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Objective The purpose of this study is to use the health action process approach (HAPA) and structural equation model to explore the influencing factors of exercise behavior in patients with type 2 diabetes, and to provide references for future interventions. Methods Totally 819 patients with type 2 diabetes mellitus in four community health service centers in Beijing were investigated using a self-compiled questionnaire. The reliability and validity of the questionnaire were good. The structural equation model was used to analyze the influencing factors and potential mediating effects of exercise behavior. Results 53. 7% of patients were over 60 years old, and 77. 2% of patients were in the action or maintenance phase of exercise behavior. HAPA can effectively explain the exercise behavior of patients (A2 = 0.466). Behavioral intentions was affected by task self-efficacy (p =0. 645) and result expectation (p =0.153). Behavioral intention (p = 0.783) and maintenance self-efficacy (p = 0.177) had direct effects on implementation intention, while implementation intention (p = 0. 340) and restoration of self-efficacy (p = 0.403) directly affected exercise behavior. Task self-efficacy also affected Maintenance Self-efficacy (p = 0. 802). Maintenance self-efficacy affected recovery self-efficacy (p = 0.450), and behavioral intentions also had a positive effect on maintenance self-efficacy (p = 0.483). Conclusions The exercise status of T2DM patients is good, but it still needs to be further improved. HAPA can well explain the patients’ exercise behavior. Promoting patients’ exercise should focus on interventions that improve their self-efficacy.

Original publication




Journal article


Chinese Journal of Disease Control and Prevention

Publication Date





56 - 60