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Association of perceived stigma with glycemic control in youth and young adults with type 1 diabetes in Rwanda

Andrews, Haylee (2017) Association of perceived stigma with glycemic control in youth and young adults with type 1 diabetes in Rwanda. Master Essay, University of Pittsburgh.

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Background: Research suggests that stigma may affect the management of glycemic control in people with diabetes. The aim of this study was to evaluate perceived stigma among youth and young adults with type 1 diabetes (T1D) who are current or past recipients of care from the Life for a Child (LFAC) program. We hypothesized that perceived stigma differs by glycemic control, age, duration of type 1 diabetes, sex, and vocational center attendance.

Methods: Hospitals with pools of former vocational center attendees were targeted for participant recruitment. Research staff administered a 25–item adapted version of the Berger HIV Stigma Scale. Higher scores indicate more stigma. Scores were summarized using median (IQR). The association between perceived stigma and glucose control were assessed by both Spearman’s correlation coefficient and a Wilcoxon rank sum test. Perceived stigma scores were compared according to age and duration of diabetes, using Spearman’s correlation coefficient, and according to groups defined by sex and vocational center attendance using Wilcoxon rank sum tests.

Results: All 54 (24 current, 30 former) approached LFAC participants completed the questionnaire. Ages ranged from 15-32 years; 31(57%) female. Stigma scores ranged from 48-83(median=64,IQR:55-67) and were weakly correlated with HbA1c(rs=0.31,p=0.11). Those with adequate glycemic control did not differ in terms of perceived stigma from those with poor glycemic control (p=0.25). Perceived stigma did not correlate significantly with age(rs=-0.21,p=0.14) or duration of diabetes(rs=-0.23,p=0.1). However, median scores were lower in males (56, IQR=53-66) than females(66,IQR=58-69; p=0.01). Median scores were higher in former center attendees than non-attendees(66, IQR=62-69 and 54, IQR=52-62, respectively)(p< 0.01).

Conclusion: Previous research employed qualitative methods to capture stigma in patients with T1D. Ours, we believe, is the first to examine perceived stigma of T1D quantitatively. Our results show that perceived stigma only weakly correlates with glycemic control, but they also confirm the hypothesis that females perceive a greater amount of stigma than males. However, our adapted stigma scale is not validated for this population.

Public health significance: Our findings of differences in perceived stigma by sex and vocational center attendance should help inform future interventions to improve psychological well being and self-management of T1D.


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Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Andrews, Hayleehaa75@pitt.eduhaa75
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairCloonan, Yona Keichcloonany@edc.pitt.eduUNSPECIFIEDUNSPECIFIED
Committee MemberOrchard, Trevor J.orchardt@edc.pitt.eduUNSPECIFIEDUNSPECIFIED
Committee MemberFinegold, David N.dnf@pitt.eduUNSPECIFIEDUNSPECIFIED
Date: 21 April 2017
Date Type: Completion
Number of Pages: 50
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Epidemiology
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Date Deposited: 12 Jul 2017 21:01
Last Modified: 12 Jul 2017 21:01


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