Psychosocial and Demographic Factors That Influence HbA1c Testing Frequency in Diabetics: Data From the 2018 Behavioral and Risk Factor Surveillance Survey (BRFSS)

Background HbA1c testing is an essential measure of glycemic control in diabetic patients. This study aims to determine the social and psychological determinants that have a role in the frequency of HbA1c testing in diabetics.Methods We used data from the Behavior and Risk Factor Surveillance Survey to develop a hierarchical linear regression model to examine associations between annual HbA1c testing frequency and the following types of variables: demographics, socioeconomic factors (SES), living environment, healthcare access, psychosocial factors, clinical factors, and diabetes self-care and knowledge. Results The study included 18,505 diabetics from the BRFSS 2018 dataset with a mean age of 61.2 years. There were significant associations between age, gender, race, insurance status, SES, healthcare access, psychosocial factors, and HbA1c testing frequency. Being American Indian or Alaskan Native was associated with increased HbA1c testing frequency compared to Whites, and non-Hispanics. Higher education/income was associated with increased HbA1c testing frequency. Regular doctor visits for diabetes were associated with increased HbA1c testing frequency. Conclusions In our analysis of a national survey, income, education level, and diabetes-specific care variables were significantly associated with the frequency of HbA1c testing. These results help identify patient groups that need more attention in managing diabetes, including the use of HbA1c testing.