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 language | English |
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Pages (from-to) | 435-442 |
Number of pages | 8 |
Journal | Diabetes Research and Clinical Practice |
Volume | 106 |
Issue number | 3 |
DOIs | |
State | Published - 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