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Medical advice and diabetes self-management reported by Mexican-American, Black- and White-non-Hispanic adults across the United States.

Vaccaro JA, Feaster DJ, Lobar SL, Baum MK, Magnus M, Huffman FG - BMC Public Health (2012)

Bottom Line: The background of the client may play a role in the patient-provider communication process.These results supported the ecological model with certain caveats.Moreover, it does not appear that race/ethnicity influenced reporting performance of the standard diabetes self-management behavior.

View Article: PubMed Central - HTML - PubMed

Affiliation: Robert Stempel College of Public Health and Social Work, Department of Dietetics and Nutrition, Florida International University, Miami, FL, USA.

ABSTRACT

Background: Diabetes has reached epidemic proportions in the United States, particularly among minorities, and if improperly managed can lead to medical complications and death. Healthcare providers play vital roles in communicating standards of care, which include guidance on diabetes self-management. The background of the client may play a role in the patient-provider communication process. The aim of this study was to determine the association between medical advice and diabetes self care management behaviors for a nationally representative sample of adults with diabetes. Moreover, we sought to establish whether or not race/ethnicity was a modifier for reported medical advice received and diabetes self-management behaviors.

Methods: We analyzed data from 654 adults aged 21 years and over with diagnosed diabetes [130 Mexican-Americans; 224 Black non-Hispanics; and, 300 White non-Hispanics] and an additional 161 with 'undiagnosed diabetes' [N = 815(171 MA, 281 BNH and 364 WNH)] who participated in the National Health and Nutrition Examination Survey (NHANES) 2007-2008. Logistic regression models were used to evaluate whether medical advice to engage in particular self-management behaviors (reduce fat or calories, increase physical activity or exercise, and control or lose weight) predicted actually engaging in the particular behavior and whether the impact of medical advice on engaging in the behavior differed by race/ethnicity. Additional analyses examined whether these relationships were maintained when other factors potentially related to engaging in diabetes self management such as participants' diabetes education, sociodemographics and physical characteristics were controlled. Sample weights were used to account for the complex sample design.

Results: Although medical advice to the patient is considered a standard of care for diabetes, approximately one-third of the sample reported not receiving dietary, weight management, or physical activity self-management advice. Participants who reported being given medical advice for each specific diabetes self-management behaviors were 4-8 times more likely to report performing the corresponding behaviors, independent of race. These results supported the ecological model with certain caveats.

Conclusions: Providing standard medical advice appears to lead to diabetes self-management behaviors as reported by adults across the United States. Moreover, it does not appear that race/ethnicity influenced reporting performance of the standard diabetes self-management behavior. Longitudinal studies evaluating patient-provider communication, medical advice and diabetes self-management behaviors are needed to clarify our findings.

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Related in: MedlinePlus

Ecological model applied to diabetes self-management and health outcomes. Adapted from the NHLBI workshop on predictors of obesity, weight gain, diet and physical activity; August 4-5, 2004; Bethesda MD and from Ecological model [7]. Notes: The grey areas denote constructs that are not measured by this study. The level and quality of patient-provider communication is unknown and is designated as a precursor for this study. It is assumed that persons diagnosed with diabetes would have some level of communication with health care professionals.
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Figure 1: Ecological model applied to diabetes self-management and health outcomes. Adapted from the NHLBI workshop on predictors of obesity, weight gain, diet and physical activity; August 4-5, 2004; Bethesda MD and from Ecological model [7]. Notes: The grey areas denote constructs that are not measured by this study. The level and quality of patient-provider communication is unknown and is designated as a precursor for this study. It is assumed that persons diagnosed with diabetes would have some level of communication with health care professionals.

Mentions: The ecological model (Figure 1) was used in this study as a framework for the concepts applied to DSM outcomes [7]. Medical advice, diabetes education, and the patient's race and cultural environment influence their behaviors and consequently their health outcomes. Diabetes care is largely the responsibility of the individual; however, healthcare professionals can play vital roles in the patient's skill development through effective patient-provider communication with respect to collaborative goal setting and individual assessment [8,9].


