The Diabetes Care Profile (DCP) is an instrument used to assess social and psychological factors related to diabetes and its treatment. The reliability of the DCP was established in populations consisting primarily of Caucasians with type 2 diabetes. This study tests whether the DCP is a reliable instrument for African Americans with type 2 diabetes. Both African American (n = 511) and Caucasian (n = 235) patients with type 2 diabetes were recruited at six sites located in the metropolitan Detroit area. Scale reliability was calculated by Cronbach's coefficient alpha. The scale reliabilities ranged from .70 to .97 for African Americans. These reliabilities were similar to those of Caucasians, whose scale reliabilities ranged from .68 to .96. The Feldt test was used to determine differences between the reliabilities of the two patient populations. No significant differences were found. The DCP is a reliable survey instrument for African American and Caucasian patients with type 2 diabetes.

Diabetes is a serious disease in the U.S. population and is more prevalent in older adults and in minorities. Fort un a t e l y, many complications from diabetes can be avoided or delayed with pro p e r management. Diabetes is foremost a selfmanaged disease; treatment and pre v e n t i o n of acute and long-term complications are l a rgely a function of the patient' s decisions on a daily basis. Because patients deliver most of their own diabetes care, understanding the factors that affect self-management behavior is important, including health attitudes and treatment modality. The relationship of patient attitudes and patient behavior has been central in both the health belief model (1) and in the theory of re asoned action (2). Several studies have also demonstrated the importance of patients' attitudes and beliefs on health behavior. M c C o rd and Brandenburg (1) found that type 2 patients described as "noncompliant" w e re more likely to believe that diabetes would not affect their life outcomes. The p a t i e n t ' s confidence in modern medicine has been found to be a factor in patient response to treatment re c o m m e n d a t i o n s (2,3). Several studies have investigated factors that influence patient attitudes. Dietrich (4) interviewed seven type 2 diabetic patients and suggested that physician attitude at the time of diagnosis was critical in patients' attitudes about the seriousness of diabetes and patients' subsequent self-management behavior. Similarly, Hunt et al. (5) found that patient attitudes toward insulin therapy were influenced by a patient' s interaction with health professionals as well as personal experience and observ a t i o n .Patient beliefs, attitudes, and behaviors a re influenced by cultural and socioeconomic factors (6). The relationship of cult u re to health beliefs, attitudes, and behavior is especially important in the t reatment of diabetes, which usually involves changing patterns of eating, physical activity, and other culturally embedded behaviors. If diabetes treatment re c o mmendations are to be effective, then they must be sensitive and relevant to the cult u re of the people who are expected to c a rry them out (7). This study examines attitude diff e rences among tre a t m e n t modalities and ethnic groups. In two previous studies assessing the psychosocial factors related to diabetes for people with type 2 diabetes, we found that attitudes d i ff e red between patients using insulin and patients not using insulin (8) but not between African-American and Caucasian patients (9). In both studies, the Diabetes C a re Profile (DCP) was used to measure diabetes attitudes. The DCP is a valid and reliable instrument that assesses social and psychological factors related to diabetes and its treatment (10). In a study focusing on the appropriateness of the DCP for the African-American population with diabetes, a two-way analysis of variance for each scale suggested that the use of insulin in the treatment of diabetes had a gre a t e r e ffect on patient attitudes than et...

African-American and Caucasian patients with non-insulin-dependent diabetes mellitus were surveyed to determine differences in self-reported dietary adherence. The relationship between dietary adherence and other psychosocial factors also was explored. The Diabetes Care Profile, an instrument designed to assess psychosocial factors related to diabetes, was completed by 178 patients. Correlation and regression analyses were used to examine the relationship between dietary adherence and 15 other scales in this instrument. Regression analyses revealed that selected scales were better at predicting dietary adherence for African Americans than for Caucasians. Self-care adherence was the most significant predictor of dietary adherence for African Americans while support was the most significant predictor for Caucasians. These findings suggest that cultural and social functions of food and diet should be examined and incorporated in the development of appropriate meal plans and educational interventions.

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