Social Cognitive Theory in Diabetes Exercise Research: An Integrative Literature Review

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Abstract
This integrative review critically examined the literature on diabetes research using Social Cognitive Theory (SCT) to determine its predictive ability in explaining exercise behavior and to identify key interventions that enhance exercise initiation and maintenance. Literature published between 1985 and 2002 was searched using the following keywords: SCT, self-efficacy, diabetes mellitus, non-insulin-dependent diabetes mellitus, insulin-dependent diabetes mellitus, physical activity, and exercise. The databases searched were CINAHL, Medline, and PsychInfo. Of the 38 articles retrieved from databases, 13 were reviewed. A statistically significant relationship between self-efficacy and exercise behavior was found in correlational studies. Results from the predictive study support the predictability of self-efficacy for exercise behavior. Mixed results were found for the predictive ability of outcome expectancies for exercise behavior. Self-efficacy was predictive of exercise initiation and maintenance over time. The evidence for successful interventions to increase self-efficacy and exercise behavior over time was inconclusive. To better understand exercise behavior and to develop effective exercise interventions, a microanalytic, theory-driven approach to studying exercise behavior is needed. Several suggestions are offered to strengthen exercise self-efficacy.