Validation of the self-care utility geriatric African American rating (SUGAAR) for type 2 diabetes
The primary purpose of this study was to further develop the SUGAAR, an instrument designed to assess the self-care practices of older African American with type 2 diabetes. The instrument was initiated as a project for a research class and was further assessed, modified, and administered for this dissertation study. The secondary purpose of this study was to draw preliminary conclusions about diabetes self-care, health and functional status of a sample of community-dwelling African Americans 65 years and older with a self-reported diagnosis of type 2 diabetes. Purposive sampling was used to recruit 125 older African Americans across five counties in Alabama. Participants were interviewed in their homes or at a private location of their choosing. Regarding the development of the instrument, findings from the cognitive interviews, pilot test, and earlier developmental work provided support for the face validity and content validity of the SUGAAR. The results from the KR-20 indicate that participants' diabetes self-care is not a unidimensional concept. The results from the factor analysis did not support a stable factor structure for the SUGAAR. The inability to identify multidimensionality in the instrument may indicate that individuals with type 2 diabetes may not accomplish self-care practices in the same clusters of practices that make sense to health care practitioners and researchers. However, findings indicate content and convergent validity of the SUGAAR, which suggests it is a valid checklist for use among African Americans 65 years and older. Regarding diabetes self-care, findings suggest differences between age groups regarding diabetes self-care. Middle-old participants are engaging in more diabetes self-care compared to the youngest-old participants, which supports a trend in the data that suggests participants 75 to 84 years old are healthier than participants 65 to 74 years, except regarding the use or ownership of supportive devices. Overall, participants are receiving messages about the importance of diabetes self-care and health in late life, which they are trying to put into practice.