Table 3.
Hierarchical regression models for influence of social determinants, clinical factors and self-care on glycemic control
| Model 1 (Demographics) | Model 2 (Socioeconomic) | Model 3 (Psychosocial) | Model 4 (Built Environment) | Model 5 (Clinical) | Model 6 (Knowledge and Self-care) | |
|---|---|---|---|---|---|---|
| Age | −0.02 ** | −0.02 * | −0.01 | −0.01 | −0.01 | −0.07 |
| Gender | ||||||
| Female (ref) | --- | --- | --- | --- | --- | --- |
| Male | 0.04 | −0.07 | 0.13 | 0.15 | 0.20 | 0.19 |
| Race | ||||||
| Non-Hispanic White (ref) | --- | --- | --- | --- | --- | --- |
| Non-Hispanic Black | 0.15 | −0.01 | 0.09 | −0.04 | −0.13 | −0.15 |
| Hispanic/Other | 0.10 | 0.05 | −0.21 | −0.24 | −0.52 | −0.61 |
| Marital Status | ||||||
| Never married (ref) | --- | --- | --- | --- | --- | --- |
| Married | 0.01 | 0.08 | 0.01 | 0.01 | −0.01 | −0.01 |
| Separated/Divorced | 0.07 | 0.05 | 0.06 | 0.10 | 0.12 | 0.13 |
| Widowed | −0.04 | −0.12 | −0.18 | −0.21 | 0.03 | −0.03 |
| Insurance | ||||||
| None (ref) | --- | --- | --- | --- | --- | --- |
| Private | 0.16 | 0.10 | 0.12 | 0.12 | −0.16 | −0.10 |
| Medicare | −0.04 | −0.13 | −0.12 | −0.09 | −0.26 | −0.21 |
| Medicaid | −0.15 | −0.32 | −0.33 | −0.41 | −0.66 * | −0.63 |
| VA | −0.28 | −0.27 | −0.36 | −0.33 | −0.43 | −0.37 |
| Other | 0.03 | −0.17 | −0.17 | −0.15 | −0.18 | −0.17 |
| Site | ||||||
| Non-VAMC (ref) | --- | --- | --- | --- | --- | --- |
| VAMC | 0.75 ** | 0.75 ** | 0.50 * | 0.48 * | 0.24 | 0.20 |
| Education | −0.05 | −0.03 | −0.03 | −0.02 | −0.02 | |
| Income | −0.04 | −0.12 | −0.001 | −0.03 | −0.04 | |
| Employment | 0.01 | 0.01 | 0.005 | 0.01 | 0.01 | |
| Fatalism | −0.01 | −0.01 | −0.02 | −0.01 | ||
| Depression | −0.01 | −0.01 | 0.01 | 0.004 | ||
| Diabetes Distress | 0.30 * | 0.31 * | 0.29 * | 0.27 | ||
| Serious Psychological Distress | 0.01 | 0.01 | 0.005 | 0.003 | ||
| Self-efficacy | −0.11 *** | −0.11 *** | −0.09 *** | −0.10 *** | ||
| Social Support | 0.01 * | 0.01 * | 0.01 * | 0.01 * | ||
| Perceived Stress | −0.02 | −0.03 | −0.03 | −0.04 | ||
| Neighborhood Aesthetics | 0.05 | 0.03 | 0.04 | |||
| Walking/Exercise Environment | 0.01 | 0.01 | 0.001 | |||
| Neighborhood Safety | −0.01 | 0.003 | −0.008 | |||
| Access to Healthy Food | −0.01 | −0.01 | −0.01 | |||
| Social Cohesion | −0.04 | −0.04 | −0.04 | |||
| Neighborhood Violence | 0.01 | 0.02 | 0.02 | |||
| Neighborhood Crime | 0.18 | 0.14 | 0.17 | |||
| Self-rating of Neighborhood | 0.01 | 0.08 | 0.10 | |||
| Neighborhood Comparison | 0.005 | −0.08 | −0.04 | |||
| Recreational Facilities | 0.02 | 0.03 | 0.03 | |||
| Neighborhood Activity Index | −0.04 | −0.03 | −0.03 | |||
| Neighborhood Problems | 0.03 | 0.03 | 0.03 | |||
| Food Insecurity | 0.07 | 0.07 | 0.07 | |||
| Duration of diabetes | 0.01 | 0.01 | ||||
| BMI | −0.01 | −0.01 | ||||
| Comorbidity | −0.07 | −0.09 * | ||||
| Insulin use | ||||||
| No (ref) | --- | --- | ||||
| Yes | 1.01 *** | 0.95 *** | ||||
| Kidney problems | ||||||
| No (ref) | --- | --- | ||||
| Yes | −0.04 | −0.09 | ||||
| Eye problems | ||||||
| No (ref) | --- | --- | ||||
| Yes | −0.05 | 0.08 | ||||
| Health status | −0.01 | −0.05 | ||||
| Diabetes knowledge | 0.01 | |||||
| General diet | 0.05 | |||||
| Specific diet | 0.01 | |||||
| Exercise | −0.05 | |||||
| Blood sugar testing | 0.04 | |||||
| Foot care | 0.03 | |||||
| Medication adherence | −0.11 * | |||||
| Smoking | ||||||
| Never smoke (ref) | --- | |||||
| Former smoker | 0.34 * | |||||
| Current smoker | −0.02 | |||||
| Adjusted R2 | 0.0393 | 0.0446 | 0.1529 | 0.1541 | 0.2334 | 0.2442 |
*
p<0.05,
**
p<0.01,
***
p<0.001,
ref = reference group
Adjusted beta estimates are given for final multiple linear regression model for influence on glycemic control, variables were entered in blocks based on theoretical relationships: demographic factors (block 1), socioeconomic factors (block 2), psychosocial factors (block 3), built environment (block 4), clinical factors (block 5), and knowledge/self-care (block 6).