Rural Elders' Diabetes Self Management: Development of a Common Sense Model Inven

描述（由申请人提供）：糖尿病影响着700万65岁以上老年人的生活。糖尿病不成比例地影响少数老年人。预计糖尿病患者将通过实践一系列行为来承担管理疾病的责任，以保持血糖控制并最大限度地减少其破坏性并发症的发生。大多数促进充分自我管理的项目都侧重于为患者提供教育和技能，以改变他们的行为。然而，越来越多的文献表明，人们对疾病管理的方法是基于常识或自我调节模式，对疾病及其管理的复杂理解是基于生活经验和文化环境。尽管这些常识模型的重要性得到了公认，但很少有人试图对其进行衡量。这项研究计划的长期目标是了解糖尿病的常识模型与血糖控制和糖尿病并发症的关系。该项目最初的资助期产生了对北卡罗来纳州农村多种族（非裔美国人、印第安人、白色）人群自我管理行为及其与血糖控制相关性的理解。拟议的资助期将致力于记录糖尿病基本行为的常识模型，描述与这些模型中的变异性相关的因素，并开发一种库存/工具，用于测量居住在农村和少数民族社区的老年糖尿病患者的这些模型。拟议的研究将采用混合方法（深入访谈、自由列表、共识小组和调查）以实现四个具体目标：（1）描绘农村老年人所持有的糖尿病常识模型;（2）确定这些常识模型的变异性来源，包括性别和种族;（3）编制糖尿病常识模型量表（CSMI），并建立其信度和效度。与公共卫生的相关性：这项研究将扩展影响个人健康行为的基本模型的知识，并提供一种工具，使调查人员和其他研究人员能够在未来的研究中测试有关文化通过个人经验与行为以及最终与疾病结果之间联系的假设。

DESCRIPTION (provided by applicant): Diabetes affects the lives of 7 million older adults aged 65+. Diabetes disproportionately affects minority older adults. Patients with diabetes are expected to take responsibility for managing their disease by practicing a set of behaviors to maintain glycemic control and minimize the occurrence of its devastating complications. Most programs to promote adequate self-management are focused on providing education and skills to patients with the intent of changing their behaviors. However, a growing literature shows that persons' approaches to disease management are grounded in common sense or self-regulatory models, complex understandings of the disease and its management that are based on life experiences and their cultural milieu. Despite the acknowledged importance of these common sense models, few attempts have been made to measure them. The long term goal of this research program is to understand how common sense models of diabetes are related to glycemic control and complications of diabetes. This project's original funding period produced an understanding of self-management behaviors and their association with glycemic control in a multi-ethnic (African American, Native American, white) population in rural North Carolina. The proposed funding period will be devoted to documenting common sense models of diabetes underlying behavior, delineating the factors related to variability in these models, and developing an inventory/instrument that measures these models in older individuals with diabetes who reside in rural and minority communities. The proposed research will use a mixed method approach (in-depth interviews, free- listing, consensus panels, and survey) to accomplish four specific aims: (1) delineate the common sense models of diabetes held by older rural adults; (2) determine the sources of variability in these common sense models, including gender and ethnicity; (3) develop the Common Sense Model Inventory (CSMI), a quantitative instrument to differentiate older adults with diabetes according to their common sense models of diabetes; and (4) establish the validity and reliability of this instrument. Relevance to public health: This study will extend knowledge of the underlying models that affect individual health behavior, and provide a tool that will allow the investigators and other researchers to test hypotheses concerning the linkage of culture through individual experience to behavior and, finally, to disease outcomes in future research.