The purpose of this study was to test the extent that constructs from two theoretical models (self-regulatory theory and social cognitive theory) mediated change in outcomes following a self-management intervention. One hundred and twenty four individuals with type 2 diabetes who had participated in a randomised controlled trial of a diabetes self-management programme were analysed for the extent that illness beliefs and self-efficacy mediated change in self-management behaviours and illness specific quality of life. Exercise specific self-efficacy significantly mediated change in exercise at three months (B = .03; .01, p < .05) while monitoring specific self-efficacy mediated change in monitoring behaviour at both three (B = .04; .01, p < .01) and nine months follow-up (B = 5.97; 1.01, p < .01). Belief in control over diabetes mediated change in illness specific quality of life at three months (B = -.07; .28, p < .05) and nine months (B = .79; .28, p < .01) follow-ups, as well as change in exercise behaviour at immediately post-intervention (B = -.12; .17, p < .05). Behaviour-specific self-efficacy may have a stronger role in mediating self-management behaviours than illness beliefs; however, belief in control over diabetes may be important to manipulate for change in quality of life. This suggests different theoretical constructs may mediate change dependent on outcome.

BackgroundThe utility of the theory of planned behaviour (TPB) in predicting the intentions of care staff to encourage healthy eating behaviour in those they supported was examined. MethodA quantitative, within-participant, questionnaire based design was used with 112 carers to assess the performance of two TPB models. The first contained the variables: attitude, subjective norm and perceived behavioural control. The second had additional variables of self efficacy and self identity. ResultsModel 1 accounted for 31% of the variance with all three variables being significant predictors. Adding variables increased the overall predictive power of the model by 4%, but resulted in a reduction in the predictive power of the individual variables. ConclusionThe results suggests the TPB is a useful model for predicting carer intentions in relation to the diet of those they support, with their perceptions of the attitudes of others towards healthy eating being a key influential factor. Ways in which this may inform interventions to improve the overall health of people with learning disabilities are discussed.Keywords: theory of planned behaviour, diet, intellectual disability, carersThe application of the theory of planned behaviour to diet

There is a growing evidence base and interest in the application of clinical psychology within public health. This article outlines our experiences working directly within a public health setting, the challenges faced, lessons learned, and the implications for future development.