Sociodemographic Factors Associated With Engagement in Diabetes Self-management Education Among People With Diabetes in the United States

被引:49
作者
Boakye, Eric Adjei [1 ]
Varble, Amanda [2 ]
Rojek, Rebecca [2 ]
Peavler, Olivia [3 ]
Trainer, Anna K. [2 ]
Osazuwa-Peters, Nosayaba [2 ,4 ,5 ]
Hinyard, Leslie [1 ]
机构
[1] St Louis Univ, Ctr Hlth Outcomes Res, 3545 Lafayette Ave,Salus Ctr 4th Floor, St Louis, MO 63104 USA
[2] St Louis Univ, Coll Publ Hlth & Social Justice, Dept Epidemiol, St Louis, MO 63103 USA
[3] St Louis Univ, Dept Hlth Management & Policy, Coll Publ Hlth & Social Justice, St Louis, MO 63103 USA
[4] St Louis Univ, Dept Otolaryngol Head & Neck Surg, Sch Med, St Louis, MO 63103 USA
[5] St Louis Univ, Canc Ctr, St Louis, MO 63103 USA
关键词
type; 2; diabetes; diabetes education; socioeconomic status; demographics; diabetes self-management; PROGRAM;
D O I
10.1177/0033354918794935
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Objective: Research outside the United States shows that certain subgroups of patients (eg, those who are older, male, of low socioeconomic status, and uninsured) are less likely than others to report receiving diabetes self-management education (DSME); however, less is known about DSME uptake in the United States. We examined sociodemographic, patient, and behavioral characteristics associated with DSME in a nationally representative sample. Methods: We analyzed data from the 2011-2013 Behavioral Risk Factor Surveillance System for 84 179 adults who self-identified receiving a diagnosis of diabetes. We constructed weighted, multivariate logistic regression models to examine the associations between DSME and sociodemographic characteristics (age, sex, race/ethnicity, marital status, education, and annual household income), patient characteristics (body mass index, having a regular provider, health insurance status, health status, and insulin use), and self-management behaviors (home foot examination, home blood glucose testing, and physical activity). Results: More than half (n = 45 557, 53.7% [weighted]) of respondents reported engaging in DSME. Compared with non-Hispanic white adults, non-Hispanic black adults were more likely to engage in DSME (adjusted odds ratio [aOR] = 1.17; 95% confidence interval [CI], 1.07-1.29). Respondents were less likely to engage in DSME if they were male (aOR = 0.85; 95% CI, 0.80-0.91) or Hispanic (aOR = 0.81; 95% CI, 0.71-0.92), were a high school graduate (but no college; aOR = 0.71; 95% CI, 0.66-0.78) or less than a high school graduate (aOR = 0.51; 95% CI, 0.45-0.59), had an annual household income of $15 000-$24 999 (aOR = 0.81; 95% CI, 0.73-0.89) or <$15 000 (aOR = 0.70; 95% CI, 0.62-0.78), or had no health insurance (aOR = 0.87; 95% CI, 0.76-0.98). DSME was significantly associated with all 3 self-management behaviors. Conclusions: Increasing public health interventions aimed at educating people with diabetes about self-management could improve outcomes.
引用
收藏
页码:685 / 691
页数:7
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