Is Self-Efficacy Associated With Diabetes Self-Management Across Race/Ethnicity and Health Literacy?

作者：Urmimala Sarkar, Lawrence Fisher, Dean Schillinger · 发表于：Diabetes Care · 年份：2006 · DOI：10.2337/diacare.29.04.06.dc05-1615 · 被引用次数：600 · 研究领域：Diabetes Management and Education、Health Literacy and Information Accessibility、Diabetes, Cardiovascular Risks, and Lipoproteins

OBJECTIVE: Although prior research demonstrated that improving diabetes self-efficacy can improve self-management behavior, little is known about the applicability of this research across race/ethnicity and health literacy levels. We examined the relationship between diabetes self-efficacy and self-management behavior in an urban, diverse, low-income population with a high prevalence of limited health literacy. RESEARCH DESIGN AND METHODS: We administered an oral questionnaire in Spanish and English to patients with type 2 diabetes at two primary care clinics at a public hospital. We measured self-efficacy, health literacy, and self-management behaviors using established instruments. We performed multivariate regressions to explore the associations between self-efficacy and self-management, adjusting for clinical and demographic factors. We tested for interactions between self-efficacy, race/ethnicity, and health literacy on self-management. RESULTS: The study participants were ethnically diverse (18% Asian/Pacific Islander, 25% African American, 42% Latino/a, and 15% white), and 52% had limited health literacy (short version of the Test of Functional Health Literacy in Adults score <23). Diabetes self-efficacy was associated with four of the five self-management domains (P < 0.01). After adjustment, with each 10% increase in self-efficacy score, patients were more likely to report optimal diet (0.14 day more per week), exercise (0.09 day more per week), self-monitoring of bl...