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


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


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


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.
Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA. arosland@umich.edu
Ann-Marie
AM
Rosland
Edith
E
Kieffer
Barbara
B
Israel
Marvis
M
Cofield
Gloria
G
Palmisano
Brandy
B
Sinco
Michael
M
Spencer
Michele
M
Heisler
D000328:Adult; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000523:psychology* / Q000628:therapy*; D019468:Disease Management; D005195:Family Relations; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D012648:Self Care / Q000523:psychology*; D012944:Social Support