Health beliefs, locus of control, and social support as predictors of dietary adherence in adults with diabetes

Adherence to diet has been identified as the biggest problem in diabetes. Diet is one of the most time-consuming aspects of the daily regimen and requires the greatest alteration in lifestyle. The literature has identified certain attitudes which may be important to an individual's efforts to adhere to a diet. This study is concerned with the ability of diabetes-specific measures of health beliefs, locus of control, and social support to predict adherence to an exchange diet IDDM (n = 30) and NIDDM (n = 53) subjects completed the Beliefs About Diabetes and Diabetes Locus of Control Scales and provided information about their prescribed meal plan. After a 4-week interval, a 24-hour dietary recall was obtained and dietary adherence was assessed. Results indicated that subjects' health beliefs and locus of control expectancies differed according to their diabetes type, their treatment mode, the duration of their diabetes, and their age. Several relationships were also found between the health beliefs, locus of control, and social support variables. Barriers to diet and belief in the benefits of therapy correlated significantly with 24-hour recall measures of dietary adherence. Subjects' perceived adherence to diet was related to barriers, social support, and perceived controllability of diabetes. The psychosocial variables were more successful in predicting perceived adherence to diet than in predicting actual adherence based on dietary recall data. The clinical application of the concepts introduced by the health beliefs and locus of control models and the utility of these indices as tools for psychosocial assessment are discussed.