Environmental Barriers Self Efficacy And The Direct And Indirect Effects Of Diabetes Specific Cultural Beliefs On Health Status In A Community Sample Of Diabetic Patients

Type 2 diabetes mellitus represents a daunting self-management challenge due to its complicated daily treatment regimen which includes adhering to diet, exercise, and medication recommendations. Little research has evaluated perceived barriers to diabetes self-care in a group that is at particular risk for diabetic complications: U.S. Latinos. This study had two aims. The first was to provide evidence that experimental and validated self-report instruments selected for this study functioned in a comparable manner in both Spanish and English in a sample of low income, predominantly Spanish-speaking diabetic patients (n = 77). The second aim was to examine hypothesized relationships of selected predictors to two criterion variables measuring health status (i.e., glycosylated hemoglobin A1c and Diabetes Impact) using a method described by Baron & Kenny (1986). Predictors included age, education, and income as covariates, and perceived environmental barriers to self-care, self-efficacy for treatment adherence, fatalistic beliefs (external health locus of control), and Latino cultural diabetes beliefs. Potential moderator and mediator variables of the relationship between perceived barriers to self care and criterion variables included self-efficacy for treatment adherence, fatalistic beliefs and Latino cultural diabetes beliefs. Scales used in this study had coefficient alpha values ranging from .82-.96 in Spanish and .74-.97 in English and also demonstrated strong factor structure integrity. Bivariate correlations indicated that higher scores on perceived barriers to self-care were significantly related to lower self-efficacy scores [r = −.34, p