The moderating effect of social cognitive factors on self-management activities and HbA1c in Thai adults with type 2 diabetes

Background. Diabetes mellitus (DM) has become a serious chronic disease. The number of people with DM is approximately 382 million people in the world, with more than 90% of them diagnosed as having type 2 diabetes. The self-management strategies help persons with DM make choices which will develop skills needed to reach their goal of blood glucose control and allow them to be successful in reaching goals. Social cognitive theory (SCT) has been used in this study to provide a framework which considers social support, self-efficacy as well as health beliefs based on religious values on self-management activities and HbA1c.;Objective. To examine the impact of self-management activities on HbA1c for persons with DM and to examine the impact of social support, self-efficacy and Buddhist values as moderators on the relationship between the self-management activities and HbA1c.;Method. This study is a cross-sectional design. The sample included 401 Thai adults diagnosed with type 2 diabetes, age 20 -- 65 years old who had at least one HbA1c test in the last three months were recruited. Participants completed four questionnaires to measure self-management activities as well as self-efficacy, Buddhist values and social support as moderating factors on self-management activities and HbA1c.;Results. The self-management activities were negatively associated (beta = -2.05, p ≤ 0.001) with HbA1c. Looking at the relationship of the four subscales, Glucose management (GM), Dietary control (DC), Physical activity (PA) and Health care use (HU) were strongly negatively associated with HbA1c (beta= -2.63, p ≤ 0.001; beta = -1.46, p ≤ 0.001; beta = -1.79, p ≤ 0.001; beta = -1.43, p ≤ 0.001). The Social support, self-efficacy and Buddhist value had a significant interaction effect between self-management activities and HbA1c (beta = -0.97, p 0.05, beta -0.18, p ≤ 0.05 and beta = -2.76, p ≤ 0.001).;Conclusion. The diabetes self-management activities were more strongly associated with HbA1c under conditions of high social support, self-efficacy and health beliefs with Buddhist values. There was a strong association between self-management activities and HbA1c with an inverse relationship which means that higher self-management activities led to a lower value of HbA1c.;Keywords: Type 2 diabetes; Self-management activities; Social support; Self-efficacy and Buddhist value.