Socio-Ecological Determinants and Health Literacy: A Path Analysis of Self-Management Agency Among Patients With Diabetes Mellitus

Alexandria University400 enrolled

Overview

This study aims to examine the relationships between socio-ecological determinants, health literacy, and self-management agency among patients with diabetes mellitus. Using a path analysis framework, the study investigates how multi-level socio-ecological factors and different dimensions of health literacy influence patients' capacity for diabetes self-management. Understanding these pathways will support the development of comprehensive, context-sensitive interventions to improve diabetes outcomes.

Diabetes mellitus is a chronic condition requiring sustained self-management behaviors influenced by individual capacities, social support systems, healthcare structures, community resources, and health policies. This observational study adopts the Social Ecological Model and Orem's Self-Care Deficit Theory to evaluate the combined effects of socio-ecological determinants and health literacy on self-management agency. Data will be collected using structured questionnaires, including adapted health literacy and self-care agency scales, along with researcher-developed instruments assessing socio-demographic variables and socio-ecological determinants. Path analysis will be employed to examine direct and indirect relationships among study variables.

Study Type

OBSERVATIONAL

Enrollment

400

Conditions

Diabetes Mellitus (Type 1 and Type 2)

Interventions

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * \- Adults aged 18 years and older. * Diagnosed with type 1 or type 2 diabetes mellitus. * Receiving follow-up care in outpatient or primary healthcare settings. * Able to communicate verbally and provide informed consent. Exclusion Criteria: * \- Patients with severe cognitive impairment. * Patients with acute medical conditions preventing participation. * Pregnant women diagnosed with gestational diabetes.

Locations (2)

Alexandria University Hospital, Faculty of Nursing

Alexandria, Alexandria Governorate, Egypt

RECRUITING

Faculty of Nursing, Alexandria University

Alexandria, Alexandria Governorate, Egypt

NOT_YET_RECRUITING

Outcomes

Primary Outcomes

Self-management agency

The level of self-management agency among adult patients with diabetes mellitus, measured using the adapted Appraisal of Self-Care Agency Scale-Revised (ASAS-R).

Time frame: Baseline (cross-sectional assessment)

Secondary Outcomes

Health literacy

Health literacy levels measured using the adapted All Aspects of Health Literacy Scale (AAHLS), including functional, communicative, and critical domains.

Time frame: At enrollment

Socio-ecological determinants of diabetes self-management

Socio-ecological determinants measured across individual, interpersonal, organizational, community, and policy levels using a researcher-developed assessment tool.