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Book Relationships Among Self efficacy  Social Support  Social Problem solving  and Self management Behaviors of People Living with Type 2 Diabetes in Rural Alabama

Download or read book Relationships Among Self efficacy Social Support Social Problem solving and Self management Behaviors of People Living with Type 2 Diabetes in Rural Alabama written by Caralise Weeks Hunt and published by . This book was released on 2011 with total page 162 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Book Endocrine System Diseases   Advances in Research and Treatment  2013 Edition

Download or read book Endocrine System Diseases Advances in Research and Treatment 2013 Edition written by and published by ScholarlyEditions. This book was released on 2013-06-21 with total page 234 pages. Available in PDF, EPUB and Kindle. Book excerpt: Endocrine System Diseases—Advances in Research and Treatment: 2013 Edition is a ScholarlyEditions™ book that delivers timely, authoritative, and comprehensive information about Thyroid Diseases. The editors have built Endocrine System Diseases—Advances in Research and Treatment: 2013 Edition on the vast information databases of ScholarlyNews.™ You can expect the information about Thyroid Diseases in this book to be deeper than what you can access anywhere else, as well as consistently reliable, authoritative, informed, and relevant. The content of Endocrine System Diseases—Advances in Research and Treatment: 2013 Edition has been produced by the world’s leading scientists, engineers, analysts, research institutions, and companies. All of the content is from peer-reviewed sources, and all of it is written, assembled, and edited by the editors at ScholarlyEditions™ and available exclusively from us. You now have a source you can cite with authority, confidence, and credibility. More information is available at http://www.ScholarlyEditions.com/.

Book Social Problem Solving

    Book Details:
  • Author : Thomas J. D'Zurilla
  • Publisher : Amer Psychological Assn
  • Release : 2004-01-01
  • ISBN : 9781591471479
  • Pages : 276 pages

Download or read book Social Problem Solving written by Thomas J. D'Zurilla and published by Amer Psychological Assn. This book was released on 2004-01-01 with total page 276 pages. Available in PDF, EPUB and Kindle. Book excerpt: "We put together a book that would offer readers multiple perspectives, insights, and directions in understanding social problem solving as an important theory that has driven wide-ranging scientific research and as an important means of training to empower and elevate the lives of individuals. We believe that social problem solving can help individuals free themselves from the problems they face or the distress that these problems cause. We recognize that some problems may be difficult or impossible to solve, but we believe that considerable value remains in understanding and promoting effective social problem solving to foster the novel insights and methods in which problems that seem insurmountable ultimately may be conquered in incremental steps, across time and across individuals. Moreover, we believe that problems can be solved in different ways. When problematic situations or circumstances are manageable or controllable, a good problem solver tries to find ways to change them for the better. However, when such situations or circumstances are unchangeable or uncontrollable, one can still use problem solving to find ways to accept and tolerate with less distress that which cannot be changed or controlled"--Preface. (PsycINFO Database Record (c) 2005 APA, all rights reserved)

Book The Relationship Between Psychosocial Self efficacy and Self management Behavior in Native Americans with Type 2 Diabetes

Download or read book The Relationship Between Psychosocial Self efficacy and Self management Behavior in Native Americans with Type 2 Diabetes written by Donna M. Olson and published by . This book was released on 2005 with total page 366 pages. Available in PDF, EPUB and Kindle. Book excerpt: Abstract: The current study was designed to determine whether a linear relationship existed between psychosocial self-efficacy and diabetes self-management behavior in Native American people living in the U.S. Cheyenne-Arapaho people (N = 36) with type 2 diabetes aged 21 to 77, living in Western Oklahoma agreed to participate in the study. Participants were administered the Diabetes Empowerment Scale (DES; Anderson et al., 1995) to measure psychosocial self-efficacy and the Summary of Diabetes Self-Care Activities (SDSCA; Toobert & Glasgow, 1994) to measure levels of self-management behavior in a one-to-one interview format. Managing the psychosocial aspects of diabetes displayed a significant positive relationship to foot self-care behavior and knowledge of diabetes. All other aspects of psychosocial self-efficacy did not show a linear relationship to diabetes self-management behavior in this population. The results suggest that practitioners should focus on enhancing the ability of patients to manage the psychosocial aspects of diabetes through diabetes education. Future researchers could focus on environmental factors that impact self-management in this population.

