Self-Reported Physical Activity in Medically Underserved Adults With Type 2 Diabetes in Clinical and Community Settings

2015 ◽  
Vol 12 (7) ◽  
pp. 968-975 ◽  
Author(s):  
John Cooper ◽  
Barbara Stetson ◽  
Jason Bonner ◽  
Sean Spille ◽  
Sathya Krishnasamy ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Low Income ◽  
Short Form ◽  
International Comparisons ◽  
Self Care ◽  
Community Dwelling ◽  
Self Report ◽  
Clinical Settings

Background:This study assessed physical activity (PA) in community dwelling adults with Type 2 diabetes, using multiple instruments reflecting internationally normed PA and diabetes-specific self-care behaviors.Methods:Two hundred and fifty-three Black (44.8%) and White (55.2%) Americans [mean age = 57.93; 39.5% male] recruited at low-income clinic and community health settings. Participants completed validated PA self-report measures developed for international comparisons (International Physical Activity Questionnaire Short Form), characterization of diabetes self-care (Summary of Diabetes Self-Care Activities Measure; SDSCA) and exercise-related domains including provider recommendations and PA behaviors and barriers (Personal Diabetes Questionnaire; PDQ).Results:Self-reported PA and PA correlates differed by instrument. BMI was negatively correlated with PA level assessed by the PDQ in both genders, and assessed with SDSCA activity items in females. PA levels were low, comparable to previous research with community and diabetes samples. Pain was the most frequently reported barrier; females reported more frequent PA barriers overall.Conclusions:When using self-report PA measures for PA evaluation of adults with diabetes in clinical settings, it is critical to consider population and setting in selecting appropriate tools. PA barriers may be an important consideration when interpreting PA levels and developing interventions. Recommendations for incorporating these measures in clinical and research settings are discussed.

scholarly journals Influence of social determinants, diabetes knowledge, health behaviors, and glycemic control in type 2 diabetes: An analysis from real-world evidence

2020 ◽  
Author(s):  
Rubén Silva-Tinoco ◽  
Teresa Cuatecontzi-Xochitiotzi ◽  
Viridiana De la Torre-Saldaña ◽  
Enrique León-García ◽  
Javier Serna-Alvarado ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Glycemic Control ◽  
Mexico City ◽  
Low Income ◽  
Self Care ◽  
Diabetes Knowledge ◽  
Care Behavior

Abstract Background Although important achievements have been done in type 2 diabetes mellitus (T2D) treatment and glycemic control, new strategies may take advantage of non-pharmacological approaches and of other potential determinants of health (e.g., socioeconomic status, education, diabetes knowledge, physical activity, and self-care behavior). However, the relationships between these factors are not totally clear and have not been studied in the context of large urban settings. This study aimed to explore the relationship between these determinants of glycemic control (GC) in a low-income urban population from Mexico City, focused in exploring potential the mediation of self-care behaviors in the association between diabetes knowledge and GC.Methods A multicenter cross-sectional study was conducted in patients with type 2 diabetes (T2D) from 28 primary care outpatient centers located in Mexico City. Using multivariable-adjusted models, we determined the associations between diabetes knowledge, self-care behaviors, and GC. The mediation analyses to determine the pathways on glycemic control were done using linear regression models, where the significance of indirect effects was calculated with bootstrapping.Results The population (N=513) had a mean age of 53.8 years (standard deviation: 11.3 yrs.), and 65.9% were women. Both socioeconomic status and level of education were directly associated with diabetes knowledge. Using multivariable-adjusted linear models, we found that diabetes knowledge was associated with GC (β: -0.102, 95% Confidence Interval [95% CI] -0.189, -0.014). Diabetes knowledge was also independently associated with self-care behavior (for physical activity: β: 0.181, 95% CI 0.088, 0.273), and self-care behavior was associated with GC (for physical activity: β: -0.112, 95% CI -0.194, -0.029). The association between diabetes knowledge and GC was not observed after adjustment for self-care behaviors, especially physical activity (β: -0.084, 95% CI -0.182, 0.014, p-value: 0.062). Finally, the mediation models showed that the effect of diabetes knowledge on GC was 17% independently mediated by physical activity (p-value: 0.049). Conclusions Socioeconomic and educational gradients influence diabetes knowledge among primary care patients with type 2 diabetes. Self-care activities, particularly physical activity, mediated the effect of diabetes knowledge on GC. Our results indicate that diabetes knowledge should be reinforced in low-income T2D patients, with an emphasis on the benefits physical activity has on improving GC.

