Objective
Examine diabetes self-care (DSC) patterns in low-income African American and Latino patients with type 2 diabetes attending primary care clinics, and identify patient-related, biomedical/disease-related, and psychosocial correlates of DSC.
Methods
Cross-sectional analysis of survey data from African Americans and Latinos aged ≥18 years with type 2 diabetes (n=250) participating in a diabetes self-management intervention at four primary care clinics. The Summary of Diabetes Self-Care Activities captured the subcomponents of healthy eating, physical activity, blood sugar testing, foot care and smoking. Correlates included patient-related attributes, biomedical/disease-related factors, and psychosocial constructs, with their multivariable influence assessed with a three-step model building procedure using regression techniques.
Results
Sample baseline characteristics were: Mean age of 53 years (SD=12.4); 69% female; 53% African American and 47% Hispanic; 74% with incomes below $20,000; and 60% with less than a high school education. DSC performance levels were highest for foot care (4.5/7 days) and lowest for physical activity (2.5/7 days). Across racial/ethnic subgroups, diabetes-related distress was the strongest correlate for diabetes self-care when measured as a composite score. Psychosocial factors (e.g., diabetes distress) accounted for 14–33% of variance in self-care areas for both racial/ethnic groups. Patient characteristics were more salient correlates in Hispanic/Latinos when examining the self-care subscales, particularly those requiring monetary resources (e.g., glucose monitoring).
Conclusions
Important information is provided on specific DSC patterns in a sample of ethnic/racial minorities with type 2 diabetes. Significant correlates found may help with identification and intervention of patients who may benefit from strategies aimed at increasing self-care adherence.
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