Relationship between social determinants of health and processes and outcomes in adults with type 2 diabetes: validation of a conceptual framework

Walker, Rebekah J; Gebregziabher, Mulugeta; Martin-Harris, Bonnie; Egede, Leonard E

doi:10.1186/1472-6823-14-82

Table 3 Standardized effects of social determinants of health on mediator/moderators of self-care, access to care and processes of care, controlling for age, gender, race and health literacy

From: Relationship between social determinants of health and processes and outcomes in adults with type 2 diabetes: validation of a conceptual framework

	Direct effect	Indirect effect	Total effect
Self-care
➔ Social Determinants
Education	−0.07	0.005	−0.07
Employment	−0.05	−0.005	−0.05
Income	−0.01	0.01	0.003
Fatalism	0.07	0.001	0.07
Self-efficacy	0.06	0.003	0.06
Depression	−0.08	0.01	−0.07
Diabetes distress	−0.13*	−0.01	−0.14**
SPD	0.01	−0.003	0.003
Social support	−0.07	−0.005	−0.07
Perceived stress	−0.14**	−0.01	−0.15**
➔ Access to care
Patient centered care	0.04	-	0.04
Usual source of care	0.06	0.002	−0.04*
Visits to primary care	0.06	0.001	−0.08
Satisfaction with care	0.05	0.02	−0.01
➔ Processes of care
Diabetes education	−0.08*	−0.0002	0.11**
A1c in 12 mo.	0.005	−0.002	−0.002
Cholesterol in 12 mo.	0.002	−0.005	0.05
Foot check in 12 mo.	0.06	−0.001	0.05
Treatment with diet	−0.04	−0.003	0.0002
Treatment with oral	−0.08*	−0.006	0.03
Treatment with insulin	−0.03	−0.02*	0.28***
Access to care
➔ Social Determinants
Education	0.01	0.0002	0.02
Employment	−0.005	−0.0003	−0.01
Income	0.08*	0.0005	0.08*
Fatalism	−0.04	0.0002	−0.04
Self-efficacy	−0.01	0.0002	−0.01
Depression	0.03	0.0005	0.03
Diabetes distress	−0.21***	−0.0001	−0.21***
SPD	−0.002	−0.0001	−0.002
Social support	0.08*	−0.0004	0.08*
Perceived stress	−0.06	−0.0004	−0.06
➔ Processes of care
Diabetes education	−0.004	-	−0.004
A1c in 12 mo.	−0.01	−0.0001	−0.009
Cholesterol in 12 mo.	0.03	−0.0003	0.03
Foot check in 12 mo.	0.03	−0.0001	0.03
Treatment with diet	0.09**	−0.0003	0.08**
Treatment with oral	−0.01	−0.0003	−0.01
Treatment with insulin	−0.02	−0.001	−0.02
Processes of care
➔ Social Determinants
Education	−0.05	-	−0.05
Employment	0.06	-	0.06
Income	−0.11*	-	−0.11*
Fatalism	−0.04	-	−0.04
Self-efficacy	−0.04	-	−0.04
Depression	−0.11	-	−0.12
Diabetes distress	0.03	-	0.03
SPD	0.03	-	0.03
Social support	0.10*	-	0.10*
Perceived stress	0.10*	-	0.10*

Note: the significance levels shown here are for the unstandardized solution. *p < 0.05; **p < 0.01; ***p < 0.001.

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ISSN: 1472-6823

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