scholarly journals Determinants of Glycemic Control among Urban Patients with Type 2 Diabetes: A mediation analysis from real-world evidence

2020 ◽  
Author(s):  
Rubén Silva-Tinoco ◽  
Teresa Cuatecontzi-Xochitiotzi ◽  
Viridiana De la Torre-Saldaña ◽  
Enrique León-García ◽  
Javier Serna-Alvarado ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Low Income ◽  
Self Care ◽  
P Value ◽  
Diabetes Knowledge ◽  
Linear Regression Models ◽  
Care Behavior

Abstract Aims To explore the determinants of glycemic control (GC) among patients with type 2 diabetes (PwD) to provide insight into the pathways of the effect of diabetes knowledge on GC.Methods A multicenter cross-sectional study was conducted in PwD from 28 primary outpatient centers located in Mexico City. Using the multivariable-adjusted models, we determined the associations between diabetes knowledge, self-care behaviors, and glycemic control. The mediation analyses used linear regression models, where the significance of indirect effects was calculated with bootstrapping.Results The population (N=513) had a mean age of 53.8 years (standard deviation: 11.3 yrs.), and 65.9% were women. Using multivariable-adjusted linear models, we found that diabetes knowledge was associated with glycemic control (β: -0.102, 95% Confidence Interval [95% CI] -0.189, -0.014). Diabetes knowledge was also independently associated with self-care behavior (for physical activity: β: 0.181, 95% CI 0.088, 0.273), and self-care behavior was associated with glycemic control (for physical activity: β: -0.112, 95% CI -0.194, -0.029).The association between diabetes knowledge and glycemic control was lost after adjustment for self-care behaviors, especially physical activity (β: -0.084, 95% CI -0.182, 0.014, p -value: 0.062). Finally, the mediation models showed that the effect of diabetes knowledge on glycemic control was 17% independently mediated by physical activity ( p -value: 0.049).Conclusions Self-care activities, particularly physical activity, mediated the effect of diabetes knowledge on glycemic control. Our results indicate that diabetes knowledge should be reinforced in low-income PwD, with an emphasis on the benefits physical activity has on improving GC.

scholarly journals Determinants of Glycemic Control among Urban Patients with Type 2 Diabetes: A mediation analysis from real-world evidence

2020 ◽  
Author(s):  
Rubén Silva-Tinoco ◽  
Teresa Cuatecontzi-Xochitiotzi ◽  
Viridiana De la Torre-Saldaña ◽  
Enrique León-García ◽  
Javier Serna-Alvarado ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Low Income ◽  
Self Care ◽  
P Value ◽  
Diabetes Knowledge ◽  
Linear Regression Models ◽  
Care Behavior

Abstract Aims To explore the determinants of glycemic control (GC) among patients with type 2 diabetes (PwD) to provide insight into the pathways of the effect of diabetes knowledge on GC.Methods A multicenter cross-sectional study was conducted in PwD from 28 primary outpatient centers located in Mexico City. Using the multivariable-adjusted models, we determined the associations between diabetes knowledge, self-care behaviors, and glycemic control. The mediation analyses used linear regression models, where the significance of indirect effects was calculated with bootstrapping.Results The population (N=513) had a mean age of 53.8 years (standard deviation: 11.3 yrs.), and 65.9% were women. Using multivariable-adjusted linear models, we found that diabetes knowledge was associated with glycemic control (β: -0.102, 95% Confidence Interval [95% CI] -0.189, -0.014). Diabetes knowledge was also independently associated with self-care behavior (for physical activity: β: 0.181, 95% CI 0.088, 0.273), and self-care behavior was associated with glycemic control (for physical activity: β: -0.112, 95% CI -0.194, -0.029).The association between diabetes knowledge and glycemic control was lost after adjustment for self-care behaviors, especially physical activity (β: -0.084, 95% CI -0.182, 0.014, p -value: 0.062). Finally, the mediation models showed that the effect of diabetes knowledge on glycemic control was 17% independently mediated by physical activity ( p -value: 0.049).Conclusions Self-care activities, particularly physical activity, mediated the effect of diabetes knowledge on glycemic control. Our results indicate that diabetes knowledge should be reinforced in low-income PwD, with an emphasis on the benefits physical activity has on improving GC.

scholarly journals Determinants of Glycemic Control among Urban Patients with Type 2 Diabetes: A mediation analysis from real-world evidence

2020 ◽  
Author(s):  
Rubén Silva-Tinoco ◽  
Teresa Cuatecontzi-Xochitiotzi ◽  
Viridiana De la Torre-Saldaña ◽  
Enrique León-García ◽  
Javier Serna-Alvarado ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Socioeconomic Status ◽  
Low Income ◽  
Self Care ◽  
P Value ◽  
Diabetes Knowledge ◽  
Care Behavior

