FIU Digital Commons

Title

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

Authors

Joan A. Vaccaro, Florida International University, Robert Stempel College of Public Health and Social Work; Department of Dietetics and NutritionFollow
Daniel J. Feaster, University of Miami, Department of Epidemiology and Public Health, Miller School of MedicineFollow
Sandra L. Lobar, Florida International University, College of Nursing and Health Sciences; Department of NursingFollow
Marianna K. Baum, Florida International University, Robert Stempel College of Public Health and Social Work; Department of Dietetics and NutritionFollow
Marcia Magnus, Florida International University, Robert Stempel College of Public Health and Social Work; Department of Dietetics and NutritionFollow
Fatma G. Huffman, Florida International University, Robert Stempel College of Public Health and Social Work; Department of Dietetics and NutritionFollow

Date of this Version

3-12-2012

Document Type

Article

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.

Comments

This article was originally published in BMC Public Health 2012, 12:185

Creative Commons License

This work is licensed under a Creative Commons Attribution 2.0 License.

Recommended Citation

Vaccaro, Joan A.; Feaster, Daniel J.; Lobar, Sandra L.; Baum, Marianna K.; Magnus, Marcia; and Huffman, Fatma G., "Medical advice and diabetes self-management reported by Mexican-American, Black- and White-non-Hispanic adults across the United States" (2012). Environmental Health Sciences. 13.
http://digitalcommons.fiu.edu/eoh/13