Table 1. Integration of Social Cognitive Theory into the Partners in Care intervention.
Social Cognitive Theory Constructs / Integration of Social Cognitive Theoryconstructs intoPartners in Care
Environment (Factors physically external to the person that can provide opportunities and social support) / Program implemented in Native Hawaiian/Pacific Islander communities.
Intervention delivered to small groups to provide venue for support.
Native Hawaiian/Pacific Island peer educators delivered intervention.
Situation (Perception of the environment that may provide an opportunity to correct misperceptions and promote healthful norms) / Use of storytelling and other historical/cultural perspectives about healthy lifestyle practices as the “norms” for Native Hawaiian/Pacific Islander in the past; positive health habits for both family and community in order to have healthy families and healthy communities; tradition of families and communities working together to make life better.
Information and encouragement to attend community activities (dancing classes, walking groups, gardening project, cooking classes).
Behavioral Capability (Knowledge and skill to perform a behavior that may allow mastery of a new behavior through learning skills) / Teach/practice how-to skills to: self-monitor blood glucose; inspect inside of shoes and feet every day; increase physical activity in day-to-day living (park farther away, take stairs); choose a physical activity; eat more fiber, fruits, and vegetables; read food labels to choose foods lower in calories, fat and sugar; substitute brown rice for white rice; ask others for support for self-care activities.
Pot luck celebration at end of intervention where participants bring healthy foods to share.
Expectations (Anticipatory outcomes of a behavior) / Participants observe changes in blood sugar after taking medication as prescribed, exercising, and losing weight.
Participants share stories of success with each other.
Expectancies (Value that a person places on a given outcome, incentives; increases likelihood that behavior will be performed; can be direct, shared through another’s experience, or self-produced) / Stay healthy for your family.
Keep your family healthy.
Diabetes complications can be delayed/prevented.
Self-control (Personal regulation of a goal-directed behavior or performance that provides opportunities for self-monitoring, goal setting, problem solving, and self-reward. An agreement on who is making a behavior change, what the change will be, how change is measured, and what the reward will be) / Encouraged to use calendars/journals to keep track of blood glucose monitoring, physical activity, and diet.
Use of self-selected nonfood rewards when goal reached.
Use of goal setting to improve self-management.
Problem solving activities for resolving barriers to diabetes self-management.
Observational Learning (Learn new behaviors by watching the actions and outcomes of others’ behavior. Often learn best from models most like oneself). / Native Hawaiian/Pacific Island community members teach intervention.
Native Hawaiian/Pacific Island role models.
Group meetings: observe others engaging in diabetes self-management activities.
Reinforcements (Responses to a behavior that may increase or decrease the likelihood or reoccurrence. Can include self-initiated rewards and incentives) / Involvement of entire family in healthy lifestyle habits that are good for everyone and may prevent or postpone diabetes in family.
Use simple self-selected, nonfood rewards for reaching goals.
Recognition, encouragement, and feedback on performance.
Improved control of diabetes (blood glucose, weight, emotions, etc.)
Self-efficacy (Person’s confidence in performing a particular behavior. Implies that behavior change should occur in small steps to ensure success) / Teach how to make short-term goals that emphasize small changes, and continue to do for the rest of your life.
Encouraged to use calendars/journals to write down goals and progress.
Activities such as role-playing, discussion, and problem solving.
Emotional Coping Responses (Strategies such as problem-solving and stress management that are used by a person to cope with emotional stimuli) / Stress reducing techniques taught and encouraged through goal setting activity.
Problem-solving techniques taught through role-playing, case study and discussion (how to ask family member for help with self-care activities).
Reciprocal Determinism (The dynamic interaction of the person, the behavior, and the environment in which the behavior is performed. Behavioral change can include environmental, skill, and personal change) / Goal setting and problem solving activities and discussion.
Community activities: walking groups, dancing classes, on-site gym, gardening project, cooking classes.
Culturally Tailored Educational Methods / Story with local characters begins each lesson to orient participants and facilitate discussion.
Visuals of Native Hawaiians/Pacific Islanders engaging in healthy behaviors.
Local and culturally specific foods and exercises included in intervention.
Community member peer educators deliver meetings.
Program occurs in community setting.