Greater conceptual distinction between fatalism as a cultural value orientation (general fatalism) and disease-specific fatalism is necessary to evaluate fatalism as a predictor of health behaviors such as diabetes treatment adherence. We tested an integrated, theory-driven structural model of relationships among income, education, age, gender, general fatalism, diabetes fatalism, and type 2 diabetes treatment adherence, as measured by hemoglobin a1c levels (hba1c), in a sample of mainstream-Chileans (n=229) and indigenous people of Chile known as the Mapuche (n=134). Hypotheses were that higher income and education would predict more general fatalism and diabetes fatalism across ethnic groups and higher general fatalism would indirectly predict higher hba1c through diabetes fatalism. Multi-group structural equation modeling comparing ethnic groups revealed excellent fit of models (Mapuche: CFI = .995, χ2 (24, n = 229) = 27.26, p =.29, χ2/df = 1.14, RMSEA = .024, 90% CI (.000, .061), R2= 0.148; mainstream-Chilean: CFI = 1.000, χ2 (24, n = 134) = 22.15, p =.57, χ2/df = .92, RMSEA = .000, 90% CI (.000, .064), R2=0.043) and partial supported of study hypotheses. Fewer years of education significantly predicted general fatalism and lower income significantly predicted diabetes fatalism across ethnic groups. Higher general fatalism was a significant indirect predictor of hba1c through diabetes fatalism only for mainstream-Chileans. This study highlights the importance of measuring fatalism as a cultural value and disease-specific fatalism as antecedents of health behavior. Findings also underscore the necessity of studying how social structural factors influence health behavior through culture and disease-specific beliefs.
School of Behavioral Health
Betancourt, Hector M.
Flynn, Patricia M.
Morrell, Holly E. R.
Doctor of Philosophy (PhD)
Year Degree Awarded
Date (Title Page)
Library of Congress/MESH Subject Headings
Diabetes; Diabetes Mellitus; Health Behavior; Fate and fatalism - Psychological aspects; Cultural awareness - Chile; Educational Status;
Subject - Local
fatalism; Treatment adherence; Cultural Value Orientation; Disease-specific fatalism
Loma Linda University Libraries
This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.
Nuñez, Esmeralda Ibette, "General Fatalism and Diabetes Fatalism as Predictors of Diabetes Treatment Adherence" (2016). Loma Linda University Electronic Theses, Dissertations & Projects. 433.
Loma Linda University Electronic Theses and Dissertations
Loma Linda University. Del E. Webb Memorial Library. University Archives