Abstract Background Evidence suggests there is a relationship between determinants of health and worse diabetes outcomes, especially among individuals with low socioeconomic status and education level. Few studies have shown the relationship between diabetes knowledge, self-care behaviors, and clinical outcomes in low-income urban populations. This study aimed to explore the determinants of glycemic control (GC) in a low-income urban population and to provide insight into the pathways of the effect of diabetes knowledge on GC. Methods A multicenter cross-sectional study was conducted in patients with type 2 diabetes (PwD) from 28 primary care outpatient centers located in Mexico City. Using the multivariable-adjusted models, we determined the associations between diabetes knowledge, self-care behaviors, and GC. The mediation analyses used linear regression models, where the significance of indirect effects was calculated with bootstrapping. Results The population (N=513) had a mean age of 53.8 years (standard deviation: 11.3 yrs.), and 65.9% were women. Both socioeconomic status and level of education were directly associated with diabetes knowledge. Using multivariable-adjusted linear models, we found that diabetes knowledge was associated with GC (β: -0.102, 95% Confidence Interval [95% CI] -0.189, -0.014). Diabetes knowledge was also independently associated with self-care behavior (for physical activity: β: 0.181, 95% CI 0.088, 0.273), and self-care behavior was associated with GC (for physical activity: β: -0.112, 95% CI -0.194, -0.029).The association between diabetes knowledge and GC was lost after adjustment for self-care behaviors, especially physical activity (β: -0.084, 95% CI -0.182, 0.014, p -value: 0.062). Finally, the mediation models showed that the effect of diabetes knowledge on GC was 17% independently mediated by physical activity ( p -value: 0.049). Conclusions Socioeconomic and educational gradients influence diabetes knowledge among primary care patients with type 2 diabetes. Self-care activities, particularly physical activity, mediated the effect of diabetes knowledge on GC. Our results indicate that diabetes knowledge should be reinforced in low-income PwD, with an emphasis on the benefits physical activity has on improving GC.

scholarly journals Influence of social determinants, diabetes knowledge, health behaviors, and glycemic control in type 2 diabetes: An analysis from real-world evidence

2020 ◽  
Author(s):  
Rubén Silva-Tinoco ◽  
Teresa Cuatecontzi-Xochitiotzi ◽  
Viridiana De la Torre-Saldaña ◽  
Enrique León-García ◽  
Javier Serna-Alvarado ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Glycemic Control ◽  
Mexico City ◽  
Low Income ◽  
Self Care ◽  
Diabetes Knowledge ◽  
Care Behavior

Abstract Background Although important achievements have been done in type 2 diabetes mellitus (T2D) treatment and glycemic control, new strategies may take advantage of non-pharmacological approaches and of other potential determinants of health (e.g., socioeconomic status, education, diabetes knowledge, physical activity, and self-care behavior). However, the relationships between these factors are not totally clear and have not been studied in the context of large urban settings. This study aimed to explore the relationship between these determinants of glycemic control (GC) in a low-income urban population from Mexico City, focused in exploring potential the mediation of self-care behaviors in the association between diabetes knowledge and GC.Methods A multicenter cross-sectional study was conducted in patients with type 2 diabetes (T2D) from 28 primary care outpatient centers located in Mexico City. Using multivariable-adjusted models, we determined the associations between diabetes knowledge, self-care behaviors, and GC. The mediation analyses to determine the pathways on glycemic control were done using linear regression models, where the significance of indirect effects was calculated with bootstrapping.Results The population (N=513) had a mean age of 53.8 years (standard deviation: 11.3 yrs.), and 65.9% were women. Both socioeconomic status and level of education were directly associated with diabetes knowledge. Using multivariable-adjusted linear models, we found that diabetes knowledge was associated with GC (β: -0.102, 95% Confidence Interval [95% CI] -0.189, -0.014). Diabetes knowledge was also independently associated with self-care behavior (for physical activity: β: 0.181, 95% CI 0.088, 0.273), and self-care behavior was associated with GC (for physical activity: β: -0.112, 95% CI -0.194, -0.029). The association between diabetes knowledge and GC was not observed after adjustment for self-care behaviors, especially physical activity (β: -0.084, 95% CI -0.182, 0.014, p-value: 0.062). Finally, the mediation models showed that the effect of diabetes knowledge on GC was 17% independently mediated by physical activity (p-value: 0.049). Conclusions Socioeconomic and educational gradients influence diabetes knowledge among primary care patients with type 2 diabetes. Self-care activities, particularly physical activity, mediated the effect of diabetes knowledge on GC. Our results indicate that diabetes knowledge should be reinforced in low-income T2D patients, with an emphasis on the benefits physical activity has on improving GC.

