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Self-Efficacy, Social Support, and Associations With Physical Activity and Body Mass Index Among Women With Histories of Gestational Diabetes MellitusFrom the Division of General Internal Medicine, Departments of Internal Medicine and Obstetrics & Gynecology, University of Michigan (Dr Kim); Division of Metabolism, Endocrinology, and Diabetes, Department of Internal Medicine, University of Michigan (Dr McEwen); School of Social Work, University of Michigan (Dr Kieffer); Division of Metabolism, Endocrinology, and Diabetes, Departments of Internal Medicine and Epidemiology, University of Michigan (Dr Herman); and Division of General Internal Medicine, Department of Internal Medicine, and Michigan Diabetes Research and Training Center, University of Michigan, and Department of Veterans Affairs Center for Practice Management and Outcomes Research (Dr Piette). Correspondence to Catherine Kim, MD, MPH, 300 NIB, Room 7C13 Box 0429, Ann Arbor, MI 48109 (cathkim{at}umich.edu). Purpose To examine the associations between 2 potential facilitators of healthy behaviors (self-efficacy and social support), and both physical activity and body mass index (BMI) among women with histories of gestational diabetes mellitus (GDM). Methods Two hundred and twenty-eight women with histories of GDM who were enrolled in a managed care plan were surveyed. A cross-sectional analysis was used to assess the association between women's social support from family and friends for physical activity and self-efficacy for physical activity with women's physical activity levels. The association between women's social support from family and friends for healthy diet and self-efficacy for not overeating and their dietary habits also were examined. Finally, the association between all of these psychosocial constructs and body mass index (BMI) were assessed before and after adjustment for covariates. Results Participants reported low to moderate social support and self-efficacy scores, suboptimal performance of physical activity, suboptimal dietary scores, and high BMIs. Self-efficacy and social support from family and friends for physical activity were associated with physical activity. Social support from family and friends for a healthy diet was associated with better dietary scores, and the association between self-efficacy for not overeating and healthy diet bordered on significance. No significant associations existed between psychosocial constructs and BMI. Conclusions Psychosocial constructs such as social support and self-efficacy are associated with physical activity and dietary habits. However, associations with BMI are weak. Further exploration of constructs associated with BMI may be needed to design effective weight-loss interventions in this population.
The Diabetes Educator, Vol. 34, No. 4,
719-728 (2008) |
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