CoChat
Sign Up
Cited by 184Medication Adherence and ComplianceDiabetes Management and EducationHealth and Wellbeing Research

An examination of the socio-demographic correlates of patient adherence to self-management behaviors and the mediating roles of health attitudes and self-efficacy among patients with coexisting type 2 diabetes and hypertension

Open access
Xie, Zhenzhen, Liu, Kaifeng, Or, Calvin, Chen, Jiayin, Yan, Mian, Wang, Hailiang·2020·BMC Public Health
DOI 10.1186/s12889-020-09274-4PMC PMC7424981
Open this paper in CoChat — free accountOpen PDF

Abstract

Background: Patients with coexisting type 2 diabetes and hypertension generally exhibit poor adherence to self-management, which adversely affects their disease control. Therefore, identification of the factors related to patient adherence is warranted. In this study, we aimed to examine (i) the socio-demographic correlates of patient adherence to a set of self-management behaviors relevant to type 2 diabetes and hypertension, namely, medication therapy, diet therapy, exercise, tobacco and alcohol avoidance, stress reduction, and self-monitoring/self-care, and (ii) whether health attitudes and self-efficacy in performing self-management mediated the associations between socio-demographic characteristics and adherence. Methods: We performed a secondary analysis of data collected in a randomized controlled trial. The sample comprised 148 patients with coexisting type 2 diabetes mellitus and hypertension. Data were collected by a questionnaire and analyzed using logistic regression. Results: Female patients were found to be less likely to exercise regularly (odds ratio [OR] = 0.49,P = 0.03) and more likely to avoid tobacco and alcohol (OR = 9.87,P < 0.001) than male patients. Older patients were found to be more likely to adhere to diet therapy (OR = 2.21,P = 0.01) and self-monitoring/self-care (OR = 2.17,P = 0.02). Patients living with family or others (e.g., caregivers) were found to be more likely to exercise regularly (OR = 3.44,P = 0.02) and less likely to avoid tobacco and alcohol (OR = 0.10,P = 0.04) than those living alone. Patients with better perceived health status were found to be more likely to adhere to medication therapy (OR = 2.02,P = 0.03). Patients with longer diabetes duration (OR = 2.33,P = 0.01) were found to be more likely to adhere to self-monitoring/self-care. Self-efficacy was found to mediate the association between older age and better adherence to diet therapy, while no significant mediating effects were found for health attitudes. Conclusions: Adherence to self-management was found to be associated with socio-demographic characteristics (sex, age, living status, perceived health status, and diabetes duration). Self-efficacy was an important mediator in some of these associations, suggesting that patient adherence may be improved by increasing patients’ self-management efficacy, such as by patient empowerment, collaborative care, or enhanced patient–physician interactions.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1186/s12889-020-09274-4

Cites

93 of 93 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • [33] observed that diabetes fatalism significantly varied by ethnicity in a diverse college student sample, influencing engagement in preventive behaviors.

    “Similarly, [33] observed that diabetes fatalism significantly varied by ethnicity in a diverse college student sample, influencing engagement in preventive behaviors.”

    From Methodological Approaches in Studying Type-2 Diabetes-Related Health Behaviors—A Systematic Review (2025) · cites this paper as [33]

    The Results > Sample characteristics section describes 148 patients with coexisting diabetes and hypertension whose mean age was 63.72 years, not a college-student sample. The paper reports associations involving adherence and self-efficacy; the only occurrence of “diabetes fatalism” found is in a reference title, not a finding about ethnic variation or preventive behaviors. (LLM, conf=0.87)

    Checked by a reasoning model — may be wrong.

    Experimental — accuracy not yet measured

  • Most reviewed studies relied on cross-sectional data or short-term interventions.

    “Most studies relied on cross-sectional data or short-term interventions [28,33], which are insufficient for evaluating the long-term impact of behavioral strategies on glycemic control or health outcomes [4,12].”

    From Methodological Approaches in Studying Type-2 Diabetes-Related Health Behaviors—A Systematic Review (2025) · cites this paper as [33]

    Methods > Data source (page unavailable) says this paper analyzed baseline data from a 24-week trial, so it provides an example of a study using cross-sectional data. It does not review the designs of multiple studies or establish that most relied on cross-sectional data or short-term interventions. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. [46]Sallis JF Owen N Determinants of physical activity, in Physical activity and behavioral medicine 1998 London SAGE publications

Cited by

Sorted by citations

Related

Authors
Xie, Z., Liu, K., Or, C., Chen, J., Yan, M., & Wang, H.
Affiliations
  • University of Hong Kong (HK)
  • Jinan University (CN)
  • City University of Hong Kong (HK)
Corresponding author
Or, Calvin
ORCID
Venue
BMC Public Health
Publisher
Springer Science and Business Media LLC
Published
2020-08-12
Volume
20
Issue
1
Pages
1227-1227
ISSN
1471-2458 (ISSN-L)
DOI
10.1186/s12889-020-09274-4
PMC
PMC7424981
OpenAlex
W3048384077
Cited by
184
References
93
Citations by year
2026: 24 · 2025: 56 · 2024: 35 · 2023: 35 · 2022: 21 · 2021: 12 · 2020: 1
FWCI
18.91
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Public Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • CityU Scholars (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Health and Medical Research Fund (12133231)
Topics
  • Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
  • Health Sciences › Health Professions › General Health Professions › Health and Wellbeing Research
Keywords
type 2 diabetes, hypertension, comorbidities, sociodemographic factors, self-efficacy, health attitudes, mediation, medication adherence, dietary therapy, physical activity, self-monitoring, health perception, diabetes duration, living arrangements, sex differences, old age, family caregivers, stress reduction, lifestyle modification, disease control, quality of life
MeSH terms
Self-Management, Aged, Diabetes Mellitus, Type 2, Female, Humans, Hypertension, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Patient Compliance, Surveys and Questionnaires, Socioeconomic Factors, Self Efficacy

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review