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Diabet Med. 2008 Mar;25(3):341-8. doi: 10.1111/j.1464-5491.2007.02371.x.

Patient-provider perceptions of diabetes and its impact on self-management: a comparison of African-American and White patients.

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University of Michigan Department of Medical Education, University of Michigan Medical School, Ann Arbor, MI, USA.



To compare patient-provider differences in diabetes-related perceptions between African-American and White patients and to examine its association with self-care behaviours.


One hundred and thirty patient-provider pairs were recruited from the greater Detroit area. Patients and providers completed a survey assessing perceptions about diabetes-related concepts and demographic background. The Diabetes Semantic Differential Scale was used to measure diabetes-related perceptions. Patients also reported the frequency of performing self-care behaviours, including following a healthy eating plan, engaging in physical activity, blood glucose monitoring, and taking medication and/or insulin.


There were a greater number of patient-provider differences in diabetes-related perceptions for the African-American patients (nine of 18 concepts) compared with the White patients (four of 18 concepts). Stepwise regression analyses found patients' semantic differential scores to be significantly associated with five self-care behaviours for African-American patients and two self-care behaviours for White patients. Providers' semantic differential scores emerged as predictors of self-care behaviours for African-American patients, but not for White patients.


Our findings suggest that compared with White patients, African-Americans differ in a greater number of diabetes-related perceptions than their providers. Patients' and providers' perceptions of diabetes care concepts have a significant impact on a greater number of self-care behaviours for African-American patients than White patients.

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