Ecological model applied to diabetes self-management and health outcomes. Adapted from the NHLBI workshop on predictors of obesity, weight gain, diet and physical activity; August 4-5, 2004; Bethesda MD and from Ecological model . Notes: The grey areas denote constructs that are not measured by this study. The level and quality of patient-provider communication is unknown and is designated as a precursor for this study. It is assumed that persons diagnosed with diabetes would have some level of communication with health care professionals.