Online Program

Social factors and barriers to self-care adherence in hispanic patients with type 2 diabetes

Wednesday, November 6, 2013 : 8:50 a.m. - 9:10 a.m.

Carol Mansyur, PhD, School of Community & Environmental Health, Old Dominion University, Norfolk, VA
Luis Rustveld, PhD, RD, LD, Family and Community Medicine, Baylor College of Medicine, Houston, TX
Susan G. Nash, PhD, Family and Community Medicine, Baylor College of Medicine, Houston, TX
Maria Jibaja-Weiss, Ed.D., Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX
Behavioral risk factors such as sedentary lifestyle and poor diet have been identified as preventable causes of morbidity in diabetes control. Conventional health promotion methods tend to emphasize individual responsibility for self-care adherence (SCA), often ignoring social factors and available resources. We used multiple linear regressions to test cross-sectional associations between social support, barriers, and facilitators of diet and exercise on SCA in a sample (n=248) of Hispanic patients with T2DM, adjusting for age, sex and insulin use. Patients were low-SES, English- and Spanish-speaking participants in a randomized controlled trial of a culturally tailored intervention for diabetes management. Mean age was 50.9 ± 8.8 years, 9.9 ± 6.6 years with diabetes; 99 (39.9%) were men, and 149 (60.1%) women. Women reported more barriers (t = .004) and less support (t =.01) than men. Higher levels of support were associated with better SCA (p<=.05) among women, and exercise barriers were associated with lower SCA (p<=.05) for both men and women. Examining specific types of support for diet and exercise, results differed for men and women. Among women, but not men, less family support for exercise (p= 007) and diet (p<=.02) was associated with lower SCA. Men appeared more likely to receive support for SCA, while women encountered numerous obstacles. Thus, social factors in this population may benefit men, but could potentially hamper women's efforts to manage their diabetes. Interventions targeting Hispanics should consider culture and social factors that may differentially impact men and women.

Learning Areas:

Chronic disease management and prevention
Diversity and culture

Learning Objectives:
Identify social factors that facilitate behavior change in Hispanic men with T2DM. Identify social factors and barriers that impede behavior change in Hispanic women with T2DM. Discuss how social support can affect diabetes management in Hispanic populations.

Keyword(s): Health Behavior, Hispanic

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have over 10 years' research experience in health promotion interventions for chronic disease management in low-SES Hispanic and African-American patient populations. I am also an Assistant Professor of Community Health and teach health promotion and health disparities classes in the MPH program at my institution. Among my scientific interests are social and structural influences on health behaviors associated with health disparities and chronic disease prevention and control in vulnerable populations.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.