Overcoming barriers to blood glucose monitoring: the mediating role of social cognitive theory components in black/African American men with type 2 diabetes.

Abstract

Objective: This study aims to investigate how the components of social cognitive theory (SCT), namely personal, behavioral, and environmental factors, mediate the relationship between barriers to regular glucose monitoring and the frequency of blood sugar testing in Black/African American men with type 2 diabetes (T2D).

Design: This cross-sectional observational survey study utilized an internet-based survey to assess barriers to glucose monitoring, SCT components, and monitoring frequency among 1,225 Black/African American men with T2D. Data were analyzed using Structural Equation Modeling (SEM) to examine direct and indirect relationships between these factors.

Results: Outcome expectations had a significant positive direct effect (path estimate) on the frequency of glucose testing (β = 0.02, p = 0.005), although they did not mediate the relationship between barriers and testing (β = -0.01, p = 0.183). Observational learning exhibited a significant positive direct effect on testing frequency (β = 0.19, p < 0.001), with barriers partially mediating monitoring frequency through observational learning (β = 0.01, p < 0.001). Self-efficacy showed a significant positive direct effect on testing frequency (β = 0.02, p < 0.001), with the relationship between barriers and testing frequency fully mediated by self-efficacy (β = -0.01, p < 0.001).

Conclusion: Both observational learning and self-efficacy partially or fully mediate the relationship between barriers and testing. These findings underscore the importance of interventions aimed at enhancing social support and observational learning to overcome barriers and improve adherence to glucose monitoring among Black/African American men with T2D.