Date of Award

Spring 4-22-2004

Document Type

Open Access Thesis

Degree Name

MS in Physician Assistant Studies (PA)


Physician Assistant Studies

First Advisor

Chris Bosquez

Second Advisor

Dawn B. Ludwig


Background The reduction of diabetes complications depends on adherence to self-management behaviors. The current study was designed to examine the influence of multiple social-environmental levels of support on diabetic self-management behaviors in a lower income community. The eight distinct levels of social-environmental support studied were personal characteristics, physician and health team, family and friends, neighborhood, community, media and policy, community organizations, and the workplace. Methods An anonymous self-administered survey, consisting of questions about demographic features, hemoglobin AlC, self-management behaviors, and perceived support from multiple social-environmental levels, was completed by 36 diabetic participants from the Regions Family Physicians clinic. Results Significant associations were found between: 1) higher personal disease management/coping and adherence to general diet, specific diet, foot care, and medication recommendations, 2) higher perceptions of support from family and friends and adherence to specific diet and foot care, and 3) higher levels of neighborhood support and regular exercise. Conclusions Multiple social-environmental factors influence adherence to diabetic self management behaviors in lower income populations. The influence of these factors needs to be recognized and addressed in order for diabetic interventions to be effective.


SC 11.PAS.2004.McKee.C