Using the IMB model of health behavior change to promote self-management behaviors in Puerto Ricans with diabetes

Most published diabetes intervention studies concerning Hispanics focus on Mexican Americans. However, Puerto Ricans have the highest prevalence of type 2 diabetes and are more likely to be hospitalized for complications than other Hispanic groups. The goal of this research was to test the efficacy of a brief, culturally sensitive, theory-driven intervention to promote self-management behaviors among Puerto Ricans with diabetes. The Information-Motivation-Behavioral Skills (IMB) model was the chosen theoretical framework. ^ A total of 118 patients from a hospital in Hartford, CT completed pretest measures, and were randomly assigned to a brief intervention (N = 59) or the standard of care control group (N = 59). Participants were reassessed 3-months later. Findings revealed that at posttest the intervention group was reading food labels and adhering to diet recommendations significantly more than the control group. The intervention group was also more physically active than the control group, but the difference was not statistically significant. Behavior change was not qualified by weight loss, but was partially qualified by decreased HbA1c. HbA1c decreased in both groups, but the intervention group experienced a greater reduction than the control group. ^ Structural equation modeling tested IMB model predictions. Overall, the IMB models of diet and exercise fit the data. The IMB constructs accounted for a moderate proportion of the variance in both diet and exercise behavior. Diet information was directly related to diet behavior. Consistently, the intervention increased both diet knowledge and diet behavior. Previous interventions with Hispanics that have increased knowledge have also reduced HbA1c, suggesting that improvements in knowledge and behavior may have contributed to the steeper HbA1c decline observed in the intervention group relative to the control group.