Book Diabetes Knowledge  Self Effecacy  Social Support  and Diabetes Self management Affecting Type II Diabetes Outcomes In Qataris

Download or read book Diabetes Knowledge Self Effecacy Social Support and Diabetes Self management Affecting Type II Diabetes Outcomes In Qataris written by Fatemah Ali Pouladi (RN) and published by . This book was released on 2018 with total page 189 pages. Available in PDF, EPUB and Kindle. Book excerpt: Background: Type II diabetes mellitus (DM) is increasing worldwide, leading to greater health expenses, and its complications were responsible for 4.6 million deaths in 2011 (International Diabetes Federation [IDF], 2011). This study investigates how diabetes knowledge, self-efficacy, social support, and self-management relate to diabetes control. Self-efficacy and social support were examined, respectively, as a mediator and a moderator. The hypothesis is that there is a directional relationship between the concepts of diabetes knowledge, self-efficacy, social support, self-management, and the outcome, glycemic control. Method: A convenience sample of 259 Qataris with type II diabetes mellitus were recruited from Hamad Medical Corporation’s outpatient clinics and Home Healthcare Services (HHCS) in Qatar. Using a cross-sectional correlational design, correlation/regression coefficient tests were used to examine the relationships among these variables and their effect on the dependent variable, glycemic control. Participants responded to a set of questionnaires independently, via telephone, or in-person interviews. The following instruments were used: the Diabetes Knowledge Test (DKT), Self-Efficacy for Diabetes (SED) scale, Social Support by Medical Outcomes Study (MOS), the Self-Management Profile for Type 2 Diabetes (SMP-T2D), and the patients' glycemic control was measured by glycosylated haemoglobin (HbA1c). The collected data were entered into a computer database and patient confidentiality was strictly maintained. Pearson correlation coefficients, multiple, and hierarchical multiple regression were used to analyze the relationships among the variable; in addition, the mediating effect of self-efficacy, and the moderating effect of social support were tested. Results: The study sample’s age averaged 50.7 years (SD=13.0). The duration of diabetes averaged 9.30 years (SD=8.1); the average blood glucose was 176.8 mg/dl (SD= 77.8), and the average HbA1c was 8.6% (SD= 2.2). There was no relationship between diabetes knowledge, self-efficacy, social support, self-management and glycemic control for adult Qataris with type 2 diabetes. Furthermore, self-efficacy did not mediate the relationship between diabetes knowledge and self-management, nor did social support moderate the relationship between self-management and HbA1c. Conclusion: No relationships were found in this sample of Qatari older adults with type 2 diabetes. Future research is needed with larger samples to examine how these and other cultural factors explain glycemic control in this population.

Book Self Management of Type 2 Diabetes in Appalachina Women

Download or read book Self Management of Type 2 Diabetes in Appalachina Women written by and published by . This book was released on 2007 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Gender, minority, and regional-related disparities have been documented in diabetes management. Self-efficacy, the belief in one's ability to carry out the actions mandated by a task, has been identified as a key predictor in glycemic control; however, it has not been investigated in rural, female populations. This crosssectional, correlation investigation examined the relationships among self-efficacy, depression, and diabetes self-care management in women living in Appalachia with type 2 diabetes. Using Banduraâs Social Cognitive Theory, 85 women ages âÆ 21 with type 2 diabetes for a minimum of 6 months who were residents in Appalachia completed the 1) Diabetes Self-Efficacy Scale, 2) Beck Depression Inventory-II, 3)Summary of Diabetes Self-Care Activities, and a 4) Diabetes Health-Related Demographics tool. Descriptive statistics detailed the sample characteristics. ANOVA, chi-square, and independent ttests were computed for between group differences as they related to depression, various physiologic states, presence of self-efficacy sources, and glycosylated hemoglobin. Pearson correlation coefficients were used to describe the relationships between selfefficacy, depression, and self-care management. Multiple linear regression analyses examined prediction models for glucose control while controlling for potential confounders. Eighty-four Caucasian and one African-American enrolled in the study with a mean age of 61. The mean time since diabetes diagnosis was 7 years with a mean glycosylated hemoglobin value of 6.9% (SD=1.3). Higher self-efficacy scores were associated with a lower glycosylated hemoglobin (r-.30, p=.005) and ability to choose foods best to maintain a healthy eating plan(r-.415, p=.001). The sources of self-efficacy associated with enhanced self-care management were mastery experience and vicarious experience. There were no significant relationships between self-efficacy and depression or depression and glycosylated hemoglobin. The diabetes self-c.

