    Article  Google Scholar 

  • Sacco, W. P., Wells, K. J., Vaughan, C. A., Friedman, A., Perez, S., & Matthew, R. (2005). Depression in adults with type 2 diabetes: The role of adherence, body mass index, and self-efficacy. Health Psychology, 24, 630–634. doi:10.1037/0278-6133.24.6.630.

    Article  PubMed  Google Scholar 

  • Sallis, J. F., Haskell, W. L., Wood, P. D., Fortmann, S. P., Rogers, T., Blair, S. N., et al. (1985). Physical activity assessment methodology in the Five-City Project. American Journal of Epidemiology, 121, 91–106.

    PubMed  Google Scholar 

  • Schwarzer, R., Luszczynska, A., Ziegelmann, J. P., Scholz, U., & Lippke, S. (2008). Social-cognitive predictors of physical exercise adherence: Three longitudinal studies in rehabilitation. Health Psychology, 27, S54–S63. doi:10.1037/0278-6133.27.1(Suppl.).S54.

    Article  PubMed  Google Scholar 

  • Sigal, R. J., Kenny, G. P., Wasserman, D. H., Castaneda-Sceppa, C., & White, R. D. (2006). Physical activity/exercise and type 2 diabetes: A consensus statement from the American Diabetes Association. Diabetes Care, 29, 1433–1438. doi:10.2337/dc06-9910.

    Article  PubMed  Google Scholar 

  • Sobel, M. E. (1982). Asymptotic confidence intervals for indirect effects in structural equation models. In A. Leinhardt (Ed.), Sociological Methodology (pp. 290–312). Washington, DC: American Sociological Association.

    Google Scholar 

  • Sullivan, P. W., Morrato, E. H., Ghushchyan, V., Wyatt, H. R., & Hill, J. O. (2005). Obesity, inactivity, and the prevalence of diabetes and diabetes-related cardiovascular comorbidities in the U.S., 2000–2002. Diabetes Care, 28, 1599–1603. doi:10.2337/diacare.28.7.1599.

    Article  PubMed  Google Scholar 

  • Thomas, D.E., Elliott, E.J., & Naughton, G.A. (2007). Exercise for type 2 diabetes mellitus. Cochrane Database of Systematic Reviews (Online : Update Software), 2, 1–41.

    Google Scholar 

  • Wangberg, S. C. (2008). An internet-based diabetes self-care intervention tailored to self-efficacy. Health Education Research, 23, 170–179. doi:10.1093/her/cym014.

    Article  PubMed  Google Scholar 

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Acknowledgements

This study was supported by the Florida State University Council on Research and Creativity (Planning Grant 017294). We would like to thank Dr. Melissa Napolitano for her valuable consultation on this project. We are also grateful to the entire staff of the Tallahassee Memorial Diabetes Center for their support and contribution to this project.

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Authors and Affiliations

  1. Department of Medical Humanities & Social Sciences, Florida State University College of Medicine, 1115 W. Call St., Tallahassee, FL, 32306, USA

    Gareth R. Dutton, Bridgette C. Provost, Jamie L. Sorenson & Brandon Allen

  2. Florida Agricultural and Mechanical University, Tallahassee, FL, USA

    Fei Tan

  3. The Diabetes Center, Tallahassee Memorial HealthCare, Tallahassee, FL, USA

    Dawn Smith

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  1. Gareth R. Dutton
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  2. Fei Tan
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Correspondence to Gareth R. Dutton.

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Dutton, G.R., Tan, F., Provost, B.C. et al. Relationship between self-efficacy and physical activity among patients with type 2 diabetes. J Behav Med 32, 270–277 (2009). https://doi.org/10.1007/s10865-009-9200-0

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