A better understanding of perceived T2D threat and self-efficacy may inform improvements in self-management education. The EPPM was used to categorize 168 adults with T2D from urban safety-net clinics and the local community by self-efficacy and perceived threat from T2D. EPPM categories were high threat (HT)/high efficacy (HE), low threat (LT)/low efficacy (LE), HT/LE and LT/HE. Characteristics of participants with T2D (PwD) were compared within and between clinic and community settings across EPPM categories.
Among clinic PwD, HT/LE PwD had the lowest medication adherence (MARS-5) (p<0.001) vs other EPPM categories. Among community PwD, HT/LE PwD had the lowest T2D management scores (p<0.001) while LT/LE PwD had the lowest BMI (p<0.05). Demographics except age did not vary by EPPM category.
Compared to the community cohort, HT/LE PwD from clinics had higher health literacy (p<0.05), lower weight (p<0.05), lower BMI (p<0.01), and were more likely to be male (p<0.01) and use insulin (p<0.01). HT/HE PwD from clinics had higher MARS-5 scores (p<0.05), more microvascular complications (p<0.01) and were more likely to use statins (p<0.01).
The EPPM identified different subgroups within and between clinics and community settings. Differences in characteristics were mostly not attributable to demographics. The EPPM may be useful to tailor behavioral interventions to people with T2D in different settings.
J. Hu: None. S. Kim: None. S.K. Chen: None. Y. Zisman-Ilani: None. D.A. Swavely: None. P.J. Kelly: None. A. Hoadley: None. S.B. Bass: None. D.J. Rubin: None.
It was partially funded by the ADA Diabetes INSIDE program.
