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Does Self-Efficacy Mediate the Link Between Impulse Control and Diabetes Adherence?

Karol Silva1, Victoria A Miller1,2

  • 1Department of Pediatrics, Children's Hospital of Philadelphia.

Journal of Pediatric Psychology
|February 28, 2020
PubMed
Summary

Diabetes self-efficacy partially explains how impulse control impacts adherence in youth with type 1 diabetes (T1D). Enhancing confidence may improve self-care, but impulse control remains key for better T1D management.

Keywords:
adherencechronic illnessdiabeteslongitudinal researchpsychosocial functioning

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Area of Science:

  • Behavioral Science
  • Psychology
  • Pediatrics

Background:

  • Type 1 diabetes (T1D) management requires consistent self-care behaviors.
  • Impulse control and self-efficacy are potential factors influencing adherence to T1D regimens.
  • Understanding mediating factors is crucial for developing effective interventions.

Purpose of the Study:

  • To examine if diabetes self-efficacy mediates the relationship between impulse control and T1D management in youth.
  • To investigate this relationship across development from ages 8 to 18 years.
  • To differentiate between within-person and between-individual effects.

Main Methods:

  • A cohort sequential design was used with 117 youth with T1D and their parents, assessed 5 times over 2 years.
  • Multilevel modeling analyzed impulse control (predictor), diabetes self-efficacy (mediator), and adherence (outcome).
  • Growth trajectories of adherence were estimated from age 8 to 18 years.

Main Results:

  • Diabetes self-efficacy partially mediated the within-person effect of impulse control on youth-reported adherence.
  • Increased impulse control was associated with higher adherence, partly due to enhanced self-efficacy.
  • Self-efficacy explained 21% of the within-person link between impulse control and adherence; no between-individual effects were found.

Conclusions:

  • Interventions should consider both impulse control and self-efficacy to improve T1D adherence in youth.
  • Fostering confidence in diabetes self-care abilities may enhance self-care behaviors.
  • While self-efficacy is beneficial, it does not fully account for the positive impact of impulse control on adherence.