Effect of neighborhood factors on diabetes self-care behaviors in adults with type 2 diabetes

Smalls, Brittany L.; Gregory, Chris; Zoller, James S.; Egede, Leonard E.

doi:10.1016/j.diabres.2014.09.029

Cited by 22 publications

(11 citation statements)

References 32 publications

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“…Participants in this study recognised that their health was compromised by difficult access to fresh food and easy access to fast food and, for some participants, the cost of engaging in formal exercise or fear of walking in the streets; all factors identified in previous research (Auchincloss et al., 2009; Giles‐Corti, 2002; Reidpath et al., 2002). In research examining the effect of neighbourhood factors on diabetes self‐care, researchers concluded that access to healthy foods had a statistically significant positive impact on diabetes self‐care however, neighbourhood violence and aesthetics did not (Smalls, Gregory, Zoller, & Egede, 2014).…”

Section: Discussion Of Findingsmentioning

confidence: 99%

Living with diabetes and disadvantage: A qualitative, geographical case study

Power

Kelly

Usher

et al. 2020

Journal of Clinical Nursing

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Aims and objectives To elucidate the experiences of people living with diabetes, residing in an urban diabetogenic area. Background Community‐level social and environmental factors have a role to play in the development of type 2 diabetes mellitus. Socio‐economic deprivation; high obesity rates; high access to fast foods; and multiculturalism contribute to higher rates of diabetes in some geographical areas. However, there is a lack of research examining people's experiences of living with diabetes in diabetogenic areas. The word diabetogenic implies that the phenomenon of interest contributes to the development of diabetes. Design Qualitative, geographical case study approach. Methods A convenience sample of 17 people living with diabetes in a diabetogenic, low‐socio‐economic urban area participated in face‐to‐face, semi‐structured interviews. Interviews were audio‐recorded, transcribed and analysed thematically. This paper adheres to the COREQ guidelines. Findings Four main themes were identified: 1. Diabetes fatalism: Inevitability and inertia; 2. Living with Inequity: Literacy and intersectionality; 3. Impersonal services: Intimidating and overwhelming; and, 4. Education in the community: Access and anecdotes. Conclusions This study has highlighted the need to develop local solutions for local problems. In this geographical area, solutions need to address generally lower health literacy, how the community would prefer to receive diabetes education and the issue of diabetes fatalism. Relevance to clinical practice Findings from this study have highlighted a need to re‐examine how diabetes education is delivered in communities that are already experiencing multiple disadvantages. There are research and practice connotations for how fatalism is positioned for people at high risk of developing diabetes.

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Section: Discussion Of Findingsmentioning

confidence: 99%

Living with diabetes and disadvantage: A qualitative, geographical case study

Power

Kelly

Usher

et al. 2020

Journal of Clinical Nursing

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show abstract

“…Providers state patients are unable to follow a diet or exercise program regularly but consider special diets and exercise very or extremely important processes; therefore, dietitians are one of the most common health professionals to whom primary care clinicians refer their patients [ 17 , 31 ]. A regular and balanced diet in conjunction with pharmacotherapy is fundamental for the treatment of diabetes [ 34 , 43 , 44 ].…”

Section: Discussionmentioning

confidence: 99%

Proportion of Brazilian diabetes patients that achieve treatment goals: implications for better quality of care

Baptista

Thieme

Reis

et al. 2015

Diabetol Metab Syndr

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BackgroundDiabetes and its complications are substantial causes of morbidity and mortality, and caused approximately 5.1 million deaths worldwide in 2013. Early detection and treatment of diabetes complications can prevent their progression.ObjectThis study compared the proportions of patients with type 1 and 2 diabetes mellitus (T1DM and T2DM, respectively) who achieved the goals of good clinical control.MethodsAdults and elderly patients with T1DM and T2DM at a public outpatient endocrinology service in Brazil were retrospectively evaluated between 2012 and 2013. Clinical and socio demographic data were obtained from medical records and evaluated in accordance with the Brazilian Diabetes Society Guidelines. Care process measures, outcomes indicators, and supporting process measures were evaluated.ResultsA total of 1031 records were analyzed: 29 and 71 % of patients had T1DM and T2DM, respectively. T2DM patients had significantly higher BMI than T1DM patients (overweight and obesity in 85.1 vs. 47.5 %, p < 0.01). The follow-up periods for diabetes and number of clinical visits to the endocrinology service were significantly greater among T1DM patients than T2DM patients (p < 0.01). However, T2DM patients required significantly more other (i.e., non-endocrinological) healthcare services (p < 0.01). HbA1c was significantly lower in T2DM patients (p < 0.01). Moreover, blood pressure and triglycerides were significantly higher in T2DM patients (p < 0.01), whereas total cholesterol and low-density lipoprotein were significantly lower in T2DM patients (p < 0.01). Only 0.5 % of the patients achieved all targets, and 1.1 % did not achieve any.ConclusionsThe achievement of goals of good clinical practice varies among the parameters evaluated. Almost no patients achieved all targets. Many patients are overweight and do not achieve targets for HbA1c, lipid profile, or blood pressure control.

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“…(52) An analysis that used latent variables in structural equation modeling found that access to healthy foods was significantly associated with diabetes self-care, while neighborhood aesthetics (walking environment, recreational facilities, neighborhood activities) and neighborhood violence (safety, crime, perceived problems) were not. (53) However, when considering glycemic control, neighborhood aesthetics did have a significant negative direct effect on A1c. (54) In this analysis, access to healthy foods did not have a direct effect on A1c, suggesting it exerts its greatest influence on self-management behaviors.…”

Section: Neighborhood Factors and Diabetesmentioning

confidence: 98%

Influence of Race, Ethnicity and Social Determinants of Health on Diabetes Outcomes

Walker

Williams

Egede

2016

The American Journal of the Medical Sciences

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335

202

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There is strong evidence that race/ethnicity and social determinants of health significantly impact outcomes for patients with diabetes. A better understanding of the mechanisms of these relationships/associations will improve development of cost-effective, culturally tailored programs for patients with diabetes. This article reviews the current state of the literature on the impact of race/ethnicity and social determinants of health on process of care, quality of care and outcomes for diabetes, with particular emphasis on the rural South to give an overview of the state of the literature. The literature review shows that racial/ethnic differences in the clinical outcomes for diabetes, including glycemic, blood pressure, and lipid control, continue to persist. In addition, the literature review shows that the role of social determinants of health on outcomes, and the possible role these determinants play in disparities have largely been ignored. Psychosocial factors, such as self-efficacy, depression, social support, and perceived stress, show consistent associations with self-care, quality of life, and glycemic control. Neighborhood factors, such as food insecurity, social cohesion, and neighborhood aesthetics have been associated with glycemic control. Perceived discrimination has also been associated with self-care and the psychological component of quality of life. Health care professionals need to be skilled in assessing social determinants of health and taking them into consideration in clinical care. In addition, more research is needed to identify the separate and combined impact of race/ethnicity and social determinants of health on process of care, quality of care and outcomes in diabetes, especially in the South, where the burden of disease is particularly high.

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Effect of neighborhood factors on diabetes self-care behaviors in adults with type 2 diabetes

Cited by 22 publications

References 32 publications

Living with diabetes and disadvantage: A qualitative, geographical case study

Living with diabetes and disadvantage: A qualitative, geographical case study

Proportion of Brazilian diabetes patients that achieve treatment goals: implications for better quality of care

Influence of Race, Ethnicity and Social Determinants of Health on Diabetes Outcomes

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