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Open Access Open Badges Research article

Validation of an information–motivation–behavioral skills model of self-care among Chinese adults with type 2 diabetes

Junling Gao1, Jingli Wang2, Yaocheng Zhu2 and Jinming Yu1*

Author Affiliations

1 School of Public Health, Fudan University; Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, 200032, China

2 Dachang Center of Primary Health Care, Shanghai, 200442, China

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BMC Public Health 2013, 13:100  doi:10.1186/1471-2458-13-100

Published: 4 February 2013



Self-care is a crucial component of diabetes management. But comprehensive behavior change frameworks are needed to provide guidance for the design, implementation, and evaluation of diabetes self-care programs in diverse populations. We tested the Information–Motivation–Behavioral Skills (IMB) model in a sample of Chinese adults with Type 2 diabetes.


A cross-sectional study of 222 Chinese adults with type 2 diabetes was conducted in a primary care center. We collected information on demographics, provider-patient communication (knowledge), social support (motivation), self-efficacy (behavioral skills), and diabetes self-care (behavior). The values of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were also obtained. Measured variable path analyses were used to the IMB framework.


Provider-patient communication (β = 0.12, p = .037), and social support (β = 0.19, p = .007) and self-efficacy (β = 0.41, p < .001) were independent, direct predictors of diabetes self-care behavior. Diabetes self-care behaviors had a direct effect on TC/HDL-C (β = −0.31, p < .001) and LDL-C/HDL-C (β = −0.30, p < .001).


Consistent with the IMB model, having better provider-patient communication, having social support, and having higher self-efficacy was associated with performing diabetes self-care behaviors; and these behaviors were directly linked to lipid control. The findings indicate that diabetes education programs should including strategies enhancing patients’ knowledge, motivation and behavioral skills to effect behavior change.

Type 2 diabetes; Self-care; Self-efficacy; Social support; Lipid ratios