Perceptions of disease severity and barriers to self-care predict glycemic control in aboriginal persons with type 2 diabetes mellitus

The Health Belief Model (HBM) was evaluated for secondary prevention of type 2 diabetes mellitus in an Aboriginal population in British Columbia. Glycemic markers (glycated hemoglobin [HbA_1c]), insulin and post-load glucose), diabetes health beliefs (susceptibility, severity, benefits and barriers), knowledge and behaviour were measured for 16 men and 18 women with diabetes (age [SD] = 57.7 [11.6]). Eighteen months later, HbA_1c and behaviour were measured for all participants, and health beliefs obtained for 17 of them. Perceived severity and perceived barriers were related to glycemic status at baseline and follow up, and predicted reduction in HbA_1c (β[SE] ≥ |0.40| [0.18], p < O 0.05). The results support a therapeutic emphasis on belief in the severity of diabetes complications, and the complementary belief that barriers to therapeutic behaviour can be overcome in efforts to support Aboriginal persons with diabetes to manage their disease. The empirical utility of the HBM in glycemic control was partially upheld.