Dataset Information

Factors affecting screening for diabetic complications in the community: a multilevel analysis.

ABSTRACT:

Objectives

The objective of the present study was to identify the factors that affect screening for diabetic complications by sex in the community.

Methods

This study used individual-level data from the 2013 Community Health Survey (CHS) for 20,806 (male, 9,958; female, 10,848) adults aged 30 years or older who were diagnosed with diabetes. Community-level data for 253 communities were derived from either CHS or national statistics. A chi-square test and multilevel logistic regression analysis was performed.

Results

There were significant differences in the rate of screening for diabetic complications according to individual-level and community-level variables. In the multilevel analysis, the community-level variance ratio of the null model was 7.4% and 9.2% for males and females, respectively. With regard to community-level variables, males were affected by the city type, number of physicians, and their living environment, while females were affected by number of physicians, natural and living environments, and public transportation.

Conclusions

The factors that influenced individual willingness to undergo screening for diabetic complications differed slightly by sex; however, both males and females were more likely to undergo screening when they recognized their health status as poor or when they actively sought to manage their health conditions. Moreover, in terms of community-level variables, both males and females were affected by the number of physicians. It is essential to provide sufficient and ongoing opportunities for education on diabetes and its management through collaboration with local communities and primary care medical centers.

SUBMITTER: Han JA

PROVIDER: S-EPMC4914545 | biostudies-literature | 2016

REPOSITORIES: biostudies-literature

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Publications

Factors affecting screening for diabetic complications in the community: a multilevel analysis.

Han Jin A JA Kim Soo Jeong SJ Kim Gawon G Kim Eun Ji EJ Lee Soon Young SY

Epidemiology and health 20160503

<h4>Objectives</h4>The objective of the present study was to identify the factors that affect screening for diabetic complications by sex in the community.<h4>Methods</h4>This study used individual-level data from the 2013 Community Health Survey (CHS) for 20,806 (male, 9,958; female, 10,848) adults aged 30 years or older who were diagnosed with diabetes. Community-level data for 253 communities were derived from either CHS or national statistics. A chi-square test and multilevel logistic regres ...[more]

PMID: 27156347

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Project description:BackgroundThis study is aimed to analyze the prognostic factors affecting the short-term efficacy of non-surgical treatment of patients in periodontitis from stage II to stage IV by the multilevel modeling analysis.Materials and methodsA total of 58 patients with chronic periodontitis were included in this study. Patients were clinically explored before and 3 months after the treatment and the difference in probing depth was determined [Reduction of probing depth (Δ PD) = baseline PD - finial probing depth (FPD)] which is considered as the therapeutic evaluation. Three different levels were analyzed: patients, teeth and sites to construct a multi-layer linear model.ResultsProbing depth (PD) improved significantly compared with that before treatment (p < 0.05), in which FPD was (3.90 ± 1.39) mm, and the ΔPD was (1.79 ± 0.97) mm. Compared with the mesial sites and distal sites of the multi-rooted teeth, the number of PD ≥ 5 mm or PD < 5 mm after the treatment was significantly different (P < 0.05), and the proportion of PD < 5 mm was higher in mesial sites. The null model showed that Δ PD varied greatly between groups at various levels (P < 0.001), with prediction variable of site level, tooth level, and patient level accounted for 66%, 18%, and 16% of the overall difference, respectively. The complete model showed that the Δ PD of smokers was significantly lower than that of non-smokers (P < 0.001). The Δ PD of the mesial and distal sites was larger than that of the buccolingual central site (P < 0.001). The Δ PD of single-rooted teeth was larger than that of multi-rooted teeth (P < 0.001). The baseline PD, tooth mobility (TM), bleeding index (BI), clinical attachment loss (CAL) were significantly negatively correlated with Δ PD (P < 0.001).ConclusionsPatients with periodontitis from stage II to stage IV, who were non-smoking, have good compliance, good awareness of oral health, and low percentage sites with PD ≥ 5 mm at baseline, single-rooted teeth with hypomobility, less clinical attachment loss and lower bleeding index and sites of mesial or distal can obtain an ideal short-term efficacy of non-surgical treatment.

Project description:This study examined the practices, personal motivation, and barriers of African American communities in Mississippi regarding their dietary practices. We selected the Metro Jackson Area comprised of Hinds, Madison and Rankin Counties because it is a combination of urban and rural communities. The sample consisted of 70 participants from seven sites. A total of seven focus groups responded to six questions to assess practices, personal motivation, and barriers to dietary practices: (1) Where in your community can you access fresh fruits and vegetables? (2) How many meals a day should a person eat? (3) What would you consider to be a healthy breakfast, lunch and dinner? (4) What would you consider to be a healthy snack? (5) What do you consider to be your motivations for eating healthy? (6) What do you consider to be your barriers to eating healthy? Each of the seven focus groups consisted of 6 to 12 participants and provided details of their dietary practices. The focus group interviews were digitally-recorded. The recorded interviews were transcribed. The majority of the participants stated that there is a limited availability of fresh fruits/vegetables in rural areas because of a shortage of grocery stores. When they do find fruits, they are priced very high and are unaffordable. Even though health conditions dictate food frequency and portion size, community members feel that individuals should eat three good balanced meals per day with snacks, and they should adhere to small portion sizes. While the desire to attain overall good health and eliminate associative risks for heart disease (e.g., diabetes, obesity) are personal motivations, the cost of food, transportation, age, and time required for food preparation were seen as barriers to healthy eating. Decisions regarding meal choice and meal frequency can have an impact on long-term health outcomes. Health promotion programs should become an integral part of academic- community collaborative agreements.

Dataset Information

Factors affecting screening for diabetic complications in the community: a multilevel analysis.

Objectives

Methods

Results

Conclusions

Publications

Factors affecting screening for diabetic complications in the community: a multilevel analysis.

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