Correlates of self-care in low-income African American and Latino patients with diabetes

Health Psychol. 2014 Jul;33(7):597-607. 
Authors: Hernandez R, Ruggiero L, Riley BB, Wang Y, Chavez N, Quinn LT, Gerber BS, Choi YK.

Objective: This study aimed to examine diabetes self-care (DSC) patterns in low-income African American and Latino patients with Type 2 diabetes, and identify patient-related, biomedical/disease-related, and psychosocial correlates of DSC. Method: We performed 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 4 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 3-step model building procedure using regression techniques. Results: Baseline characteristics were as follows: mean age of 53 years (SD = 12.4); 69% female; 53% African American; 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 DSC when measured as a composite score. Psychosocial factors accounted for 14% to 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. 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 to increase self-care adherence. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

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