Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine , Miami, Florida , USA.
Department of Public Health Sciences , University of Miami Miller School of Medicine , Miami, Florida , USA.
BMJ Open Diabetes Res Care. 2016 Aug 10;4(1):e000236. doi: 10.1136/bmjdrc-2016-000236. eCollection 2016.
The objective of this study was to examine the prevalence and correlates of ocular screening adherence among select Hispanics/Latinos living with diabetes.
Data were obtained through an ancillary study of the Hispanic Community Health Study/Study of Latinos (Miami site). Participants included Hispanics/Latinos aged 40+ years who underwent a baseline examination/risk factor assessment (2008-2011) and then completed a survey on vision health/knowledge (conducted October 2011-September 2013; sample n=1235; diabetic subsample=264). The dependent variable was having a dilated eye examination within the past 12 months. Covariate candidate selection for entry into sequential multivariable logistic regression models was guided by Anderson's Behavioral Model of Health Services Use and the Behavioral Model for Vulnerable Populations.
Participants aged 65+ were more likely to have dilated eye examinations (OR 2.62, 95% CI 1.22 to 5.60) compared with those aged 40-54 years. Participants less likely to have dilated examinations had a high school degree or general educational development (GED) (OR 0.30, 95% CI 0.10 to 0.96, compared to no degree) and those currently uninsured or never insured ((OR 0.34, 95% CI 0.14 to 0.83) and (OR 0.19, 95% CI 0.07 to 0.51)) compared to those currently insured. Participants who heard or saw something about eye health from two or more sources (eg, media outlets, doctor's office, relatives/friends) compared to those who reported no sources in the past 12 months were more likely to have a dilated eye examination (OR 2.82, 95% CI 1.26 to 6.28).
Lack of health insurance is strongly associated with low screening uptake in Hispanics/Latinos living with diabetes. Health promotion strategies stressing the importance of annual dilated eye examinations and increasing sources of information on eye health are other potential strategies to increase screening uptake in Hispanics/Latinos.
本研究旨在调查特定患有糖尿病的西班牙裔/拉丁裔人群中眼部筛查的依从率及其相关因素。
数据来自西班牙裔社区健康研究/拉丁裔研究(迈阿密站点)的辅助研究。参与者包括年龄在 40 岁及以上、接受基线检查/风险因素评估(2008-2011 年),并随后于 2011 年 10 月至 2013 年 9 月完成关于视力健康/知识的调查(样本量为 1235 名;糖尿病亚组为 264 名)的西班牙裔/拉丁裔。因变量为在过去 12 个月内进行过散瞳检查。多变量逻辑回归模型的逐步进入的协变量候选选择由安德森健康服务使用行为模型和弱势群体行为模型指导。
与 40-54 岁年龄组相比,年龄在 65 岁及以上的参与者更有可能进行散瞳检查(OR 2.62,95%CI 1.22 至 5.60)。不太可能进行散瞳检查的参与者具有高中或普通教育发展程度(GED)(OR 0.30,95%CI 0.10 至 0.96,与无学位相比)和当前未投保或从未投保(OR 0.34,95%CI 0.14 至 0.83 和 OR 0.19,95%CI 0.07 至 0.51),与当前投保者相比。与过去 12 个月内没有来源的参与者相比,从两个或更多来源(如媒体、医生办公室、亲戚/朋友)听说或了解过眼部健康的参与者更有可能进行散瞳检查(OR 2.82,95%CI 1.26 至 6.28)。
缺乏健康保险与患有糖尿病的西班牙裔/拉丁裔人群中低筛查率密切相关。强调年度散瞳检查重要性和增加眼部健康信息来源的健康促进策略是提高西班牙裔/拉丁裔人群筛查率的其他潜在策略。