Testing a self-determination theory process model for promoting glycemic control through diabetes self-management

Health Psychol. 2004 Jan;23(1):58-66. doi: 10.1037/0278-6133.23.1.58.


A longitudinal study tested the self-determination theory (SDT) process model of health behavior change for glycemic control within a randomized trial of patient activation versus passive education. Glycosylated hemoglobin for patients with Type 2 diabetes (n=159) was assessed at baseline, 6 months, and 12 months. Autonomous motivation and perceived competence were assessed at baseline and 6 months, and the autonomy supportiveness of clinical practitioners was assessed at 3 months. Perceptions of autonomy and competence were promoted by perceived autonomy support, and changes in perceptions of autonomy and competence, in turn, predicted change in glycemic control. Self-management behaviors mediated the relation between change in perceived competence and change in glycemic control. The self-determination process model fit the data well.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Demography
  • Diabetes Mellitus / drug therapy*
  • Female
  • Health Behavior
  • Humans
  • Hyperglycemia / prevention & control*
  • Hypoglycemia / prevention & control*
  • Male
  • Middle Aged
  • Personal Autonomy*
  • Psychological Theory*
  • Self Care*
  • Surveys and Questionnaires