Building Competency in Diabetes Education THE ESSENTIALS

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behaviours; there is no “global” self-efficacy for overall diabetes care (159). SME interventions need to provide opportunities for all sources of self-efficacy to be used, as well as providing the required skills and knowledge to be successful. Self-efficacy theory forms the basis of several educational interventions today, including the CDSM program at Stanford University, California (124,125). One limitation may be a lack of direction/guidance for the design and implementation of interventions for relapse prevention and outreach (i.e. those targeted at persons not ready/resistant to learn). Social Cognitive Theory In the social cognitive theory, Bandura builds on the concept of self-efficacy and introduces us to the idea of “reciprocal determinism” (159). He suggests that human behaviour is the result of the continuous relationship between: • Individual • Environment • Behaviour Behaviour is determined by the individual’s interaction and reaction with his environment. Expectancies and incentives drive the behaviour in the context of the environment the individual lives within (155). As one factor or interpretation of that factor changes, it will influence the others, resulting in a change in behaviour.

“Human health is a social matter, not just an individual one” (161).