Mansyur Carol L, Rustveld Luis O, Nash Susan G, Jibaja-Weiss Maria L
School of Community and Environmental Health, Old Dominion University, Norfolk, Virginia (Dr Mansyur)
Department of Family and Community Medicine, Baylor College of Medicine, Houston, Texas (Dr Rustveld, Dr Nash)
Diabetes Educ. 2016 Jun;42(3):315-24. doi: 10.1177/0145721716640905. Epub 2016 Mar 31.
The purpose of this study was to determine whether perceived support, social norms, and their association with self-efficacy varied by gender and language-based acculturation in Hispanic men and women with uncontrolled type 2 diabetes mellitus (T2DM).
A cross-sectional, secondary analysis of baseline survey data from a randomized control trial. Participants were 248 Hispanic patients from 4 community health centers who participated in a culturally targeted intervention for diabetes management. Quantitative statistical methods were used, including chi-square analyses, one-way ANOVA, and multiple regression.
Gender and language both moderated the relationship between social factors and self-efficacy. Regardless of language, better perceived support was associated with improved self-efficacy in women but not men. Dietary norms were associated with self-efficacy in English-speaking men and women, while physical activity norms were associated with self-efficacy for Spanish-speaking women only.
This study builds on previous research by exploring the extent to which the social context of diabetes self-management may vary in its effects depending on gender and acculturation. The findings revealed potentially important differences based on both gender and language, suggesting that interventions must be designed with these differences in mind. Diabetes-specific support from family members, especially spouses, may be especially important for Hispanic women. For both men and women, it may be effective to find creative ways of involving the family in creating healthier social norms and expectations.
本研究旨在确定在未得到有效控制的2型糖尿病（T2DM）的西班牙裔男性和女性中，感知到的支持、社会规范及其与自我效能感的关联是否因性别和基于语言的文化适应程度而有所不同。
对一项随机对照试验的基线调查数据进行横断面二次分析。参与者为来自4个社区卫生中心的248名西班牙裔患者，他们参与了一项针对糖尿病管理的文化针对性干预措施。使用了定量统计方法，包括卡方分析、单因素方差分析和多元回归。
性别和语言均调节了社会因素与自我效能感之间的关系。无论使用何种语言，感知到更好的支持与女性而非男性自我效能感的提高相关。饮食规范与说英语的男性和女性的自我效能感相关，而体育活动规范仅与说西班牙语的女性的自我效能感相关。
本研究在先前研究的基础上，探讨了糖尿病自我管理的社会背景在影响程度上可能因性别和文化适应程度而异的情况。研究结果揭示了基于性别和语言的潜在重要差异，表明干预措施的设计必须考虑到这些差异。来自家庭成员，尤其是配偶的糖尿病特定支持对西班牙裔女性可能尤为重要。对于男性和女性而言，找到让家庭参与创建更健康的社会规范和期望的创新方法可能会有效。
