Self-Care Disparities Among Adults with Type 2 Diabetes in the USA

Mayberry, Lindsay S.; Bergner, Erin M.; Chakkalakal, Rosette J.; Elasy, Tom A.; Osborn, Chandra Y.

doi:10.1007/s11892-016-0796-5

Cited by 45 publications

(36 citation statements)

References 77 publications

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“…14,15 Quality of diabetes care and preventive care practices to forestall diabetes-related complications vary according to disparities in access to care. 16 For example, even among insured populations, Latinos are less likely to receive regular care and less likely to meet HbA1c targets. 17,18 Lack of access to care in non-Hispanic Blacks is associated with not meeting blood pressure targets.…”

Section: Epidemiologic Overviewmentioning

confidence: 99%

New research directions on disparities in obesity and type 2 diabetes

Thornton

Kumanyika

Gregg

et al. 2019

Annals of the New York Academy of Sciences

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Obesity and type 2 diabetes disproportionately impact U.S. racial and ethnic minority communities and low-income populations. Improvements in implementing efficacious interventions to reduce the incidence of type 2 diabetes are underway (i.e., the National Diabetes Prevention Program), but challenges in effectively scaling-up successful interventions and reaching at-risk populations remain. In October 2017, the National Institutes of Health convened a workshop to understand how to (1) address socioeconomic and other environmental conditions that perpetuate disparities in the burden of obesity and type 2 diabetes; (2) design effective prevention and treatment strategies that are accessible, feasible, culturally relevant, and acceptable to diverse population groups; and (3) achieve sustainable health improvement approaches in communities with the greatest burden of these diseases. Common features of guiding frameworks to understand and address disparities and promote health equity were described. Promising research directions were identified in numerous areas, including study design, methodology, and core metrics; program implementation and scalability; the integration of medical care and social services; strategies to enhance patient empowerment; and understanding and addressing the impact of psychosocial stress on disease onset and progression in addition to factors that support resiliency and health.Directions on disparities in obesity and diabetes Thornton et al.

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Section: Epidemiologic Overviewmentioning

confidence: 99%

New research directions on disparities in obesity and type 2 diabetes

Thornton

Kumanyika

Gregg

et al. 2019

Annals of the New York Academy of Sciences

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“…Recent studies estimate 1 in 3 patients do not take their diabetes medication as prescribed [1, 2], with even higher rates of nonadherence among racial/ethnic minorities [2, 3] and people with low socioeconomic status (SES) [4, 5]. Medication nonadherence is a very costly issue [6], associated with suboptimal glycemic control [7], severe health complications including stroke and heart attack [8], and mortality [9, 10].…”

Section: Introductionmentioning

confidence: 99%

Assessing barriers to diabetes medication adherence using the Information-Motivation-Behavioral skills model

Nelson

Wallston

LeStourgeon

et al. 2018

Diabetes Research and Clinical Practice

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Aims: Medication nonadherence is a prevalent and costly problem among patients with type 2 diabetes. Applications of theory can inform and improve adherence promotion interventions. We used a new assessment based on the Information-Motivation-Behavioral skills (IMB) model of adherence to assess patient-reported barriers and test the theoretical model. Methods: Participants (N = 237) completed a card sorting task to identify barriers to adherence, a survey, and a hemoglobin A1c (HbA1c) test. We identified the most commonly reported adherence barriers and examined associations between patient characteristics and barriers mapped onto each of the IMB constructs. We used structural equation modeling to test the IMB model and determine if barriers as reported on this measure predict patients’ self-reported diabetes medication adherence and, in turn, HbA1c levels. Results: The most frequently reported barriers were forgetting doses, thinking brand name medicine works better than generic medicine, not seeing immediate benefit, and feeling burned out with taking diabetes medicine. Younger age and lower health literacy were associated with higher barrier scores for all IMB model constructs. Information and social motivation barriers affected adherence via behavioral skills barriers (indirect effects −0.19, CI [−0.33, −0.09] and −0.24, CI [−0.37, −0.14], respectively). The IMB barrier constructs explained 44% of the variance in diabetes medication adherence which, in turn, was significantly associated with and explained 8% of the variance in HbA1c (both p<.001). Conclusions: Results suggest this assessment task can identify patient-specific barriers to diabetes medication adherence. Interventions targeting patient-specific barriers using this assessment could improve adherence and HbA1c.

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“…In addition, the association may be divergence among various types of coping resources. One review showed that self-care activities were associated with improved glycemic control (21). A previous meta-analysis has proven that social support is not an important risk factor for type 2 diabetes (17).…”

Section: Discussionmentioning

confidence: 99%

“…In addition to these work-related psychosocial factors, psychosocial resources, such as social support (20), self-care (21), and social network (22), have been shown to be associated with type 2 diabetes. The effect of workplace psychosocial factors on diabetes may be influenced by coping resources.…”

mentioning

confidence: 99%