Social factors and barriers to self-care adherence in hispanic patients with type 2 diabetes

Background: Behavioral risk factors such as sedentary lifestyle and poor diet have been identified as preventable causes of morbidity in diabetes control. Conventional health promotion methods tend to emphasize individual responsibility for self-care adherence (SCA), often ignoring social factors and available resources. Methods: We used multiple linear regressions to test cross-sectional associations between social support, barriers, and facilitators of diet and exercise on SCA in a sample (n=248) of Hispanic patients with T2DM, adjusting for age, sex and insulin use. Patients were low-SES, English- and Spanish-speaking participants in a randomized controlled trial of a culturally tailored intervention for diabetes management. Mean age was 50.9 ± 8.8 years, 9.9 ± 6.6 years with diabetes; 99 (39.9%) were men, and 149 (60.1%) women. Results: Women reported more barriers (t = .004) and less support (t =.01) than men. Higher levels of support were associated with better SCA (p<=.05) among women, and exercise barriers were associated with lower SCA (p<=.05) for both men and women. Examining specific types of support for diet and exercise, results differed for men and women. Among women, but not men, less family support for exercise (p= 007) and diet (p<=.02) was associated with lower SCA. Conclusions: Men appeared more likely to receive support for SCA, while women encountered numerous obstacles. Thus, social factors in this population may benefit men, but could potentially hamper women's efforts to manage their diabetes. Interventions targeting Hispanics should consider culture and social factors that may differentially impact men and women.