Does self-efficacy mediate the cross-sectional relationship between perceived quality of health care and self-management of diabetes? Results from Diabetes MILES – Australia

Objective: Quality of health care (QoC) and self-efficacy may affect self-management of diabetes, but such effects are not well understood. We examined the indirect role of diabetes-specific self-efficacy (DSE) and generalised self-efficacy (GSE) in mediating the cross-sectional relationship between self-reported QoC and diabetes self-management. Design: Diabetes MILES–Australia was a national survey of 3,338 adults with diabetes. We analysed data from 1,624 respondents (age: M\ua0=\ua052.1, SD\ua0=\ua013.9) with type 1 (T1D; n\ua0=\ua0680) or type 2 diabetes (T2D; n\ua0=\ua0944), who responded to a version of the survey containing key measures. Main Outcome Measures: self-reported healthy eating, physical activity, self-monitoring of blood glucose frequency, HbA, medication/insulin adherence. Results: We used Preacher and Hayes’ bootstrapping method, controlling for age, gender and diabetes duration, to test mediation of DSE and GSE on the relationship of QoC with each self-management variable. We found statistically significant but trivial mediation effects of DSE and of GSE on most, but not all, variables (all effect sizes\ua