Book Impact of Social Support  Self efficacy  and Outcome Expectations on Self care Behaviors and Glycemic Control in Caucasian and African American Adults with Type 2 Diabetes Mellitus

Download or read book Impact of Social Support Self efficacy and Outcome Expectations on Self care Behaviors and Glycemic Control in Caucasian and African American Adults with Type 2 Diabetes Mellitus written by Diane Orr Chlebowy and published by . This book was released on 2002 with total page 390 pages. Available in PDF, EPUB and Kindle. Book excerpt: Abstract: Caucasians and African-Americans with type 2 diabetes continue to experience preventable diabetes-related life-threatening complications despite medical advances and health care availability. African-Americans are more likely to suffer from diabetes-related complications and experience a higher diabetes-related mortality rate than Caucasians. There is a definite need to better understand the relationship of psychosocial variables to diabetes control in these two racial groups. The purpose of this two-group, comparative, descriptive study was to examine the relationships of social support, self-efficacy, and outcome expectations (beliefs that diabetes-related behaviors will lead to certain outcomes) to self-care behaviors and glycemic control in Caucasian and African-American adults with type 2 diabetes. A convenience sample of 91 Caucasian and African-American subjects receiving health care at three outpatient facilities participated in the study. All subjects completed four self-report measures: Social Support Questionnaire, Self-Efficacy Questionnaire, Outcome Expectancy Questionnaire, and the Diabetes Activities Questionnaire at the time of the outpatient visit. Long-term glycemic control was assessed by glycosylated hemoglobin analyses at the time of the outpatient visit. Two-sample t-tests revealed no significant differences between the two racial groups in regards to age (p = .81), duration of diabetes (p = .69), and glycosylated hemoglobin (p = .85). Chi-square analyses revealed two significant differences between the two racial groups with regard to sex (p = .04) and marital status (p

Book Psychosocial Care for People with Diabetes

Download or read book Psychosocial Care for People with Diabetes written by Deborah Young-Hyman and published by American Diabetes Association. This book was released on 2012-12-25 with total page 330 pages. Available in PDF, EPUB and Kindle. Book excerpt: Psychosocial Care for People with Diabetes describes the major psychosocial issues which impact living with and self-management of diabetes and its related diseases, and provides treatment recommendations based on proven interventions and expert opinion. The book is comprehensive and provides the practitioner with guidelines to access and prescribe treatment for psychosocial problems commonly associated with living with diabetes.

Book Self efficacy and Social Support as Predictors of Diabetic Self care

Download or read book Self efficacy and Social Support as Predictors of Diabetic Self care written by Mary Katherine Crabtree and published by . This book was released on 1986 with total page 272 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Book Relationship Among Religious Coping  Psychosocial Factors  and Quality of Life in Individuals with Type 2 Diabetes

