Courtney R. Lyles|Michael S. Wolf|Dean Schillinger|Terry C. Davis|Darren A. DeWalt|Allison R. Dahlke|Laura M. Curtis|Hilary K. Seligman
Food Insecurity in Relation to Changes in Hemoglobin A1c, Self-Efficacy, and Fruit/Vegetable Intake During a Diabetes Educational Intervention
San Francisco General Hospital|University of California, San Francisco|Northwestern University|San Francisco General Hospital|University of California, San Francisco|Louisiana State University Health Sciences Center Shreveport|University of North Carolina at Chapel Hill|Northwestern University|Northwestern University|San Francisco General Hospital|University of California, San Francisco
objective food insecurity hypothesized make diabetes selfmanagement difficult conducted longitudinal assessment food insecurity several diabetes selfcare measures research design methods conducted secondary observational analysis 665 lowincome patients diabetes received selfmanagement support part larger diabetes educational intervention analyzed baseline food insecurity measured us department agriculture food security module relation changes hemoglobin a1c hba1c well selfreported diabetes selfefficacy daily fruit vegetable intake examined longitudinal differences using generalized estimating equation linear regression models controlling time age sex race income intervention arm results overall 57 sample income amplt15000 participants food insecure 33 younger less income likely unemployed compared participants food secure baseline food insecure higher mean hba1c values 84 vs 80 lower selfefficacy fruit vegetable intake food secure p amplt 005 compared foodsecure individuals participants food insecure significantly greater improvements hba1c time 038 decrease compared 001 decrease p value interaction amplt005 well selfefficacy p value interaction amplt001 significant difference hba1c food security status followup conclusions participants experiencing food insecurity poorer diabetesrelated measures baseline made significant improvements hba1c selfefficacy lowincome patients food insecure may particularly receptive diabetes selfmanagement support even interventions explicitly structured address finances food security challenges