Language and Other Factors Associated With Foot Self-Management Among Puerto Ricans With Diabetes in New York City

Abstract

Daily self-inspection of feet for sores and irritations is an essential and cost-effective diabetes self-management practice to prevent foot complications (1,2). It is relatively easy to perform and does not require equipment or supplies, yet nearly 40% of people with diabetes in New York state do not practice daily foot inspection, and Hispanics are the least likely to do so (3). Puerto Ricans are the largest Hispanic group in the state and have a markedly high prevalence of diabetes (4,5). Studies have found that Puerto Ricans show poor overall self-management of diabetes (6,7) and suffer from a high prevalence of foot complications (8–10). Poor English skills are often identified as a major reason for their suboptimal self-care practice (11,12), but some studies concluded that language may not be a barrier (13,14). The present study examines factors associated with Puerto Ricans’ daily foot self-inspection practice using population-based survey data. The data were collected in 2000–2001 through a random digit–dialing telephone survey aimed to reach Puerto Rican adults (≥18 years of age) residing in New York City (5). The survey protocol and questions were taken from the Behavioral Risk Factor Surveillance System developed by the Centers for Disease Control and Prevention (15). Those who responded affirmatively to the question “Have you been told by your doctor that …