Guided by the theoretical framework of Betancourt’s integrative model The aim of this study is to examine the relations among sociodemographic, cultural beliefs (i.e., cultural inhibitors of exercise), diabetes social support, and psychological factors (i.e., exercise self-efficacy, diabetes distress), as predictors of treatment adherence (biological and self-reported frequency) in a diverse population with Type-II Diabetes. It was hypothesized that: (1) cultural inhibitors of exercise and diabetes social support would predict exercise treatment adherence directly and/or indirectly via exercise self-efficacy; and (2) diabetes social support would predict HbA1c via the direct and/or indirect effect of diabetes distress. Findings suggest that both cultural inhibitors of exercise and diabetes social support predict exercise treatment adherence via the mediating role of exercise self-efficacy and explained 33% of variance in adherence. Diabetes social support was not a statistically significant predictor of HbA1c, however diabetes social support and diabetes treatment distress accounted for 9% of variance in HbA1c. Findings from the present study may inform clinical interventions that aim at improving rates of adherence among people from cultural minority groups with Type-II diabetes.

LLU Discipline

Clinical Psychology


Clinical Psychology


School of Behavioral Health

First Advisor

Hector Betancourt

Second Advisor

Patricia Flynn

Third Advisor

Sonika Ung

Fourth Advisor

David Vermeersch

Degree Name

Doctor of Philosophy (PhD)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Self Efficacy; Diabetes Mellitus, Type 2 - prevention & control; Minority Groups



Page Count

x, 85 p.

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


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Loma Linda University. Del E. Webb Memorial Library. University Archives