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Cited by 594Diabetes Management and EducationHealth Literacy and Information AccessibilityHealth and Wellbeing Research

Is self-efficacy associated with diabetes self-management across race/ethnicity and health literacy?

Sarkar, Urmimala, Fisher, Lawrence, Schillinger, Dean·2006·Diabetes Care
DOI 10.2337/diacare.29.04.06.dc05-1615
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Abstract

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 blood glucose (odds ratio 1.16), and foot care (1.22), but not medication adherence (1.10, P = 0.40). The associations between self-efficacy and self-management were consistent across race/ethnicity and health literacy levels. CONCLUSIONS—Self-efficacy was associated with self-management behaviors in this vulnerable population, across both race/ethnicity and health literacy levels. However, the magnitude of the associations suggests that, among diverse populations, further study of the determinants of and barriers to self-management is warranted. Policy efforts should be focused on expanding the reach of self-management interventions to include ethnically diverse populations across the spectrum of health literacy.

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Crossref · 10.2337/diacare.29.04.06.dc05-1615

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  • Self-efficacy for diabetes self-management is an important psychosocial factor linked to better self-management and treatment outcomes.

    “Patient perceptions about their own ability, or self-efficacy, to self-manage diabetes are one important psychosocial factor related to improved diabetes self-management and treatment outcomes in diabetes (22–26) and should be a target of ongoing assessment and treatment planning.”

    From Psychosocial care for people with diabetes: a position statement of the American Diabetes Association (2016) · cites this paper as [22]

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Authors
Sarkar, U., Fisher, L., & Schillinger, D.
Affiliations
  • University of California, San Francisco (US)
  • San Francisco General Hospital (US)
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2006-04-01
Volume
29
Issue
4
Pages
823-829
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/diacare.29.04.06.dc05-1615
OpenAlex
W2098177322
Cited by
594
References
72
Citations by year
2026: 12 · 2025: 19 · 2024: 24 · 2023: 15 · 2022: 21 · 2021: 34 · 2020: 40 · 2019: 40 · 2018: 48 · 2017: 39 · 2016: 37 · 2015: 34 · 2014: 44 · 2013: 28 · 2012: 42
FWCI
13.23
Type
journal article
Language
en
Open access
closed
Locations
  • Diabetes Care (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (2m01rr000083-41)
  • U.S. Public Health Service (1 T32 HP9025)
  • National Center for Research Resources (M01RR00083-42, K23RR016539, K23 RR 16539-03)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
  • Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
  • Health Sciences › Health Professions › General Health Professions › Health and Wellbeing Research
Keywords
diabetes self-efficacy, diabetes self-management, type 2 diabetes, health literacy, race and ethnicity, medication adherence, diet, physical activity, self-monitoring of blood glucose, foot care, low-income populations, Spanish-speaking patients, primary care
MeSH terms
Diabetes Mellitus, Type 2, Educational Status, Hispanic or Latino, Humans, Health Knowledge, Attitudes, Practice, Middle Aged, Surveys and Questionnaires, Regression Analysis, San Francisco, Self Care, Socioeconomic Factors, Urban Population, Health Behavior, Multivariate Analysis, Self Efficacy, Racial Groups

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