Skip to main content
×
×
Home

The development of self-efficacy and outcome expectation measures regarding glycaemic load and the nutritional management of type 2 diabetes

  • Carla K Miller (a1), Melissa Davis Gutschall (a2) and Frank Lawrence (a3)
Abstract
Objective

Traditionally, carbohydrate has been the largest contributor to energy intake among people with diabetes, yet different carbohydrate foods produce different glycaemic responses. Glycaemic load represents the total glycaemic effect of the diet and influences glycaemic control. Adequate self-efficacy and outcome expectations are needed to change carbohydrate intake and to evaluate relevant interventions. The purpose of this research was to develop and test instruments regarding self-efficacy and outcome expectations for the adoption of a lower glycaemic load diet.

Design

Participants completed each instrument at their convenience and mailed the instruments to the investigators.

Setting/subjects

A community sample of individuals 21–75 years of age with type 2 diabetes for ≥ 1 year (n = 108) was recruited.

Results

Principal components analysis revealed three factors on the self-efficacy questionnaire: glycaemic index, negative food selection and self-regulation efficacy which accounted for 62% of the variance in these items. The outcome expectations instrument yielded three factors: barriers to dietary change and glycaemic control, and family support expectations which accounted for 48% of the variance. Coefficient α for each construct was >0.70 and coefficient H for each construct was ≥ 0.80.