Medical advice and diabetes self-management reported by Mexican-American, Black- and White-non-Hispanic adults across the United States.

Vaccaro JA, Feaster DJ, Lobar SL, Baum MK, Magnus M, Huffman FG - BMC Public Health (2012)

Ecological model applied to diabetes self-management and health outcomes. Adapted from the NHLBI workshop on predictors of obesity, weight gain, diet and physical activity; August 4-5, 2004; Bethesda MD and from Ecological model [7]. Notes: The grey areas denote constructs that are not measured by this study. The level and quality of patient-provider communication is unknown and is designated as a precursor for this study. It is assumed that persons diagnosed with diabetes would have some level of communication with health care professionals.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3362774&req=5

Figure 1: Ecological model applied to diabetes self-management and health outcomes. Adapted from the NHLBI workshop on predictors of obesity, weight gain, diet and physical activity; August 4-5, 2004; Bethesda MD and from Ecological model [7]. Notes: The grey areas denote constructs that are not measured by this study. The level and quality of patient-provider communication is unknown and is designated as a precursor for this study. It is assumed that persons diagnosed with diabetes would have some level of communication with health care professionals.
Mentions: The ecological model (Figure 1) was used in this study as a framework for the concepts applied to DSM outcomes [7]. Medical advice, diabetes education, and the patient's race and cultural environment influence their behaviors and consequently their health outcomes. Diabetes care is largely the responsibility of the individual; however, healthcare professionals can play vital roles in the patient's skill development through effective patient-provider communication with respect to collaborative goal setting and individual assessment [8,9].

Bottom Line: The background of the client may play a role in the patient-provider communication process.These results supported the ecological model with certain caveats.Moreover, it does not appear that race/ethnicity influenced reporting performance of the standard diabetes self-management behavior.

View Article: PubMed Central - HTML - PubMed

Affiliation: Robert Stempel College of Public Health and Social Work, Department of Dietetics and Nutrition, Florida International University, Miami, FL, USA.

ABSTRACT

Background: Diabetes has reached epidemic proportions in the United States, particularly among minorities, and if improperly managed can lead to medical complications and death. Healthcare providers play vital roles in communicating standards of care, which include guidance on diabetes self-management. The background of the client may play a role in the patient-provider communication process. The aim of this study was to determine the association between medical advice and diabetes self care management behaviors for a nationally representative sample of adults with diabetes. Moreover, we sought to establish whether or not race/ethnicity was a modifier for reported medical advice received and diabetes self-management behaviors.

Methods: We analyzed data from 654 adults aged 21 years and over with diagnosed diabetes [130 Mexican-Americans; 224 Black non-Hispanics; and, 300 White non-Hispanics] and an additional 161 with 'undiagnosed diabetes' [N = 815(171 MA, 281 BNH and 364 WNH)] who participated in the National Health and Nutrition Examination Survey (NHANES) 2007-2008. Logistic regression models were used to evaluate whether medical advice to engage in particular self-management behaviors (reduce fat or calories, increase physical activity or exercise, and control or lose weight) predicted actually engaging in the particular behavior and whether the impact of medical advice on engaging in the behavior differed by race/ethnicity. Additional analyses examined whether these relationships were maintained when other factors potentially related to engaging in diabetes self management such as participants' diabetes education, sociodemographics and physical characteristics were controlled. Sample weights were used to account for the complex sample design.

Results: Although medical advice to the patient is considered a standard of care for diabetes, approximately one-third of the sample reported not receiving dietary, weight management, or physical activity self-management advice. Participants who reported being given medical advice for each specific diabetes self-management behaviors were 4-8 times more likely to report performing the corresponding behaviors, independent of race. These results supported the ecological model with certain caveats.

Conclusions: Providing standard medical advice appears to lead to diabetes self-management behaviors as reported by adults across the United States. Moreover, it does not appear that race/ethnicity influenced reporting performance of the standard diabetes self-management behavior. Longitudinal studies evaluating patient-provider communication, medical advice and diabetes self-management behaviors are needed to clarify our findings.

Show MeSH
Related in: MedlinePlus