scholarly journals Depression-related weight change and incident diabetes in a community sample

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Eva Graham ◽  
Tristan Watson ◽  
Sonya S. Deschênes ◽  
Kristian B. Filion ◽  
Mélanie Henderson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Weight Gain ◽  
Weight Change ◽  
Short Form ◽  
Community Sample ◽  
Overweight And Obesity ◽  
Community Dwelling ◽  
Increased Risk

AbstractThis cohort study aimed to compare the incidence of type 2 diabetes in adults with depression-related weight gain, depression-related weight loss, depression with no weight change, and no depression. The study sample included 59,315 community-dwelling adults in Ontario, Canada. Depression-related weight change in the past 12 months was measured using the Composite International Diagnostic Interview—Short Form. Participants were followed for up to 20 years using administrative health data. Cox proportional hazards models compared the incidence of type 2 diabetes in adults with depression-related weight change and in adults with no depression. Adults with depression-related weight gain had an increased risk of type 2 diabetes compared to adults no depression (HR 1.70, 95% CI 1.32–2.20), adults with depression-related weight loss (HR 1.62, 95% CI 1.09–2.42), and adults with depression with no weight change (HR 1.39, 95% CI 1.03–1.86). Adults with depression with no weight change also had an increased risk of type 2 diabetes compared to those with no depression (HR 1.23, 95% CI 1.04–1.45). Associations were stronger among women and persisted after adjusting for attained overweight and obesity. Identifying symptoms of weight change in depression may aid in identifying adults at higher risk of type 2 diabetes and in developing tailored prevention strategies.

scholarly journals Self-care adherence and affective disorders in Barbadian adults with type 2 diabetes

2021 ◽  
Vol 9 (1) ◽  
pp. 62-72
Author(s):  
Allison DaSantos ◽  
◽  
Carlisle Goddard ◽  
Dalip Ragoobirsingh ◽  
◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetes Management ◽  
Behavioral Problem ◽  
Self Care ◽  
Self Report ◽  
Diabetes Distress ◽  
Glucose Testing ◽  
Blood Glucose Testing ◽  
Distress Scale

<abstract><sec> <title>Purpose</title> <p>Diabetes management requires adherence to complicated self-care behaviors. Therefore, the emotional state of the individual living with diabetes, is likely to affect their ability to comply with recommendations. This study explored the relationship of self-care adherence to diabetes distress and depression in Barbadian adults with type 2 diabetes.</p> </sec><sec> <title>Methods</title> <p>Adults aged 20 to 80 years, with type 2 diabetes, completed self-report questionnaires comprised of a profile section consisting of demographic and clinical characteristics; and standardized questionnaires comprising, The Diabetes Distress Scale (DDS), The Patient Health Questionnaire (PQH-9), and the Summary of Diabetes Self-care Activities Scale (SDSCA). Additionally biological measures (BP and HbA1c) were collected.</p> </sec><sec> <title>Results</title> <p>For the 509 participants there were no differences in adherence for males (30.8%) and females (69.2%), high diabetes distress and depression were associated with low adherence. General diet was negatively associated with BP and HbA1c; while HbA1c was positively correlated with blood glucose testing.</p> </sec><sec> <title>Conclusion</title> <p>Self-care non-adherence is more than a behavioral problem; it is a multidimensional phenomenon inclusive of demographic factors, condition or disease factors, psychological and social factors.</p> </sec></abstract>

scholarly journals Association Between Change in Accelerometer-Measured and Self-Reported Physical Activity and Cardiovascular Disease in the Look AHEAD Trial

2022 ◽  
Author(s):  
John M. Jakicic ◽  
Robert I. Berkowitz ◽  
Paula Bolin ◽  
George A. Bray ◽  
Jeanne M. Clark ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Proportional Hazards ◽  
Secondary Analysis ◽  
Cox Proportional Hazards ◽  
Self Report ◽  
Look Ahead ◽  
The Look

