In an attempt to identify factors associated with patients' experience of self-management support in primary care settings, Wallace and colleagues looked at the self-reported care ratings of patients in a diabetes management program and examined them in relation to the patients' race, gender, insurance status, literacy, length of disease, and intensity of care management.

A total of 204 patients were included in the study, which was based on the results of a survey completed by 96% of participants. The majority of patients were women (64%), nearly half were African American (48%), average age was 58 years, and mean time since diabetes diagnosis was 10 years. Approximately one-third of those surveyed didn't complete high school, and 31% were considered to have "less than adequate literacy."

The Patient Assessment of Chronic Illness Care (PACIC) was used to assess patients' opinions of the quality of self-management support they received. Results of a bivariate analysis showed lower ratings with increasing age and higher ratings from women. Patients with more education and better literacy skills also had higher PACIC scores. Ratings weren't associated with race, insurance status, length of disease, intensity of disease management, number of telephone contacts, number of physician visits attended by a care assistant, or number of glycated hemoglobin tests during the previous year. Further analysis using multivariate models demonstrated that literacy level was the only factor contributing significantly to differences in patient ratings of self-management support.

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