All ETDs from UAB

Advisory Committee Chair

Jeffrey Burkhardt

Advisory Committee Members

Carlos Estrada

Lisa Gary

Max Michael

George Munchus

Bisakha Sen

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Health Professions


The International Diabetes Federation states that there are over 246 million people in the world who have diabetes. The occurrence of co-morbidities associated with diabetes can be significantly reduced with adherence to diabetes self-care behaviors. Self-care behaviors consist of a series of behaviors that encompass life-diet, exercise, self-blood glucose examinations, and self-foot examinations. This is the only national population -based study of diabetes self-care behaviors to comprehensively identify the influence of age, gender, income, and having a regular provider of care across a complete range of self-care behaviors. This is also the first analysis of its kind to examine how environmental influences and population characteristics function to influence self-care behaviors of diabetic adults over time. The study design consisted of a time series cross-sectional design with binary dependent variables. Behavioral Risk Factor Surveillance System cross-sectional data sets from the years 2000-2003, 2005, and 2007 were pooled. A Pearson Chi Square Test was performed. This was followed by a multivariate logistic regression analysis. Next, a stratification analysis was performed on the multivariate logistic regression model. A majority of sample participants stated that they performed lifestyle behaviors (i.e., diet, exercise) and medical surveillance behaviors (i.e., self-foot examination, self-monitored blood glucose examinations). Multivariate logistic regression analysis revealed that women were more likely than men to perform diet, self-foot examinations, and self-monitored blood glucose examinations. Older diabetics (35-64; 65 and older) were more likely than younger diabetics to perform diet and self-foot examinations. However, they were less likely to perform exercise self-care. There was a positive marriage effect on the performance of self-care behaviors - this was seen for the stratum of both men and women. Having health insurance and a regular healthcare provider were associated with a positive effect on the performance of self-care behaviors. Diabetics do not behave as a uniform body of individuals. Some individuals display propensity to perform certain self-care behaviors while others do not. There are a multitude of factors from various levels that are associated with the performance of self-care behaviors. More research is needed to further understand the effect of these factors on self-care behaviors.



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