OBJECTIVE: To conduct <i>post-hoc</i> secondary analysis examining the association between change in physical activity (PA), measured with self-report and accelerometry, from baseline to 1 and 4 years and cardiovascular disease (CVD) outcomes in the Look AHEAD Trial. <p>RESEARCH DESIGN AND METHODS: Participants were adults with overweight/obesity and type 2 diabetes with PA data at baseline and year 1 or 4 (n = 1,978). Participants were randomized to diabetes support and education or intensive lifestyle intervention. Measures included accelerometry-measured moderate-to-vigorous PA (MVPA), self-reported PA, and composite (morbidity and mortality) CVD outcomes.</p> <p>RESULTS: In pooled analyses of all participants, using Cox proportional hazards models, each 100 MET-min/wk increase in accelerometry-measured MVPA from baseline to 4 years was associated with decreased risk of the subsequent primary composite outcome of CVD. Results were consistent for changes in total MVPA [HR=0.97 (95% CI: 0.95, 0.99)] and MVPA accumulated in <u>></u>10-minute bouts [HR=0.95 (95% CI: 0.91, 0.98)], with a similar pattern for secondary CVD outcomes. Change in accelerometry-measured MVPA at 1 year and self-reported change in PA at 1 and 4 years were not associated with CVD outcomes.</p> <p>CONCLUSIONS: Increased accelerometry-measured MVPA from baseline to year 4 is associated with decreased risk of CVD outcomes. This suggests the need for long-term engagement in MVPA to reduce the risk of CVD in adults with overweight/obesity and type 2 diabetes.</p>

scholarly journals Factors Related to Self-care in Patients with Type 2 Diabetes

2020 ◽  
Vol 14 (1) ◽  
pp. 64-73
Author(s):  
Seung-Yeon Kong ◽  
Mi-Kyoung Cho
Keyword(s):  
Type 2 Diabetes ◽  
Self Efficacy ◽  
Smoking Status ◽  
Explanatory Power ◽  
Fasting Blood Glucose ◽  
Self Care ◽  
Self Report ◽  
University Hospital ◽  
Diabetes Patients

Purpose: The prevalence of diabetes and the personal and national burden from diabetes, a serious health issue around the globe, continues to increase. The purpose of this study was to identify factors influencing self-care among patients with type 2 diabetes. Methods: We conducted a cross-sectional descriptive survey of 118 outpatients with type 2 diabetes in national university hospital C in Korea. Data were collected from self-report questionnaires covering information on demographics, self-care, and self-efficacy. Additional data were collected from medical records including information on HbA1c, fasting blood glucose levels, and cholesterol levels. Collected data were analyzed using descriptive statistics, Pearson’s correlation coefficient, and multiple regression using SPSS/WIN version 22.0 software. Results: Factors affecting self-care were the following four: self-efficacy, HbA1c, occupation status, and smoking status. Higher engagement in self-care was associated with higher self-efficacy (β = .53, p < .001), lower HbA1c (β = -0.33, p < .001), unemployment (β = -0.20, p < .001), and non-smoking status (β = -0.15, p = .011). The regression model of self-care among the type 2 diabetes patients was statistically significant (F = 67.15, p < .001), and the explanatory power of the adjusted R2 was 69%. Conclusion: Type 2 diabetes patients with high self-efficacy and self-care scores showed good glycemic control. Therefore, this finding suggests that nursing interventions should be developed to enhance self-efficacy, which is the greatest influencing factor for self-care.

A Diabetes Management Program for African American Women With Type 2 Diabetes

2000 ◽  
Vol 26 (5) ◽  
pp. 796-805 ◽  
Author(s):  
Thomas C. Keyserllng ◽  
Alice S. Ammerman ◽  
Carmen D. Samuel-Hodge ◽  
Allyson F. Ingram ◽  
Anne H. Skelly ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
African American ◽  
Randomized Trial ◽  
African American Women ◽  
Diabetes Management ◽  
Self Care ◽  
American Women ◽  
Phone Calls

PURPOSE this paper describes a clinic and community-based diabetes intervention program designed to improve dietary, physical activity, and self-care behaviors of older African American women with type 2 diabetes. It also describes the study to evaluate this program and baseline characteristics of participants. METHODS The New Leaf... Choices for Healthy Living With Diabetes program consists of 4 clinic-based health counselor visits, a community intervention with 12 monthly phone calls from peer counselors, and 3 group sessions. A randomized, controlled trial to evaluate the effectiveness of this intervention is described. RESULTS Seventeen focus groups of African American women were used to assessed the cultural relevance/acceptability of the intervention and measurement instruments. For the randomized trial, 200 African American women with type 2 diabetes were recruited from 7 practices in central North Carolina. Mean age was 59, mean diabetes duration was 10 years, and participants were markedly overweight and physically inactive. CONCLUSIONS Participants found this program to be culturally relevant and acceptable. Its effects on diet, physical activity, and self-care behaviors will be assessed in a randomized trial.

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