When Is Social Support Important? The Association of Family Support and Professional Support with Specific Diabetes Self-management Behaviors
- 1.9k Downloads
Social support is associated with better diabetes self-management behavior (SMB), yet interventions to increase family and friend support (FF support) have had inconsistent effects on SMB.
To test whether FF support differentially affects specific SMBs and compare the influence of support from health professionals and psychological factors on specific SMBs to that of FF support.
Cross-sectional survey of people with diabetes recruited for a self-management intervention
PARTICIPANTS AND SETTING
One hundred sixty-four African-American and Latino adults with diabetes living in inner-city Detroit
MEASUREMENTS AND MAIN RESULTS
For every unit increase in FF support for glucose monitoring, the adjusted odds ratio (AOR) of completing testing as recommended was 1.77 (95% CI 1.21–2.58). FF support was not associated with four other SMBs (taking medicines, following a meal plan, physical activity, checking feet). Support from non-physician health professionals was associated with checking feet [AOR 1.72 (1.07–2.78)] and meal plan adherence [AOR = 1.61 (1.11–2.34)]. Diabetes self-efficacy was associated with testing sugar, meal plan adherence, and checking feet. Additional analyses suggested that self-efficacy was mediating the effect of FF support on diet and checking feet, but not the FF support effect on glucose monitoring.
The association between FF support and SMB performance was stronger for glucose monitoring than for other SMBs. Professional support and diabetes self-efficacy were each independently associated with performance of different SMBs. SMB interventions may need to differentially emphasize FF support, self-efficacy, or professional support depending on the SMB targeted for improvement.
KEY WORDSdiabetes self-management social support community based participatory research Hispanic Americans African Americans
We thank the CHASS/REACH Detroit Partnership staff, the REACH Detroit Partnership Steering Committee (www.reachdetroit.org), and the REACH Detroit Partnership intervention participants for their involvement in this study. The REACH Detroit Partnership is affiliated with the Detroit Community-Academic Urban Research Center (www.sph.umich.edu/URC/).
Support for this study was provided by the Centers for Disease Control and Prevention Cooperative Agreement no. U50/CCU417409, the Michigan Diabetes Research and Training Center (NIDDK P60DK-20572). Michele Heisler is a VA HSR&D Career Development awardee. Ann-Marie Rosland is a Robert Wood Johnson Clinical Scholar.
Results from this paper were presented at the Society of General Internal Medicine Midwest Region Annual Meeting on 29 September 2007.
Conflict of Interest
- 16.Greene J, Yedidia MJ, et al. Provider behaviors contributing to patient self-management of chronic illness among underserved populations. Journal of Health Care for the Poor & Underserved. 2005;16(4):808–24.Google Scholar
- 28.Behavioral Risk Factor Surveillance System Survey Questionnaire. In. U.S. Department of Health and Human Services: Centers for Disease Control and Prevention (CDC); 2004.Google Scholar
- 29.Fitzgerald J, Davis W, et al. Development and validation of the diabetes care profile. Evaluation and the Health Professions. 1996;19(2):209–231.Google Scholar
- 32.Toobert DJ, Glasgow RE. Assessing diabetes self-management: the summary of diabetes self-care activities questionnaire. In: Clare B, ed. Handbook of psychology and diabetes. Amsterdam: Harwood Academic Publishers; 1994:351–375.Google Scholar
- 33.Behavioral Risk Factor Surveillance System Survey Questionnaire. In. U.S. Department of Health and Human Services: Centers for Disease Control and Prevention (CDC); 2003.Google Scholar
- 36.Long J. Regression models for categorical and limited dependent variables. Sage Publications; 1997.Google Scholar
- 38.StataCorp. Stata Statistical Software: Release 9. In. College Station, TX: StataCorp LP; 2005.Google Scholar