Effect of neighborhood factors on diabetes self-care behaviors in adults with type 2 diabetes. Diabetes Res Clin Pract 2014 Dec;106(3):435-42
Date
12/03/2014Pubmed ID
25451904Pubmed Central ID
PMC4275065DOI
10.1016/j.diabres.2014.09.029Scopus ID
2-s2.0-84920690891 (requires institutional sign-in at Scopus site) 24 CitationsAbstract
OBJECTIVE: The objective of this study was to identify latent variables for neighborhood factors and diabetes self-care and examine the effect of neighborhood factors on diabetes self-care in adults with type 2 diabetes.
RESEARCH DESIGN AND METHODS: 615 subjects were recruited from an academic medical center and a Veterans affairs medical center in the southeastern United States. Validated scales were used to assess neighborhood factors and diabetes-related self-care. Confirmatory factor analysis (CFA) was used to determine the latent constructs. Structural equation modeling (SEM) was then used to assess the relationship between neighborhood factors and diabetes self-care.
RESULTS: Based on a theoretical framework, CFA yielded four latent variables for neighborhood factors (neighborhood violence, access to healthy food, social support, and neighborhood esthetics) and one latent variable diabetes self-care (including diet, exercise, foot care, blood sugar testing and medication adherence). SEM showed that social support (r=0.28, p<0.001) and access to healthy foods (r=-0.16, p=0.003) were significantly associated with self-care behaviors, while neighborhood violence (r=-0.06, p<0.001) and esthetics (r=-0.07, p=0.278) were not χ(2) (180, N=611)=192, p=0.26, RMSEA=0.01, CFI=0.999). In the final trimmed model, social support (r=0.31, p<0.001) and access to healthy foods (r=-0.20, p<0.001) remained significantly associated with self-care behaviors χ(2) (76, N=611)=60, p=0.91, RMSEA=0.00, CFI=1.0).
CONCLUSION: This study developed latent factors for neighborhood characteristics and diabetes self-care and found that social support and access to healthy foods were significantly associated with diabetes self-care and should be considered as targets for future interventions.
Author List
Smalls BL, Gregory CM, Zoller JS, Egede LEMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Blood Glucose Self-Monitoring
Diabetes Mellitus, Type 2
Feeding Behavior
Female
Health Behavior
Health Knowledge, Attitudes, Practice
Humans
Hypoglycemic Agents
Male
Medication Adherence
Middle Aged
Residence Characteristics
Self Care
Social Support
United States
Young Adult
