542-P: Socio-clinical Correlations with Threat Perception and Self-Efficacy in People with T2D

Abstract

Interventions are needed to address health disparities among racial and ethnic minorities with type 2 diabetes (T2D). In a novel application, the Extended Parallel Processing Model (EPPM) was used to categorize 168 adults with T2D from urban safety-net clinics and the local community by self-efficacy and perceived threat from T2D and cardiovascular disease based on validated measures. The EPPM groups were high threat (HT)/high efficacy (HE), low threat (LT)/low efficacy (LE), HT/LE, and LT/HE. Socio-clinical characteristics were compared across EPPM groups, threat level, and self-efficacy level. HT/LE people had the lowest medication adherence and T2D management score, the highest A1C (p=0.10), and most microvascular complications relative to other EPPM groups. Gender, Race/Ethnicity, education, and health insurance did not vary by EPPM group. HT people were younger, had lower medication adherence, more diabetic complications, more blood pressure medications, and more insulin use (p=0.08) than LT people. LE people had lower medication adherence, lower T2D management score, and higher A1C (p=0.07) than HE people. The EPPM is associated with clinical outcomes and self-management behaviors. This model may be useful to target people with T2D for behavioral intervention. Moving people from HT/LE to LT/HE may improve T2D management and outcomes. Disclosure J.Hu: None. S.K.Chen: None. S.Kim: None. P.J.Kelly: None. A.Hoadley: None. Y.Zisman-ilani: None. D.A.Swavely: None. S.B.Bass: None. D.J.Rubin: Research Support; AstraZeneca.