Rebekah J. Walker|Mulugeta Gebregziabher|Bonnie Martin?Harris|Leonard E. Egede
Independent effects of socioeconomic and psychological social determinants of health on self-care and outcomes in Type 2 diabetes
Ralph H. Johnson VA Medical Center|Medical University of South Carolina|Ralph H. Johnson VA Medical Center|Medical University of South Carolina|Medical University of South Carolina|Ralph H. Johnson VA Medical Center|Medical University of South Carolina
purpose study investigate independent effects socioeconomic psychological social determinants health diabetes knowledge selfcare diabetes outcomes quality life crosssectional sample 615 adults two adult primary care clinics southeastern united states primary outcome variables diabetes knowledge selfcare behaviors diet exercise medication adherence blood sugar testing foot care diabetes outcomes hba1c lowdensity lipoprotein blood pressure physical component summary score sf12 quality life mental component summary score sf12 quality life covariates included age sex raceethnicity marital status health literacy comorbidity linear regression models used assess independent associations controlling covariates final adjusted models significant associations hba1c included education 072 95 confidence interval ci 136 008 income 066 ci 130 016 selfefficacy 012 ci 015 008 diabetes distress 043 ci 014 072 significant associations selfcare included medication adherence diabetes distress 058 ci 091 025 perceived stress 012 ci 018 005 exercise depression 006 ci 010 001 selfefficacy 006 ci 001 010 significant associations quality life included depression 008 ci 012 003 serious psychological distress 009 ci 012 005 social support 001 ci 0001 002 perceived stress 012 ci 019 006 social determinants health significantly associated diabetes selfcare outcomes socioeconomic factors often associated diabetes outcomes psychological factors specifically selfefficacy perceived stress often associated selfcare quality life