Conceptualizing the Effect of Community and Neighborhood Factors on Type 2 Diabetes Health Outcomes

2016 ◽  
Vol 49 (5) ◽  
pp. 560-582 ◽  
Author(s):  
Brittany L. Smalls ◽  
Chris M. Gregory ◽  
James S. Zoller ◽  
Leonard E. Egede
Keyword(s):  
Social Support ◽  
Type 2 Diabetes ◽  
Medication Adherence ◽  
Glycemic Control ◽  
Conceptual Framework ◽  
Social Cohesion ◽  
Neighborhood Characteristics ◽  
Direct Effects ◽  
Neighborhood Factors

The objective of this study was to validate a conceptual framework of the relationship between neighborhood factors and diabetes process and outcomes in type 2 diabetes. Structural equation modeling was used to conduct path analysis to examine relationships between neighborhood characteristics and diabetes self-care and glycemic control based on an adapted conceptual framework. Medication adherence and social cohesion has significant direct effects on glycemic control. There was an indirect effect between social support and glycemic control, where 46% of the effect was mediated by medication adherence. Last, medication adherence, food insecurity, and social cohesion had significant total effects on glycemic control. Furthermore, walking environment, social support, neighborhood safety, and neighborhood problems had significant direct effects on food insecurity. The modified conceptual model was validated using path analysis, and neighborhood characteristics had direct and indirect effects on glycemic control.

scholarly journals Can autonomy support have an effect on type 2 diabetes glycemic control? Results of a cluster randomized controlled trial

2020 ◽  
Vol 8 (1) ◽  
pp. e001018
Author(s):  
Qingping Yun ◽  
Ying Ji ◽  
Shenglan Liu ◽  
Yang Shen ◽  
Xuewen Jiang ◽  
...  
Keyword(s):  
Social Support ◽  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Support Group ◽  
Autonomy Support ◽  
Controlled Trial ◽  
Support Intervention ◽  
Randomized Controlled ◽  
Cluster Randomized

ObjectivesTo assess whether social support or autonomy support intervention for patients with type 2 diabetes can achieve glycemic control at the end of intervention, and to test whether the glycemic control effect can be maintained for a long time.Research design and methodsIn this cluster randomized controlled trial, 18 community healthcare stations (CHSs) were randomized to the following: (1) usual care group (UCG) offering regular public health management services, (2) social support group (SSG) providing 3-month social support intervention based on problem solving principles, and (3) autonomy support group (ASG) offering 3-month autonomy support intervention based on self-determination theory. A total of 364 patients registered in the CHSs were enrolled into either of the three groups. The primary outcome was hemoglobin A1c (HbA1c), and secondary outcomes were diabetes self-management (DSM) behaviors. Assessment was conducted at baseline and at 3 and 6 months.ResultsPatients in ASG achieved better HbA1c reduction at the end of intervention (0.53% or 7.23 mmol/mol, p<0.001) than those in the UCG and successfully maintained it up to 6 months (0.42% or 5.41 mmol/mol, p<0.001). However, patients in SSG did not experience significant change in HbA1c at 3 or 6 months when compared with patients in UCG. Besides, patients in both the SSG (0.12, p<0.05) and ASG (0.22, p<0.001) experienced improvement in exercise at 3 months. Patients in ASG sustained improvement in exercise up to 6 months (0.21, p<0.001), but those in the SSG did not.ConclusionsAutonomy support for patients with type 2 diabetes could help achieve glycemic control at the end of intervention and successfully maintain it up to 6 months. These findings indicate that autonomy support has positive long-term effects on DSM behaviors and glycemic control and can be recommended in future diabetes intervention programs.Trial registration numberChiCTR1900024354.

scholarly journals Pengaruh Pelayanan Kefarmasian di Rumah pada Pasien Diabetes Melitus Tipe 2 di Puskesmas Wilayah Kota Yogyakarta

2020 ◽  
Vol 10 (2) ◽  
pp. 126
Author(s):  
Nur Rasdianah ◽  
Suwaldi Martodiharjo ◽  
Tri Murti Andayani ◽  
Lukman Hakim
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Medication Adherence ◽  
Glycemic Control ◽  
Blood Sugar ◽  
Fasting Blood Sugar ◽  
Level Of Knowledge ◽  
Sugar Levels

The increasing prevalence of diabetes mellitus (DM) in Indonesia requires participation of all parties including pharmacists. This study aims to determine the impact of the implementation of home pharmacy service guidelines for patients with type 2 diabetes mellitus on the level of knowledge, medication adherence, therapeurical satisfaction and glycemic control. This study used a quasi-experimental design with one group pre-test and post-test design involving 37 patients with type 2 diabetes mellitus who met the requirements of inclusion and exclusion criterias. The Diabetes Knowledge Questionnaire (DKQ-24) and the Diabetes Medication Satisfaction Tool (DMSAT) were used for collecting the data. Patient adherence was measured using a pillcount method and fasting blood sugar levels (FSB) data were obtained from the laboratory results. The study was conducted in two community health centers and patient’s home in the Yogyakarta Municipality area. The data were analysed using Wilcoxon and Spearman test. The results showed the change of the level of knowledge, medication adherence, therapeutic satisfaction and glycemic control before and after intervention of pharmacy services at home. The average decreasing of fasting blood sugar levels 17.09 mg/dL ± 1.43

scholarly journals The Effect of Social Support on Glycemic Control in Patients with Type 2 Diabetes Mellitus: The Mediating Roles of Self-Efficacy and Adherence

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Yechang Shao ◽  
Lu Liang ◽  
Linjing Shi ◽  
Chengsong Wan ◽  
Shouyi Yu
Keyword(s):  
Diabetes Mellitus ◽  
Social Support ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Self Efficacy ◽  
Goodness Of Fit ◽  
Equation Modeling ◽  
Ample Evidence

Ample evidence suggests that social support, self-efficacy, and adherence significantly, independently, and together affect glycemic control in patients with type 2 diabetes mellitus (T2DM), but the pathway from social support to glycemic control remains unclear. This study hypothesized that the effect of social support on glycemic control was mediated sequentially by self-efficacy and adherence. Patients with T2DM were recruited from two hospitals in Guangzhou, China, from January 1 to July 31, 2014, and their sociodemographic clinical data and their assessments on social support, self-efficacy, and adherence were obtained from medical records and self-completed questionnaires. Of the 532 patients who participated, 35% achieved glycemic control (i.e., HbA1c < 7%). Social support, self-efficacy, and adherence had significant correlations with each other and with glycemic control (P<0.05). Regression analyses and structural equation modeling showed that better social support was associated to better patient self-efficacy, which, in turn, was associated with better medical adherence, which was associated with improved glycemic control, and the relationship between social support and glycemic control was sequentially and completely mediated by self-efficacy and adherence. The five goodness-of-fit indices confirmed that our data fitted the hypothesized pathway model strongly.

Regimen-Related Distress, Medication Adherence, and Glycemic Control in Rural African American Women With Type 2 Diabetes Mellitus

2014 ◽  
Vol 48 (8) ◽  
pp. 970-977 ◽  
Author(s):  
Doyle M. Cummings ◽  
Lesley Lutes ◽  
Kerry Littlewood ◽  
Emily DiNatale ◽  
Bertha Hambidge ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
African American ◽  
Medication Adherence ◽  
Glycemic Control ◽  
African American Women ◽  
American Women
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