Download or read book Relationship Among Religious Coping Psychosocial Factors and Quality of Life in Individuals with Type 2 Diabetes written by Julia M. Lager and published by . This book was released on 2010 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: The purpose of this study was to examine the relationship among religious coping, acceptance of diabetes, social support, diabetes management, and quality of life among individuals with type 2 diabetes (T2DM). Religious coping, acceptance of diabetes, and social support were hypothesized to encourage adherence to self - management behaviors thus enhancing quality of life. A convenience sample of 247 T2DM patients was recruited from local churches, clinics, a diabetes support group, and a diabetes education class. Participants completed a 10-page survey comprising the following reliable and valid scales: Religious Problem Solving Scale-Short Form, Ideas About Diabetes-Revised Scale (IAD-R), the PRQ2000, the Religious Support Scale, Summary of Diabetes Self-Care Activities-Revised, and the Diabetes Quality of Life Measure. The mean age of the respondents was 54 years, with the majority being female (68%), Caucasian (53%), and of Protestant religious affiliation (58%). Gender and ethnic differences were found for religious coping, acceptance of diabetes, and selfmanagement behaviors. African Americans and women were more religious and used more religious coping. African Americans also felt more inhibited by diabetes and women were more likely to regularly examine their feet. Gender, general social support, and feeling less inhibited by diabetes (subscale of acceptance) were significant predictors of quality of life in the multivariate (regression) analysis (F (19, 219) = 7.777, p

Book The Relationships Between Mindfulness  Diabetes related Distress  Selected Demographic Variables  and Self management in Adults with Type 2 Diabetes

Download or read book The Relationships Between Mindfulness Diabetes related Distress Selected Demographic Variables and Self management in Adults with Type 2 Diabetes written by Jennifer Bell Brown and published by . This book was released on 2014 with total page 304 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Type 2 diabetes is a disease of worldwide scope and epidemic proportion. Two hundred and eighty-five million individuals have been diagnosed worldwide--a number expected to rise to 330 million by 2025 (Unwin, Whiting, & Roglic, 2010) and to 366 million by 2030 (Adriaanse et al., 2008). It is estimated that 18.8 million diagnosed and 7.0 million undiagnosed Americans have type 2 diabetes, numbers expected to rise to a total of 48.3 million by 2050 (Centers for Disease Control [CDC], 2011; Geiss & Cowie, 2011; Narayan, Williams, Gregg, & Cowie 2011). A recent American Diabetes Association (ADA) report estimated that the total costs of diabetes related health care rose from $174 billion in 2007 to $245 billion in 2012--figures that underscore the significant social costs associated with the disease (ADA, 2013). The considerable personal, social, and financial tolls of type 2 diabetes make effective self-management imperative./DISS_para Diabetes-related distress (DRD) and mindfulness are two variables that are believed to significantly impact effective diabetes self-management yet more research is needed to better understand and empirically confirm these relationships. DRD is characterized by the negative emotional reactions to the diabetes diagnosis, threat of complications, self-management demands, and unsupportive interpersonal relationships (Polonsky et al., 1995, 2005; Gonzalez, Fisher, & Polonsky, 2011). Recent studies indicate the relevance of mindfulness, the mindfulness components of awareness and acceptance, and the use of mindfulness-based interventions to enhance the self-management behaviors of individuals with type 2 diabetes (Gregg, Callaghan, Hayes, & Glenn-Lawson, 2007; Hernandez, Bradish, Rodger, & Rybansky, 1999; Ingadottir & Halldorsdottir, 2008). However, to date the literature is incomplete in drawing an explicit connection between mindfulness, diabetes-related distress, and diabetes self-management. This study was designed to address this gap in the literature. The prevalence of type 2 diabetes, its related debilitating conditions (e.g., cardiovascular disease, vascular dementia, kidney disease, and diabetic retinopathy), and mental health implications, make the exploration of self-management pathways imperative so that counselors and counselor educators may develop a greater understanding of the type 2 diabetes condition and appropriate counseling approaches. Greater understanding of the mechanisms to better diabetes self-management, with mindfulness as the theoretical foundation, may pave the way for improved prevention and intervention efforts among health care and mental health professionals. DISS_para The results of the current study indicated that mindfulness is a statistically significant predictor of self-management. Further, the results indicated social support as a significant predictor of self-management. The results suggest the potential value of the clinical application of mindfulness-based interventions with the type 2 diabetes population and continued development of resources that provide positive social support for the millions of people who are affected by this disease."--Abstract from author supplied metadata.

