Document Type

Dissertation

Major/Program

Dietetics and Nutrition

First Advisor's Name

Fatma G. Huffman

First Advisor's Committee Title

Committee Chair

Second Advisor's Name

Marianna K. Baum

Third Advisor's Name

Sandra L. Lobar

Fourth Advisor's Name

Daniel J. Feaster

Fifth Advisor's Name

Marcia Magnus

Keywords

medical advice, diabetes, diabetes self-management, minorities, health behavior, health outcomes

Date of Defense

2-25-2011

Abstract

Diabetes self-management, an essential component of diabetes care, includes weight control practices and requires guidance from providers. Minorities are likely to have less access to quality health care than White non-Hispanics (WNH) (American College of Physicians-American Society of Internal Medicine, 2000). Medical advice received and understood may differ by race/ethnicity as a consequence of the patient-provider communication process; and, may affect diabetes self-management.
This study examined the relationships among participants’ report of: 1) medical advice given; 2) diabetes self-management, and; 3) health outcomes for Mexican-Americans (MA) and Black non-Hispanics (BNH) as compared to WNH (reference group) using data available through the National Health and Nutrition Examination Survey (NHANES) for the years 2007-2008. This study was a secondary, single point analysis. Approximately 30 datasets were merged; and, the quality and integrity was assured by analysis of frequency, range and quartiles. The subjects were extracted based on the following inclusion criteria: belonging to either the MA, BNH or WNH categories; 21 years or older; responded yes to being diagnosed with diabetes. A final sample size of 654 adults [MA (131); BNH (223); WNH (300)] was used for the analyses.
The findings revealed significant statistical differences in medical advice reported given. BNH [OR = 1.83 (1.16, 2.88), p = 0.013] were more likely than WNH to report being told to reduce fat or calories. Similarly, BNH [OR = 2.84 (1.45, 5.59), p = 0.005] were more likely than WNH to report that they were told to increase their physical activity. Mexican-Americans were less likely to self-monitor their blood glucose than WNH [OR = 2.70 (1.66, 4.38), pThese findings indicate a need for patient-provider communication and care to be assessed for effectiveness and, the importance of ongoing diabetes education for persons with diabetes.

Identifier

FI11042704

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