Using path analysis to model the process of change in HbA1c among African Americans and Latinos in a community health
Alana M W LeBrón1, Nicolaus R Espitia2, Edith C Kieffer2
1Department of Health, Society, and Behavior, University of California, Irvine, Irvine, CA, USA; Department of Chicano/Latino Studies, University of California, Irvine, Irvine, CA, USA.
Objective:
To examine which components of a culturally tailored community health worker (CHW) intervention improved glycemic control and intermediate outcomes among Latina/o and African American participants with diabetes.
Methods:
The sample included 326 African American and Latina/o adults with type 2 diabetes in Detroit, MI. CHWs provided interactive group diabetes self-management classes and home visits, and accompanied clients to a clinic visit during the 6-month intervention period. We used path analysis to model the processes by which each intervention component affected change in diabetes self-efficacy, diabetes-related distress, knowledge of diabetes management, and HbA1c.
Results:
The group-based healthy lifestyle component was significantly associated with improved knowledge. The group-based self-management section was significantly associated with reduced diabetes-related distress. Intervention class attendance was positively associated with self-efficacy. Diabetes self-management mediated the reductions in HbA1c associated with reductions in diabetes distress.
Conclusions:
Path analysis allowed each potential pathway of change in the intervention to be simultaneously analyzed to identify which aspects of the CHW intervention contributed to changes in diabetes-related behaviors and outcomes among African Americans and Latinas/os.
Practice Implications:
Findings reinforce the importance of interactive group sessions in efforts to improve diabetes management and outcomes among Latina/o and African American adults with diabetes.
Related Concept Videos
Methods of Documentation VI: Case Management Model
For example, a patient with a chronic...
Pathophysiology of Diabetes
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
Models of Health Promotion and Illness Prevention I
The health belief model (HBM) attempts to predict health-related behavior in specific belief patterns. According to the HBM, a person's...
Diabetes: Symptoms, Diagnosis, and Complications
Diabetes Mellitus: Type 2 and Gestational
Diabetes: Management and Pharmacotherapy
Insulin remains the cornerstone of treatment for most patients with type 1 and many...


