{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T22:03:10Z","timestamp":1788559390267,"version":"build-2803163510"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>While individual behavior is governed by both conscious control and unconscious automatic processes, the extent to which habit strength influences the relationship between self-efficacy and self-management behaviors in type 2 diabetes mellitus (T2DM) remains insufficiently quantified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To examine the associations among habit strength, self-efficacy, and diabetes self-management behaviors, and to explore whether habit strength may help explain the association between self-efficacy and diabetes self-management behaviors among patients with T2DM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a multicenter, cross-sectional study. A total of 292 patients with T2DM were recruited from four hospitals in Hainan Province, China. Self-efficacy, habit strength, and self-management behaviors were assessed using validated questionnaires. Associations among variables were examined using correlation. Path analysis was conducted using SPSS with the PROCESS macro to explore whether habit strength may explain the association between self-efficacy and self-management behaviors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients demonstrated moderate levels of diabetes self-management behaviors (mean\u202f=\u202f34.15\u202f\u00b1\u202f13.51). Self-efficacy was positively associated with both habit strength and self-management behaviors, and habit strength was also positively associated with self-management behaviors. Path analysis suggested that habit strength may partially explain the association between self-efficacy and self-management behaviors, accounting for 18.6% of the total effect.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Habit strength is associated with diabetes self-management behaviors and may partially explains the relationship between self-efficacy to behavioral performance in individuals with T2DM. Interventions that support habit formation may facilitate the application of patients\u2019 self-efficacy to sustained self-management behaviors. Incorporating strategies that reduce cognitive burden and promote automatic behavioral engagement may enhance the effectiveness of diabetes self-management support.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1870512","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T06:18:55Z","timestamp":1782195535000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Habit strength as a partial explanation of the association between self-efficacy and self-management behaviors in type 2 diabetes: a multicenter cross-sectional study"],"prefix":"10.3389","volume":"14","author":[{"given":"Yan","family":"Lin","sequence":"first","affiliation":[{"name":"School of Nursing, Hainan Medical University","place":["Haikou, Hainan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caihua","family":"Ye","sequence":"additional","affiliation":[{"name":"School of Nursing, Hainan Medical University","place":["Haikou, Hainan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuping","family":"Xing","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Hainan General Hospital","place":["Haikou, Hainan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaining","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Hainan General Hospital","place":["Haikou, Hainan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiwei","family":"Zhou","sequence":"additional","affiliation":[{"name":"School of Nursing, Hainan Medical University","place":["Haikou, Hainan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengying","family":"Yu","sequence":"additional","affiliation":[{"name":"School of Nursing, Hainan Medical University","place":["Haikou, Hainan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Hyperbaric Oxygen, 928th Hospital of PLA Joint Logistics Support Force","place":["Haikou, Hainan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yane","family":"Yan","sequence":"additional","affiliation":[{"name":"School of Nursing, Hainan Medical University","place":["Haikou, Hainan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenfei","family":"Yang","sequence":"additional","affiliation":[{"name":"School of Nursing, Hainan Medical University","place":["Haikou, Hainan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Nursing Management, Hainan General Hospital","place":["Haikou, Hainan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinjun","family":"Jiang","sequence":"additional","affiliation":[{"name":"School of Nursing, Hainan Medical University","place":["Haikou, Hainan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2077","DOI":"10.1016\/S0140-6736(24)02317-1","article-title":"NCD Risk Factor Collaboration (NCD-RisC). 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