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Abstract
BackgroundTo examine whether the social adaptability index (SAI) alone or components of the index provide a better explanatory model for self-care and diabetes outcomes.MethodsSix hundred fifteen patients were recruited from two primary care settings. A series of multiple linear regression models were run to assess (1) associations between the SAI and diabetes self-care/outcomes, and (2) associations between individual SAI indicator variables and diabetes self-care/outcomes. Separate models were run for each self-care behavior and outcome. Two models were run for each dependent variable to compare associations with the SAI and components of the index.ResultsThe SAI has a significant association with the mental component of quality of life (0.23, p < 0.01). In adjusted analyses, the SAI score did not have a significant association with any of the self-care behaviors. Individual components from the index had significant associations between self-care and multiple SAI indicator variables. Significant associations also exist between outcomes and the individual SAI indicators for education and employment.ConclusionsIn this population, the SAI has low explanatory power and few significant associations with diabetes self-care/outcomes. While the use of a composite index to predict outcomes within a diabetes population would have high utility, particularly for clinical settings, this SAI lacks statistical and clinical significance in a representative diabetes population. Based on these results, the index does not provide a good model fit and masks the relationship of individual components to diabetes self-care and outcomes. These findings suggest that five items alone are not adequate to explain or predict outcomes for patients with type 2 diabetes.
Highlights
To examine whether the social adaptability index (SAI) alone or components of the index provide a better explanatory model for self-care and diabetes outcomes
This study found that the relationship between the social adaptability index (SAI) score and self-care behaviors was not significant in adjusted models, and only showed significant association with the mental component of quality of life
When entering components of the SAI as individual variables, education and employment were significantly associated with Hemoglobin A1c (HbA1c) and the mental component of quality of life; education and income were associated with exercise; and substance abuse was associated with foot care
Summary
To examine whether the social adaptability index (SAI) alone or components of the index provide a better explanatory model for self-care and diabetes outcomes. Diabetes is the seventh leading causes of death among adults in the US population and affects more than 382 billion people worldwide [1, 2]. It is associated with an increased risk of mortality, heart disease, and stroke, and is the leading cause of kidney failure [1]. Based on factors including employment status, substance abuse, marital status, and income, the SAI provides a composite score that has been correlated with health outcomes and overall mortality [13]. The SAI was found to be a predictor of mortality in patients with diabetes through a dose response relationship between SAI score and mortality in US adults [13,14,15,16]
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