Theses Doctoral

Health Communication, Health Literacy, and the Prevalence of Obesity, Depression, Anxiety and Good Disease Self-Management Among Diverse Adults Living With Type 2 Diabetes: Identifying Predictors of High Quality Patient-Provider Communication and Quality of Life

Caleb, JoNise

Type 2 diabetes is a highly prevalent disease, projected to increase in prevalence, while expensive to treat. This study sought to identify significant predictors of each of the two study outcome variables—a higher quality of patient-provider communication, and a higher quality of life.

The online sample (N=72) was 78% (n=56) female with a mean age of 55.3 years, while 71% Black/African American with a good overall health status. They rated the overall quality of care received from their provider between good and very good. Using the new Patient-Provider Communication Scale (PP-CS-07, patient-provider communication was closest to very good. Health literacy skills were closest to very good, and health literacy self-efficacy was closest to very good. Level of knowledge for caring for type 2 diabetes was closest to very good knowledge. Participants were in an action stage with 80% confidence (very good self-efficacy) to perform seven diabetes self-management behaviors. Some 43.1% experienced depression, 44.4% experienced anxiety, and 20.8% sought counseling in the past year. The mean quality of life rating was closest to good quality of life. While controlling for social desirability, backward stepwise regression showed better quality patient-provider communication was significantly predicted by: received diabetes education, higher rating of health care quality, higher level of health literacy skills, and, being in a lower stage of change for self-care behaviors—with 79.2% of variance explained by this model. Better quality of life was significantly predicted by: female gender, having received diabetes education, no past year anxiety, higher annual household income, lower weight status, higher health literacy self-efficacy, higher rating of knowledge of diabetes self-management—with 69.4% of the variance explained by this model.

Findings make a compelling case for screening patients for depression and anxiety, using the brief tool used in this study; and future research evaluating the impact of health educators and providers being trained in motivational interviewing, while using the Patient-Provider Communication Scale (PP-CS-7) as a new tool to compare ratings by patients of providers trained in motivational interviewing. Healthcare policy should mandate such training in brief motivational interviewing, and evaluate the impact of training in containing costs.


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More About This Work

Academic Units
Health and Behavior Studies
Thesis Advisors
Wallace, Barbara C.
Ed.D., Teachers College, Columbia University
Published Here
July 28, 2021