PERSONAL-MODEL BELIEFS AND SOCIAL-ENVIRONMENTAL BARRIERS RELATED TO DIABETES SELF-MANAGEMENT

OBJECTIVE - The specific aims of the present study were to report on t he level of personal beliefs and social and environmental barriers acr oss different regimen areas and patient subgroups and on the relations hip of personal models and perceived barriers to the level of selfmana gement RESEARCH DESIGN AND METHODS - This study focused on several iss ues related to personal models (representations of illness) and percei ved barriers to diabetes self-management among a large heterogeneous s urvey sample of 2,056 adults throughout the U.S. RESULTS - Respondents felt that diabetes was a serious disease and that their self-manageme nt activities will control their diabetes and reduce the likelihood of long-term complications. Most frequently reported barriers were relat ed to dietary adherence, followed by exercise and glucose testing barr iers. Both personal models and barriers significantly predicted level of self-management in all three regimen areas studied (diet, exercise, and glucose testing) after controlling for the influence of demograph ic and medical history factors. Regimen-specific models and barriers p roved to be stronger predictors than more global measures. Differences on personal models and barriers were observed among different patient groups (e.g., age, health insurance, and insulin-taking status). Poss ible reasons for these differences and implications for intervention a nd future research are discussed. CONCLUSIONS - Both the personal-mode l and barriers scales had good internal consistency and predicted vari ance in each of the self-management variables after controlling for de mographic and medical history factors. These brief self-report persona l-model scales demonstrated good internal reliability and were as pred ictive of self-management as the lengthier interview-based measures in previous studies. The assessment of the treatment effectiveness compo nent of personal models may be sufficient for most clinical purposes.