title: Influence of patient characteristics on assessment of diabetes self-management support.
abstract: BACKGROUND
  Factors contributing to patient-reported experiences of diabetes self-management support are not understood well, particularly over time.
  
  
  OBJECTIVE
  The aim of the study was to identify the contribution of patient characteristics to patient-reported quality of SMS.
  
  
  METHODS
  Using secondary data from a prospective clinical trial (n = 339) comparing three approaches of providing diabetes self-management support (Group Medical Visits, Automated Telephone Support, and Usual Care) in a diverse, underserved population, the influence of patient characteristics (e.g., age, gender, income, and health status) was examined on Patient Assessment of Chronic Illness Care ratings.
  
  
  RESULTS
  At baseline, older age (p = .014), being female (p = .038), and having lower income (p = .001) were associated with lower ratings. Income and interactions involving income combined explained 12% of the variance in baseline ratings. Compared with White patients, African American and Asian patients tended to have higher baseline ratings (p = .076 and p = .045, respectively). Race or ethnicity influenced perceptions throughout the trial, explaining 5% of the variance at baseline and 2% of the variance in 1-year changes in Patient Assessment of Chronic Illness Care ratings. As expected, over 1 year, ratings increased more for patients in both intervention groups compared with the control group (p < .001).
  
  
  CONCLUSIONS
  Ratings of healthcare quality are influenced by patient characteristics independent of the nature of the care provided. Understanding more precisely how these differences are associated with differences in clinical processes will be particularly important for efforts aiming to integrate patient-reported measures into assessments of healthcare quality during routine clinical care and clinical trials.
authors: College of Nursing, The University of Iowa, Iowa City, IA, USA. andrea-wallace@uiowa.edu
authors: Andrea
authors: A
authors: Wallace
authors: Yelena
authors: Y
authors: Perkhounkova
authors: Huichen
authors: H
authors: Tseng
authors: Dean
authors: D
authors: Schillinger
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015404:Nursing Methodology Research; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012648:Self Care / Q000523:psychology*; D012944:Social Support; D012959:Socioeconomic Factors; D055815:Young Adult