Assessing Sources Of Support For Diabetes Self-Care In Urban And Rural Underserved Communities

Abstract

The ability of adults with diabetes to manage their illness properly and prevent complications is, in part, a function of support provided by the people and institutions surrounding them. Using data from over 200 adults with diabetes in two medically underserved communities--one urban and one rural--this study examines the self-care specific support provided by four key sources: family and friends, community organizations, one's neighbors and neighborhood, and resources in the wider community. More specifically, this study aims to assess the support needs of adults with diabetes in these communities by estimating their rates of various self-care behaviors, the amount of support provided by key sources, and the associations between support from these sources and adherence to recommended diabetes self-care behaviors. Descriptive findings indicate that close to 40% of the sample failed to report at least moderate levels of adherence, and that physical activity in the rural community, and smoking in the urban community represent particular problem areas. Individuals from the urban sub-sample reported receiving more support from all of the sources assessed. Logistic regression models indicated that one's neighbors and neighborhood resources appear to have a broad influence on adherence to diabetes self-care behaviors. Support from family and friends, as well as from community organizations, also seems to be important. These results have implications for the design of interventions aimed at bolstering support for diabetes self-care, and point to the need for an enhanced focus on strengthening the social environmental resources of adults with diabetes.

Depressive symptomatology mediates the effect of socioeconomic disadvantage on HbA1c among rural African Americans with type 2 diabetes

“…Although aspects of community disadvantage have been associated with the incidence of diabetes [61], neither the present study nor a recent study with urban African Americans [60] detected direct associations with HbA 1c . Detection of direct effects, if they exist, may be hampered by the more distal influence of neighborhood conditions and a number of intermediary, confounding variables such as access to health care [30] and access to and support for adherence to dietary and exercise recommendations [62]. Consistent with studies focused on community samples and persons with chronic disease, educational attainment, community disadvantage, and financial distress were significant predictors of depressive symptoms.…”

Keys to Successful Diabetes Self-management for Uninsured Patients: Social Support, Observational Learning, and Turning Points: A Safety Net Providers' Strategic Alliance Study

“…These findings are consistent with studies that demonstrate the importance of social networks for patients with diabetes, particularly for those in underserved communities. 32,33 It may be useful for clinicians to assess social support at the time of diagnosis. This can be achieved using a tool such as the Social Network Map 34 that prompts patients to describe and discuss the quality and scope of their social support system.…”

Perceived support from family and friends among adults with type 2 diabetes

“…For instance, several studies on diabetes have found that support from family and friends can motivate people with type 2 diabetes to engage in glucose monitoring, healthier eating habits and increased physical activity. [5][6][7][8][9][10][11][12] In addition, studies have demonstrated that higher levels of family and friends support may be associated with better diabetes management. 11,13 Although most diabetes research has assumed that social support is constructive, there are considerable challenges in the research about social support from family and friends and its influence on self-management in type 2 diabetes.…”