Date of Award

Fall 11-11-2022

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Nursing

First Advisor

Melissa Faulkner

Second Advisor

Dawn Aycock

Third Advisor

Mary Rhee

Abstract

Type 2 diabetes is a significant problem among veterans in the United States, affecting about 25%. Informal peer support, a type of support that is provided by someone who also has diabetes, may be a useful adjunct to interventions targeting diabetes self-management behaviors in this population. The purpose of this study was to explore informal peer support among veterans living with diabetes, its impact on behaviors and self-efficacy related to diabetes self-management, and glucose control.

A cross-sectional, correlational design was used to evaluate relationships between variables of interest. Non-random sampling was used, and participants were recruited mostly through social media sites. Data were collected using self-report surveys administered via Qualtrics. Data were analyzed using descriptive statistics, correlations, independent sample t-tests, and PROCESS macro.

Participants (N=165) had a mean age of 41.5 (SD=11.27) years, were mostly African American (49.7%), had bachelor’s degrees (58.8%) and were married (76.4%). Most participants had been living with diabetes for less than 10 years (59.4%) and HbA1C’s of the sample were 7-7.9% (29.7%), 8-8.9 (24.8%), and 9-9.9 (20%). The majority reported having a peer supporter (98.2%). On average, participants had moderate levels of informal peer support, engagement in self-management behaviors, and self-efficacy. Informal peer support was positively associated with diet (r=.48, p<.001), self-management behaviors (r=.52, p<.001), and HbA1C (τb= .26 p<.001). Self efficacy was found to mediate the relationship between informal peer support and diet (B=.21, 95% CI [.11, .31]) as well as a global measure of self-management behaviors (B=.14, 95% CI [.04, .24] , but not medication adherence or glucose control. Those who described their informal peer supporter as a veteran had higher (M=39.06, SE=.75) self-management scores than those described them as non-veterans (M=35.72, SE=1.11), t(159) = 2.59, p=.01).

Veterans need additional support to manage diabetes and control blood glucose, given that survey results were overall moderate, and participants reported suboptimal glucose control. Informal peer support was associated with self-management behaviors which may influence better glucose control. Future research is needed to further explore these relationships and how informal peer support may be used to enhance existing interventions that target peer support and diabetes management for veterans.

DOI

https://doi.org/10.57709/32454518

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