In a systematic review of empirical evidence regarding the relationship between self-efficacy and diabetes self-management, Krichbaum et al. (2003) emphasized the importance of increasing self-efficacy by involving people living with diabetes in their own care, guiding them in actively learning about their disease, exploring their feelings about having the disease, and teaching them skills necessary to adjust behaviors to generate positive health outcomes. A descriptive correlational study of people living with diabetes in rural areas found significant positive correlations between self-efficacy and diabetes self-management behaviors; specifically diet, exercise, and foot care (Hunt et al., 2012). In another study of rural participants, those with higher levels of self-efficacy experienced greater reductions in HA1C values over the course of the study. Participants in this study received videophone calls from a nurse practitioner who promoted and reinforced self-efficacy for diabetes self-management behaviors (Hawkins, 2010). Similarly, another study found a strong association between self-efficacy and HA1C. Based on these findings, researchers recommend screening patients for self-efficacy and implementing self-efficacy enhancing interventions (O'Hea et al., 2009). Although self-efficacy appears to be important in improving diabetes self-management, there are few studies using rural populations.