Book Stigma  Self efficacy  and Adherence Behaviors in People with Type 2 Diabetes

Download or read book Stigma Self efficacy and Adherence Behaviors in People with Type 2 Diabetes written by Annie N. Laweryson and published by . This book was released on 2020 with total page 266 pages. Available in PDF, EPUB and Kindle. Book excerpt: Type 2 diabetes mellitus is a health condition treated with behavioral modifications including changes in diet, exercise, foot care regimens, and medication. Stigma associated with type 2 diabetes negatively effects health outcomes, whereas patient-provider relationships positively affects health outcomes. The growing literature base on type 2 diabetes stigma and health outcomes is mostly conducted outside of the United States. The present study used online crowdsourcing methods to gather cross-sectional survey data from people (n=152) who have been diagnosed with type 2 diabetes and are living in the United States. Participants completed the survey battery measuring stigma, self-efficacy, patientprovider relationships, and health behaviors. It was predicted that 1) internalized stigma would have a negative impact on self-care behaviors including diet, exercise, foot care, and medication adherence as well as glycated hemoglobin [HbA1C] levels 2) self-efficacy would mediate each of those relationships, and 3) the patient-provider relationship, characterized by trust in providers would moderate the relationship between stigma and self-efficacy thus indirectly moderating self-care behaviors and HbA1C. To test these hypotheses, a set of five moderated-mediation analysis were conducted to test each outcome variable of diet, exercise, foot care, medication adherence, and HbA1C. Main findings of this study revealed paradoxical relationships between stigma, self efficacy, and trust in providers, although consistent with psychological reactance theory. Stigma was associated with medication non-adherence and worse HbA1C, which is consistent with literature. Results of this study suggest that patients who exhibit psychological reactance may struggle to adhere to recommendations despite being more likely to report that everything is okay. This dynamic may make it difficult for providers to accurately gauge patient engagement in care, ability, or progress in health behavior change. However, one could argue responding to stigma with reactance may be protective in other ways. There was some evidence to suggest providers can attend to reactance by attuning to trust within the patient-provider relationship. In summary, this study adds to the pool of literature on stigma and type 2 diabetes, specifically within the US which is important considering variances in social climates and health care systems across nations. Future research should corroborate our suppositions about the relationships between stigma, self-efficacy, and psychological reactance.

Book Cumulated Index Medicus

Download or read book Cumulated Index Medicus written by and published by . This book was released on 1994 with total page 1496 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Book The Relationship of Depression and Tangible Social Support on the Self efficacy of an Elderly Puerto Rican Diabetic Population

Download or read book The Relationship of Depression and Tangible Social Support on the Self efficacy of an Elderly Puerto Rican Diabetic Population written by Maren Jill Coffman and published by . This book was released on 2005 with total page 408 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Book Communities in Action

    Book Details:
  • Author : National Academies of Sciences, Engineering, and Medicine
  • Publisher : National Academies Press
  • Release : 2017-04-27
  • ISBN : 0309452961
  • Pages : 583 pages

Download or read book Communities in Action written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2017-04-27 with total page 583 pages. Available in PDF, EPUB and Kindle. Book excerpt: In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.

Book Social Support  Social Problem Solving and Adherence To Self Glucose Monitoring in Type 2 Diabetes

Download or read book Social Support Social Problem Solving and Adherence To Self Glucose Monitoring in Type 2 Diabetes written by Barbara M. Holdren and published by . This book was released on 2016 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background and Significance: Type 2 diabetes is one of the fastest growing chronic diseases in the United States affecting one in four adults ages 65 and older. Proper disease management is crucial. It involves not only technical skills, but social support and social problem-solving abilities to prevent barriers to regimen adherence. However, the impact of social support and social problem-solving on adherence is not well understood. The purpose of this study is to examine the relationships of social support and social problem-solving to adherence in adults with type 2 diabetes. Methods: A cross-sectional, descriptive, correlation design was used. One hundred and one patients participated in the study. Social support was measured using the Social Support Scale for Self-Care in Middle-Aged Patients with Type 2 Diabetes (S4-MAD). Problem solving was measured using the Social Problem-Solving Inventory-Revised Short Form (SPSI-R:S). Adherence was measured by calculating the average blood glucose over seven days as recorded in the glucometer. Descriptive statistics and multiple regression analyses were used to analyze the data. Results: H1 was supported. The findings showed that there was a significant relationship (rho= -0.32; p=0.001) between social support and S4MAD nutrition subscale; 4% of the variance in adherence was accounted for by social support in the nutrition subscale. H2 was not supported. Specifically, there was no significant relationship (rho=-0.20; p=0.41) between problem solving and adherence. Less than 1 % of the variance in adherence was accounted for by problem solving. H3 was not supported. There was no significant interaction between social support and problem solving on adherence. Conclusion: This study suggests that there are other domains that need to be examined as predictors of adherence to blood glucose monitoring among adult diabetic patients.

