An ecological perspective on diabetes self-care support, self-management behaviors, and hemoglobin A1C among Latinos

Diabetes Educ. 2015 Apr;41(2):214-23. doi: 10.1177/0145721715569078. Epub 2015 Feb 5.


Purpose: The purpose of this study was to examine the role of self, interpersonal (ie, family/friend), and organizational (ie, health care) support in performing diabetes-related self-management behaviors and hemoglobin A1C (A1C) levels among rural Latinos with type 2 diabetes.

Methods: Cross-sectional data from baseline interviews and medical records were used from a randomized controlled trial conducted in rural Southern California involving a clinic sample of Latinos with type 2 diabetes (N = 317). Self-management behaviors included fruit and vegetable intake, fat intake, physical activity, glucose monitoring, daily examination of feet, and medication adherence. Multivariate linear and logistic regression models were used to assess the relationships of sources of support with self-management behaviors and A1C.

Results: Higher levels of self-support were significantly associated with eating fruits and vegetables most days/week, eating high-fat foods few days/week, engaging in physical activity most days/week, daily feet examinations, and self-reported medication adherence. Self-support was also related to A1C. Family/friend support was significantly associated with eating fruits and vegetables and engaging in physical activity most days/week. Health care support was significantly associated with consuming fats most days/week.

Conclusions: Health care practitioners and future interventions should focus on improving individuals' diabetes management behaviors, with the ultimate goal of promoting glycemic control. Eliciting family/friend support should be encouraged to promote fruit and vegetable consumption and physical activity.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Blood Glucose
  • Blood Glucose Self-Monitoring / psychology
  • California
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / psychology*
  • Diet, Diabetic / psychology
  • Exercise
  • Female
  • Glycated Hemoglobin A / analysis
  • Health Knowledge, Attitudes, Practice
  • Hispanic or Latino / psychology*
  • Humans
  • Male
  • Medication Adherence
  • Middle Aged
  • Rural Population
  • Self Care / psychology*
  • Social Support*


  • Blood Glucose
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human