Doctor of Philosophy (PhD)



Document Type



Individuals with Type 2 diabetes often do not adhere to their treatment regimens (e.g., exercise, diet, medication, glucose monitoring). Non-adherence results in poor metabolic control, further morbidity and mortality, and increased health care utilization and costs. One common thread among many health-behavior-theories that attempt to explain non-adherence behaviors is the importance of perceived control. This psychosocial variable has most often been conceptualized as ‘health locus of control,’ which refers to the belief that one has the ability to influence or change one’s health outcomes. Inconsistent findings have been reported regarding the relationship of health locus of control and medical regimen adherence in individuals with Type 2 diabetes. These inconsistencies may be related to a need for further research focused on the interaction of internal locus with other perceived control constructs (e.g., self-efficacy and outcome expectancy) as well as other types of external loci of control. The present study examined the relationship between internal locus of control, self-efficacy, and outcome expectancy on medical regimen adherence behaviors in low-income adults with Type 2 diabetes. It also investigated the influence of four types of external loci of control, independent and when combined with internal locus of control, on medical regimen adherence in Type 2 diabetic patients. A biological marker, HbA1c, which is considered the most reliable medical indicator for medical regimen adherence behaviors of diabetic patients, was used to measure medical regimen adherence. Multiple regression analyses demonstrate that though self efficacy, in its solidarity, was the best predictor of medical regimen adherence, as indicated by HbA1c levels, the interaction of high internal locus of control and high outcome expectancy was also meaningfully linked to medical regimen adherence. Further, results suggest that high internal locus of control and low chance locus of control beliefs are significantly related to medical regimen adherence in this sample of low-income patients with Type 2 diabetes.



Document Availability at the Time of Submission

Release the entire work immediately for access worldwide.

Committee Chair

Phillip J. Brantley



Included in

Psychology Commons