Book Effects of a Peer led Educational Intervention on Support Resources  Self effcacy  Depression  Beliefs  and Self management Behaviors in Latinos with Type 2 Diabetes

Download or read book Effects of a Peer led Educational Intervention on Support Resources Self effcacy Depression Beliefs and Self management Behaviors in Latinos with Type 2 Diabetes written by and published by . This book was released on 2013 with total page 47 pages. Available in PDF, EPUB and Kindle. Book excerpt: Type 2 diabetes mellitus (T2DM) affects roughly 20 million individuals in the US and this amount is projected to more than double by the year 2034. Latinos are at disproportionately greater risk for developing T2DM and often exhibit poorer adherence to diabetes self-management recommendations, and in turn, worse glycemic control and more diabetes-related complications, compared to non-Latino Whites. Project Dulce was a randomized controlled trial to investigate the effects of a peer-educator led, culturally-appropriate intervention designed to improve diabetes self-management and glycemic control among Latinos with poorly controlled diabetes. The current project investigated the effects of the Project Dulce intervention on diabetes self-management behavior, support resources, self-efficacy, depressive symptomatology, and culture-based beliefs about diabetes, using the Resources and Supports for Self-Management (RSSM) as a conceptual framework. Study participants (N = 207) completed clinical and self-report assessments at baseline, post-intervention (4 months), and follow-up (10 months). Study hypotheses were evaluated via multi-level models using Hierarchical Linear Modeling (HLM) 6.08. The study aimed to assess whether the Project Dulce peer-education group exhibited greater improvements over time in diabetes self-management behaviors, depressive symptoms, support resources for disease management and self-efficacy, as well as culture-based beliefs about diabetes, compared to the control ("care as usual") group. An exploratory aim of the study investigated whether "dosage" (i.e., classes attended) was associated with greater improvements in the Project Dulce intervention group. Analyses revealed improvements in dietary self-management behaviors, depressive symptomatology, self-efficacy, culture-based beliefs about diabetes, support resources for disease management (i.e., friends and family, healthcare providers, neighborhood, and personal support), and self-efficacy, over time, across groups. Analyses also revealed that Project Dulce group participants showed greater improvements in personal support resources for disease management and endorsed fewer culture-based beliefs about diabetes over time, compared to the control group. Furthermore, "dosage" (attendance) analyses, including only Project Dulce group participants, revealed that greater dosage (i.e., attending more sessions) led to greater improvements over time in support resources for disease management (self and neighborhood support), as well as exercise and blood-glucose checking self-management behaviors, compared to those who attended fewer classes. Although analyses revealed that Project Dulce group participants showed improvements over time with increased attendance, this was not significantly greater than improvements experienced by the control group. Possible explanations for improvements in the control group may relate to participants' motivation for change, or contact with the peer-educator during assessments which may have conveyed support or may have created expectancy effects (i.e., "social desirability effects") leading to biased self-report responding. Findings from "Dosage" analyses (including Project Dulce group participants only) indicate that individuals with type 2 diabetes who enroll in the Project Dulce intervention and attend more classes may experience greater support resources from their neighborhood and self-support, which may lead to improved self-management behavior, compared to individuals who attend fewer classes. Distinction of assessor and interventionist roles, and use of objective behavioral data collection methods, may shed light on the degree to which interventions such as Project Dulce can modify health behavior among this high-risk population.