Conclusions

The two instruments developed for this study can provide important insights about the self-efficacy and outcome expectations regarding the quantity and quality of carbohydrate consumed and self-monitoring performed for diabetes management. Future research is needed to evaluate the relationship among these constructs, dietary intake and glycaemic control.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      The development of self-efficacy and outcome expectation measures regarding glycaemic load and the nutritional management of type 2 diabetes
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      The development of self-efficacy and outcome expectation measures regarding glycaemic load and the nutritional management of type 2 diabetes
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      The development of self-efficacy and outcome expectation measures regarding glycaemic load and the nutritional management of type 2 diabetes
      Available formats
      ×
Copyright
Corresponding author
*Corresponding author: Email: ckm105@psu.edu
References
Hide All
1Harris, ML. Diabetes in America: epidemiology and scope of the problem. Diabetes Care 1998; 21(Suppl. 3): C1114.
2Mokdad, AH, Bowman, BA, Ford, ES, Vinicor, F, Marks, JS, Koplan, JP. The continuing epidemics of obesity and diabetes in the United States. Journal of the American Medical Association 2001; 286: 1195–200.
3Wild, S, Roglic, G, Green, A, Sicree, R, King, H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care 2004; 27: 1047–53.
4Ohkubo, Y, Kishikawa, H, Araki, E, Miyata, T, Isami, S, Motoyoshi, S, et al. . Intensive insulin therapy prevents the progression of diabetic microvascular complications in Japanese patients with non-insulin-dependent diabetes mellitus: a randomized prospective 6-year study. Diabetes Research and Clinical Practice 1995; 28: 103–17.
5UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998; 352: 837–53.
6American Diabetes Association. Evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications. Diabetes Care 2002; 25(Suppl. 1): S5060.
7Jarvi, AE, Karlstrom, BE, Granfeldt, YE. Improved glycemic control and lipid profile and normalized fibrinolytic activity on a low-glycemic index diet in type 2 diabetic patients. Diabetes Care 1999; 22: 10–8.
8Sheard, NF, Clark, NG, Brand-Miller, JC, Franz, MJ, Pi-Sunyer, FX, Mayer-Davis, E, et al. . Dietary carbohydrate (amount and type) in the prevention and management of diabetes: a statement by the American Diabetes Association. Diabetes Care 2004; 27: 2266–71.
9Miller, JCB. Importance of glycemic index in diabetes. American Journal of Clinical Nutrition 1994; 59(Suppl.): 747S–52S.
10Ludwig, DS. The glycemic index: physiological mechanisms relating to obesity, diabetes, and cardiovascular disease. Journal of the American Medical Association 2002; 287: 2414–23.
11Hodge, AM, English, DR, O'Dea, K, Giles, GG. Glycemic index and dietary fiber and the risk of type 2 diabetes. Diabetes Care 2004; 27: 2701–6.
12Salmeron, J, Ascherio, A, Rimm, EB, Colditz, GA, Spiegelman, D, Jenkins, DJ, et al. . Dietary fiber, glycemic load, and risk of NIDDM in men. Diabetes Care 1997; 20: 545–50.
13Salmeron, J, Manson, JE, Stampfer, MJ, Colditz, GA, Wing, AL, Willett, WC. Dietary fiber, glycemic load, and risk of non-insulin-dependent diabetes mellitus in women. Journal of the American Medical Association 1997; 277: 472–7.
14Michaud, DS, Fuchs, CS, Liu, S, Willett, WC, Colditz, GA, Giovannucci, E. Dietary glycemic load, carbohydrate, sugar, and colorectal cancer risk in men and women. Cancer Epidemiology, Biomarkers & Prevention 2005; 14: 138–43.
15Franceschi, S, Dal Maso, L, Augustin, L, Negri, E, Parpinel, M, Boyle, P, et al. . Dietary glycemic load and colorectal cancer risk. Annals of Oncology 2001; 12: 173–8.
16Ma, Y, Olendzki, B, Chiriboga, D, Hebert, JR, Li, Y, Li, W, et al. . Association between dietary carbohydrates and body weight. American Journal of Epidemiology 2005; 161: 359–67.
17Jarvi, AE, Karlstrom, BE, Granfeldt, YE, Bjorck, IME, Vessby, BOH, Asp, NGL. The influence of food structure on postprandial metabolism in patients with non-insulin-dependent diabetes mellitus. American Journal of Clinical Nutrition 1995; 61: 837–42.
18Anderson, JW, Randles, KM, Kendall, CWC, Jenkins, DJA. Carbohydrate and fiber recommendations for individuals with diabetes: a quantitative assessment and meta-analysis of the evidence. Journal of the American College of Nutrition 2004; 23: 517.
19Brand, JC, Colagiuri, S, Crossman, S, Allen, A, Roberts, DCK, Truswell, AS. Low-glycemic index foods improve long-term glycemic control in NIDDM. Diabetes Care 1991; 14: 95101.
20Buyken, AE, Toeller, M, Heitkamp, G, Karamanos, B, Rottiers, R, Muggeo, M, et al. . Glycemic index in the diet of European outpatients with type 1 diabetes; relations to glycosylated hemoglobin and serum lipids. American Journal of Clinical Nutrition 2001; 73: 574–81.
21Wolever, TMS, Jenkins, DJA, Vuksan, V, Jenkins, AL, Buckley, GC, Wong, GS. Beneficial effect of a low glycaemic index diet in type 2 diabetes. Diabetic Medicine 1992; 9: 451–8.
22Ford, ES, Liu, S. Glycemic index and serum high-density lipoprotein cholesterol concentration among US adults. Archives of Internal Medicine 2001; 161: 572–6.
23Jenkins, DJA, Wolever, TMS, Kalmusky, J, Giudici, S, Giordano, C, Wong, GS, et al. . Low glycaemic index carbohydrate foods in the management of hyperlipidemia. American Journal of Clinical Nutrition 1985; 42: 604–17.
24Brand-Miller, J, Hayne, S, Petocz, P, Colagiuri, S. Low-glycemic index diets in the management of diabetes: a meta-analysis of randomized controlled trials. Diabetes Care 2003; 26: 2261–7.
25Trevino, RP, Pugh, JA, Hernandez, AE, Menchaca, VD, Ramirez, RR, Mendoza, M. Bienestar: a diabetes risk-factor prevention program. Journal of School Health 1998; 68: 62–7.
26Kingery, PM, Glasgow, RE. Self-efficacy and outcome expectations in the self-regulation of non-insulin dependent diabetes mellitus. Health Education 1989; 20: 1319.
27Hurley, CC, Shea, CA. Self-efficacy: strategy for enhancing diabetes self-care. Diabetes Educator 1992; 18: 146–50.
28Skelly, AH, Marshall, JR, Haughey, BP, Davis, PJ, Dunford, RG. Self-efficacy and confidence in outcomes as determinants of self-care practices in inner-city African-American women with non-insulin-dependent diabetes. Diabetes Educator 1995; 21: 3846.
29Miller, CK, Edwards, L, Kissling, G, Sanville, L. Evaluation of a theory-based nutrition intervention for older adults with diabetes mellitus. Journal of the American Dietetic Association 2002; 102: 1069–74, 1079–81.
30Bandura, A. Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood Cliffs, NJ: Prentice-Hall, Inc., 1986.
31Baranowski, T, Perry, CL, Parcel, GS. How individuals, environments, and health behavior interact: social cognitive theory. In: Glanz, K, Lewis, FM, eds. Health Behavior and Health Education: Theory, Research, and Practice, 3rd ed. San Francisco, CA: Jossey-Bass, 2002; 165–84.
32Davis, MS, Miller, CK. Educational needs regarding the glycemic index in diabetes management. Topics in Clinical Nutrition 2006; 21: 1725.
33Miller, CK, Probart, CK, Achterberg, CL. Knowledge and misconceptions about the food label among women with non-insulin-dependent diabetes mellitus. Diabetes Educator 1997; 23: 425–32.
34Bandura, A. Self-efficacy: The Exercise of Control. New York, NY: WH Freeman and Company, 1997.
35Pajares, F, Hartley, J, Valiante, G. Response format in writing self-efficacy assessment: greater discrimination increases prediction. Measurement and Evaluation in Counseling and Development 2001; 33: 214–21.
36Benson, J. A redefinition of content validity. Educational and Psychological Measurement 1981; 41: 793802.
37Martuza, VR. Applying Norm-referenced and Criterion-referenced Measurement in Education. Boston, MA: Allyn & Bacon, Inc., 1977.
38Cattell, RB. The scree test for the number of factors. Multivariate Behavior Research 1966; 27: 509–40.
39Lawrence, FR, Hancock, GR. Conditions affecting integrity of a factor solution under varying degrees of overextraction. Educational and Psychological Measurement 1999; 59: 549–79.
40Hancock, GR. Effect size, power, and sample size determination for structured means modeling and mimic approaches to between-groups hypothesis testing of means on a single latent construct. Psychometrika 2001; 66: 373–88.
41van der Bijl, J, van Poelgeest-Eeltink, A, Shortridge-Baggett, L. The psychometric properties of the diabetes and management self-efficacy scale for patients with type 2 diabetes mellitus. Journal of Advanced Nursing 1999; 30: 352–9.
42Hancock, GR, Mueller, RO. Rethinking construct reliability within latent variable systems. In: Cudeck, R, Toit, SD, Sorbom, D, eds. Structural Equation Modeling: Present and Future. Lincolnwood, IL: Scientific Software, International, 2001; 195216.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Public Health Nutrition
  • ISSN: 1368-9800
  • EISSN: 1475-2727
  • URL: /core/journals/public-health-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed