Predictors of Diabetes Preventive Care Practices in Asian Americans

Using secondary data collected from the CDC's Behavioral Risk Factor Surveillance System from 2004 to 2008, the purposes of this study were to identify the factors associated with five diabetes preventive care practices, including comprehensive clinical foot exam, dilated eye exam, hemoglobin A1c testing, self-monitoring of blood glucose, and self-foot check; and to identify the factors that best predict the number of diabetes preventive care practices in Asian Americans with diabetes. This was a descriptive-correlational study, guided by Green and Kreuter's PRECEDE model and professional guidelines on diabetes care. The association between predisposing, reinforcing and enabling factors, and the five diabetes preventive care practices were explored. The sample comprised of 1,985 Asian Americans with diabetes (n = 264 insulin; n = 1,194 non-insulin users). Approximately 71.6% of all participants had a comprehensive clinical foot exam one or more times a year; 76.5% had an annual dilated eye exam; 76.5% had two or more HbA1c tests; and 54.4% had reported checking their feet at least daily. By insulin use, 31.4% of insulin users reported SMBG three or more times a day and 44.2% of non-insulin users reported SMBG at least daily. The predictors for each individual practice differed, however, DSME was a significant factor related to all preventive care practices and overall score. Significant differences were found between insulin users and non-insulin users in the number of preventive care practices completed as recommended. For Asian Americans with diabetes, DSME should be tailored to improve diabetes preventive care practices. Additional studies are needed to confirm these findings.