BACKGROUND: Variability in disease-related outcomes may relate to how patients experience self-management support in clinical settings. OBJECTIVES: The purpose of this study was to identify factors associated with experiences of self-management support during primary care encounters. METHODS: A cross-sectional survey was conducted of 208 patients seen in a multidisciplinary diabetes program in an academic medicine clinic. Multiple regression analysis was used to test associations between patient-rated experiences of self-management support (Patient Assessment of Chronic Illness Care) and race, gender, insurance status, literacy, duration of diabetes, and intensity of care management. RESULTS: The Patient Assessment of Chronic Illness Care ratings decreased with age (r = -.235, p = .001), were higher for women than for men (3.95 vs. 3.65, t = 2.612, p= .010), and were greater for those with more education (F= 3.927, p = .009) and greater literacy skills (t = 3.839, p< .001). The ratings did not vary between racial (t = -1.108, p = .269) or insurance (F = 1.045, p = .374) groups and were unaffected by the duration of diabetes (r= .052, p = .466) and the intensity of care management (F = 1.028, p = .360). In multivariate models, literacy was the only variable contributing significantly to variation in self-management support ratings. DISCUSSION: Even when considering the objective intensity of health services delivered, literacy was the sole variable contributing to differences in patient ratings of self-management support. Although conclusions are limited by the cross-sectional nature of this study, the results emphasize the need to consider literacy when developing and communicating treatment plans requiring self-management skills.
BACKGROUND: Variability in disease-related outcomes may relate to how patients experience self-management support in clinical settings. OBJECTIVES: The purpose of this study was to identify factors associated with experiences of self-management support during primary care encounters. METHODS: A cross-sectional survey was conducted of 208 patients seen in a multidisciplinary diabetes program in an academic medicine clinic. Multiple regression analysis was used to test associations between patient-rated experiences of self-management support (Patient Assessment of Chronic Illness Care) and race, gender, insurance status, literacy, duration of diabetes, and intensity of care management. RESULTS: The Patient Assessment of Chronic Illness Care ratings decreased with age (r = -.235, p = .001), were higher for women than for men (3.95 vs. 3.65, t = 2.612, p= .010), and were greater for those with more education (F= 3.927, p = .009) and greater literacy skills (t = 3.839, p< .001). The ratings did not vary between racial (t = -1.108, p = .269) or insurance (F = 1.045, p = .374) groups and were unaffected by the duration of diabetes (r= .052, p = .466) and the intensity of care management (F = 1.028, p = .360). In multivariate models, literacy was the only variable contributing significantly to variation in self-management support ratings. DISCUSSION: Even when considering the objective intensity of health services delivered, literacy was the sole variable contributing to differences in patient ratings of self-management support. Although conclusions are limited by the cross-sectional nature of this study, the results emphasize the need to consider literacy when developing and communicating treatment plans requiring self-management skills.
Authors: M H Chin; S B Auerbach; S Cook; J F Harrison; J Koppert; L Jin; F Thiel; T G Karrison; A G Harrand; C T Schaefer; H T Takashima; N Egbert; S C Chiu; W L McNabb Journal: Am J Public Health Date: 2000-03 Impact factor: 9.308
Authors: Dean Schillinger; Kevin Grumbach; John Piette; Frances Wang; Dennis Osmond; Carolyn Daher; Jorge Palacios; Gabriela Diaz Sullivan; Andrew B Bindman Journal: JAMA Date: 2002 Jul 24-31 Impact factor: 56.272
Authors: Andrea S Wallace; Yelena Perkhounkova; Andrew L Sussman; Maria Hein; Sophia Jihey Chung; Toni Tripp-Reimer Journal: Transl Behav Med Date: 2016-06 Impact factor: 3.046
Authors: Fatima Al Sayah; Sumit R Majumdar; Beverly Williams; Sandy Robertson; Jeffrey A Johnson Journal: J Gen Intern Med Date: 2012-10-13 Impact factor: 5.128
Authors: Stacy Cooper Bailey; Angela G Brega; Trisha M Crutchfield; Tom Elasy; Haley Herr; Kimberly Kaphingst; Andrew J Karter; Sarah Moreland-Russell; Chandra Y Osborn; Michael Pignone; Russell Rothman; Dean Schillinger Journal: Diabetes Educ Date: 2014-06-19 Impact factor: 2.140