{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T21:18:39Z","timestamp":1791839919099,"version":"4.3.4"},"reference-count":39,"publisher":"JCFCorp SG PTE LTD","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["am j health behav"],"published-print":{"date-parts":[[2022,10,17]]},"abstract":"<jats:p>Objectives: Mechanisms underlying relationships among patients' health literacy, diabetes distress, diabetes education, and provider counseling for self-care of chronic conditions are unclear. This study tested these relationships using SEM with adult patients with comorbid diabetes\n and hypertension in rural WV. Methods: Ninety-one participants of a 12-week self-management program reported on diabetes self-care (diet, exercise, blood glucose (BG) monitoring) and related provider counseling. Results:Based on patient report, providers' recommendations included following\n a low-fat diet, eating fruits\/ vegetables, limiting sweets, a daily low-level of exercise and\/or exercise \u226520 minutes three times\/week, and BG monitoring. Provider recommendations were shown to be associated with patients' self-care behaviors (r=0.22, p&lt;0.05). Multiple factors directly\n influenced provider recommendations: diabetes distress, health literacy, and family history of diabetes. A positive association was also noted between prior diabetes education and provider recommendations and diabetes self-care (r=0.44, p&lt;0.001). A negative association was noted between\n diabetes distress and self-care, but a positive effect on provider recommendations was found. The model demonstrated good fit [CFI=0.94, and Root Mean Square Error of Approximation (RMSEA) =0.05]. Conclusions: To enhance diabetes self-care, providers should consistently provide education on\n self-care behaviors as well as partner with them to address diabetes distress.<\/jats:p>","DOI":"10.5993\/ajhb.46.5.4","type":"journal-article","created":{"date-parts":[[2022,11,5]],"date-time":"2022-11-05T04:36:58Z","timestamp":1667623018000},"page":"528-540","source":"Crossref","is-referenced-by-count":23,"title":["Relationship Among Diabetes Distress, Health Literacy, Diabetes Education, Patient-Provider Communication and Diabetes Self-Care"],"prefix":"10.5993","volume":"46","author":[{"given":"Ranjita","family":"Misra","sequence":"first","affiliation":[{"name":"Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan M","family":"Adelman","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Akron General \u2013 Center for Family Medicine, Akron, 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