Effect of neighborhood factors on diabetes self-care behaviors in adults with type 2 diabetes

Brittany L. Smalls, Chris M. Gregory, James S. Zoller, Leonard E. Egede

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

Objective: The objective of this study was to identify latent variables for neighborhood factors and diabetes self-care and examine the effect of neighborhood factors on diabetes self-care in adults with type 2 diabetes. Research design and methods: 615 subjects were recruited from an academic medical center and a Veterans affairs medical center in the southeastern United States. Validated scales were used to assess neighborhood factors and diabetes-related self-care. Confirmatory factor analysis (CFA) was used to determine the latent constructs. Structural equation modeling (SEM) was then used to assess the relationship between neighborhood factors and diabetes self-care. Results: Based on a theoretical framework, CFA yielded four latent variables for neighborhood factors (neighborhood violence, access to healthy food, social support, and neighborhood esthetics) and one latent variable diabetes self-care (including diet, exercise, foot care, blood sugar testing and medication adherence). SEM showed that social support (r=0.28, p<0.001) and access to healthy foods (r=-0.16, p=0.003) were significantly associated with self-care behaviors, while neighborhood violence (r=-0.06, p<0.001) and esthetics (r=-0.07, p=0.278) were not χ2 (180, N=611)=192, p=0.26, RMSEA=0.01, CFI=0.999). In the final trimmed model, social support (r=0.31, p<0.001) and access to healthy foods (r=-0.20, p<0.001) remained significantly associated with self-care behaviors χ2 (76, N=611)=60, p=0.91, RMSEA=0.00, CFI=1.0). Conclusion: This study developed latent factors for neighborhood characteristics and diabetes self-care and found that social support and access to healthy foods were significantly associated with diabetes self-care and should be considered as targets for future interventions.

Original languageEnglish
Pages (from-to)435-442
Number of pages8
JournalDiabetes Research and Clinical Practice
Volume106
Issue number3
DOIs
StatePublished - Dec 1 2014

Bibliographical note

Publisher Copyright:
© 2014 Elsevier Ireland Ltd.

Keywords

  • Diabetes
  • Diabetes outcomes
  • Neighborhood/community
  • Self-care behaviors
  • Social determinants

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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