Yale School of Nursing, Yale University, Orange, Connecticut.
Sci Diabetes Self Manag Care. 2023 Jun;49(3):206-216. doi: 10.1177/26350106231169693. Epub 2023 Apr 27.
The purpose of this study was to examine racial and ethnic differences in diabetes self-management education (DSME) participation among adults with diabetes.
Population-based, cross-sectional data from the 2020 Behavioral Risk Factor Surveillance System diabetes module were analyzed. Study cohort included 9881 adults age 18 years or older with self-reported diabetes living in 11 US states, Washington, DC, and Puerto Rico. The outcome variable was participation in DSME. Weighted descriptive statistics and multivariable logistic regression were computed to investigate the association between race and ethnicity and participation in DSME, adjusting for self-reported social determinants of health factors (eg, sex, education, employment, health insurance).
Overall, 19.3% self-identified as non-Hispanic Black, 16.5% as Hispanic, and 59.9% as non-Hispanic White. Of participants, 44.3% were between 66 and 80 years old, and 50.4% were women. Half (50.1%) reported participating in DSME, and 78.5% had seen clinicians for diabetes-related care 1 to 5 times in the past year. Hispanic participants were less likely to report participation in DSME (28.5%) compared to non-Hispanic Black (60.3%) and non-Hispanic White (53.4%) participants ( < .001). Adults with diabetes who were less likely to participate in DSME tend to be unmarried, have high school or lower-level education, and not exercise regularly.
Racial and ethnic differences exist in DSME participation. Because DSME has been shown to improve diabetes outcomes, there is a need to develop strategies promoting equity in DSME participation, particularly among Hispanic populations, to reduce health disparities in diabetes care.
本研究旨在探讨糖尿病患者中，不同种族和民族之间在糖尿病自我管理教育（DSME）参与方面的差异。
本研究分析了 2020 年行为风险因素监测系统糖尿病模块的基于人群的横断面数据。研究队列包括来自美国 11 个州、华盛顿特区和波多黎各的 9881 名年龄在 18 岁及以上、自我报告患有糖尿病的成年人。因变量为参与 DSME。使用加权描述性统计和多变量逻辑回归来调查种族和民族与参与 DSME 之间的关联，同时调整了自我报告的健康决定因素（例如，性别、教育程度、就业状况、医疗保险）。
总体而言，19.3%的参与者自我认定为非西班牙裔黑人，16.5%的参与者自我认定为西班牙裔，59.9%的参与者自我认定为非西班牙裔白人。参与者中，44.3%的人年龄在 66 至 80 岁之间，50.4%的人为女性。有一半（50.1%）的人报告参加了 DSME，78.5%的人在过去一年中曾 1 至 5 次因糖尿病相关护理而就诊过临床医生。与非西班牙裔黑人（60.3%）和非西班牙裔白人（53.4%）相比，西班牙裔参与者报告参与 DSME 的比例较低（28.5%）（ < .001）。不太可能参与 DSME 的糖尿病患者往往未婚、接受过高中或以下教育、且不经常锻炼。
在 DSME 参与方面存在种族和民族差异。由于 DSME 已被证明可以改善糖尿病结局，因此需要制定策略，促进 DSME 参与的公平性，特别是在西班牙裔人群中，以减少糖尿病护理方面的健康差距。
