Validation of an Information-Motivation-Behavioral Skills model of diabetes self-care (IMB-DSC)

Objective: Comprehensive behavior change frameworks are needed to provide guidance for the design, implementation, and evaluation of diabetes self-care programs in diverse populations. We applied the Information-Motivation-Behavioral Skills (IMB) model, a well-validated, comprehensive health behavior change framework, to diabetes self-care. Methods: Patients with diabetes were recruited from an outpatient clinic. Information gathered pertained to demographics, diabetes knowledge (information); diabetes fatalism (personal motivation); social support (social motivation); and diabetes self-care (behavior). Hemoglobin A1C values were extracted from the patient medical record. Structural equation models tested the IMB framework. Results: More diabetes knowledge (r = 0.22 p < 0.05), less fatalistic attitudes (r = -0.20, p < 0.05), and more social support (r = 0.27, p < 0.01) were independent, direct predictors of diabetes self-care behavior; and through behavior, were related to glycemic control (r = -0.20, p < 0.05). Conclusions: Consistent with the IMB model, having more information (more diabetes knowledge), personal motivation (less fatalistic attitudes), and social motivation (more social support) was associated with behavior; and behavior was the sole predictor of glycemic control. Practice implications: The IMB model is an appropriate, comprehensive health behavior change framework for diabetes self-care. The findings indicate that in addition to knowledge, diabetes education programs should target personal and social motivation to effect behavior change.