Hosler Akiko S, Melnik Thomas A
The Bureau of Chronic Disease Epidemiology and Surveillance, New York State Department of Health, Albany (Dr Hosler, Dr Melnik)
The Department of Epidemiology, University at Albany School of Public Health, Rensselaer, New York (Dr Hosler)
Diabetes Educ. 2005 May-Jun;31(3):418-26. doi: 10.1177/0145721705276580.
The purpose of this study was to assess the status of diabetes medical care and self-management among adult Puerto Ricans in New York City.
A random-digit-dialing telephone survey with a dual-frame sampling design was employed to obtain a probability sample of adult Puerto Ricans with diagnosed diabetes (n = 606). Demographic characteristics, health status, and indicators of diabetes medical care and self-management were collected using the standard Behavioral Risk Factor Surveillance System (BRFSS) questionnaire. A statewide sample of adults with diagnosed diabetes (n = 232) was obtained from the BRFSS for comparison.
Compared to New York State adults, Puerto Ricans were significantly less likely to receive annual A1C testing (72.7% vs 84.9%), cholesterol testing (67.5% vs 87.2%), blood-pressure-lowering medication (82.4% vs 91.9%), and pneumococcal vaccination (19.3% vs 28.5%, among those aged 18 to 64 years). Puerto Ricans were also less likely to take aspirin every day or every other day to prevent cardiovascular complications (30.6% vs 40.7%). Puerto Ricans were younger and more likely to have lower educational attainment and lower income than New York State adults, but they were not significantly disadvantaged in access to health care indicated by rates of health insurance coverage, having a particular place for medical care, and frequencies of seeing a provider for diabetes.
These findings support the need to introduce culturally sensitive and linguistically appropriate diabetes education programs for Puerto Ricans and continue system-based diabetes care quality improvement efforts in the areas of prevention and control of cardiovascular complications, adult immunization, and A1C testing.
本研究旨在评估纽约市成年波多黎各人的糖尿病医疗护理及自我管理状况。
采用双框架抽样设计的随机数字拨号电话调查，以获取确诊糖尿病的成年波多黎各人的概率样本（n = 606）。使用标准的行为危险因素监测系统（BRFSS）问卷收集人口统计学特征、健康状况以及糖尿病医疗护理和自我管理指标。从BRFSS中获取全州确诊糖尿病成年人的样本（n = 232）用于比较。
与纽约州成年人相比，波多黎各人接受年度糖化血红蛋白（A1C）检测（72.7% 对 84.9%）、胆固醇检测（67.5% 对 87.2%）、降血压药物治疗（82.4% 对 91.9%）以及肺炎球菌疫苗接种（18至64岁人群中为19.3% 对 28.5%）的可能性显著更低。波多黎各人每天或隔天服用阿司匹林以预防心血管并发症的可能性也更低（30.6% 对 40.7%）。波多黎各人比纽约州成年人更年轻，受教育程度和收入更低，但在医疗保险覆盖率、有特定医疗场所及看糖尿病专科医生的频率等方面所显示的获得医疗保健的机会上，他们并未处于明显劣势。
这些研究结果表明，有必要为波多黎各人引入具有文化敏感性和语言适宜性的糖尿病教育项目，并继续在心血管并发症预防与控制、成人免疫接种以及A1C检测等领域开展基于系统的糖尿病护理质量改进工作。
