When is social support important? The association of family support and professional support with specific diabetes self-management behaviors

J Gen Intern Med. 2008 Dec;23(12):1992-9. doi: 10.1007/s11606-008-0814-7. Epub 2008 Oct 15.

Abstract

Background: Social support is associated with better diabetes self-management behavior (SMB), yet interventions to increase family and friend support (FF support) have had inconsistent effects on SMB.

Objective: To test whether FF support differentially affects specific SMBs and compare the influence of support from health professionals and psychological factors on specific SMBs to that of FF support.

Design: Cross-sectional survey of people with diabetes recruited for a self-management intervention

Participants and setting: One hundred sixty-four African-American and Latino adults with diabetes living in inner-city Detroit

Measurements and main results: For every unit increase in FF support for glucose monitoring, the adjusted odds ratio (AOR) of completing testing as recommended was 1.77 (95% CI 1.21-2.58). FF support was not associated with four other SMBs (taking medicines, following a meal plan, physical activity, checking feet). Support from non-physician health professionals was associated with checking feet [AOR 1.72 (1.07-2.78)] and meal plan adherence [AOR = 1.61 (1.11-2.34)]. Diabetes self-efficacy was associated with testing sugar, meal plan adherence, and checking feet. Additional analyses suggested that self-efficacy was mediating the effect of FF support on diet and checking feet, but not the FF support effect on glucose monitoring.

Conclusions: The association between FF support and SMB performance was stronger for glucose monitoring than for other SMBs. Professional support and diabetes self-efficacy were each independently associated with performance of different SMBs. SMB interventions may need to differentially emphasize FF support, self-efficacy, or professional support depending on the SMB targeted for improvement.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Diabetes Mellitus / psychology*
  • Diabetes Mellitus / therapy*
  • Disease Management
  • Family Relations*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Physician-Patient Relations*
  • Self Care / psychology*
  • Social Support*