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

描述(申请人提供)：糖尿病影响700万65岁以上老年人的生活。糖尿病对少数族裔老年人的影响不成比例。糖尿病患者应该通过实践一套行为来保持血糖控制，并将其破坏性并发症的发生降至最低，从而承担起管理疾病的责任。大多数促进充分自我管理的计划都侧重于向患者提供教育和技能，以期改变他们的行为。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，基于生活经验和文化环境对疾病及其管理的复杂理解。尽管这些常识模型的重要性得到了承认，但很少有人尝试对它们进行衡量。这项研究计划的长期目标是了解糖尿病常识模型与血糖控制和糖尿病并发症之间的关系。该项目最初的资助期对北卡罗来纳州农村地区多种族(非裔美国人、印第安人、白人)人群的自我管理行为及其与血糖控制的关系有了深入的了解。拟议的资助期将专门用于记录糖尿病潜在行为的常识模型，描述这些模型中与变异性相关的因素，并开发一种清单/工具来衡量居住在农村和少数族裔社区的老年糖尿病患者的这些模型。拟议的研究将使用混合方法(深度访谈、自由列出、共识小组和调查)来实现四个具体目标：(1)描绘农村老年人糖尿病的常识模型；(2)确定这些常识模型中的变异性来源，包括性别和种族；(3)开发常识模型问卷(CSMI)，这是根据老年人糖尿病的常识模型区分他们的量化工具；以及(4)建立该工具的有效性和可靠性。与公共健康的相关性：这项研究将扩展影响个人健康行为的潜在模型的知识，并提供一个工具，使研究人员和其他研究人员能够在未来的研究中检验关于文化通过个人经验与行为以及最终与疾病结果之间的联系的假说。

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.