The Impact of Hispanic Ethnicity on Knowledge and Behavior Among Patients With Diabetes

PURPOSE: The purpose of the study was to measure the current level of awareness of the American Heart Association's 7 risk/protective factors of cardiovascular health among adults with diabetes of Hispanic and non-Hispanic origin and to identify factors associated with knowledge deficits. METHODS: A cross-sectional survey measured demographic data, personal behaviors/health factors, cardiovascular disease (CVD) history, and knowledge of 7 components of ideal cardiovascular health (smoking, obesity, exercise, diet, cholesterol, blood pressure, and blood glucose). A subset of 331 Hispanic and white patients with diabetes was surveyed. Knowledge scores were dichotomized between full knowledge (7 components) and less than full knowledge and compared between ethnicities using multiple logistic regression. RESULTS: Seventy-nine percent of surveys were returned; 50.5% of subjects were Hispanic. Median age was 64.5 years with 60.7% being female. Two-thirds of the sample completed high school and 26% reported comorbid CVD. Recognition of diabetes as a risk factor didn't differ by ethnicity. Thirty-five percent of respondents identified 7 American Heart Association risk factors. Hispanics were less likely to identify 7 components. After adjustment for education and English literacy, the difference disappeared. Better knowledge was positively associated with healthier behaviors for high cholesterol, hypertension, and exercise only among white patients. CONCLUSIONS: Hispanic patients with diabetes exhibit less knowledge about CVD risk/protective factors due to lower education and English literacy. Educational interventions should be tailored to those with less education/limited English proficiency.