Bender Mette, Glümer Charlotte, Brønnum-Hansen Henrik, Andersen Ingelise, Vrangbæk Karsten
Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Copenhagen Centre for Diabetes and Heart Diseases, Copenhagen, Denmark.
Eur J Public Health. 2024 Dec 1;34(6):1112-1116. doi: 10.1093/eurpub/ckae155.
The aim of this paper was to study ethnic and socioeconomic (SEP) factors' association with provision and participation in a type 2 diabetes disease-management program. In 2016-21, 3464 persons were referred to type 2 diabetes management in Copenhagen municipality. Personalized plans included a mix of activities; program consultations, dietary education, telephone conversations, patient education, and physical training. We estimated the association between education, income, civic status, employment, and country of origin with the number of booked and participated activities using Poisson regression models. A total of 55 394 program sessions were scheduled. Small differences in booked dietary education, program consultations, telephone conversations, and patient education were seen between SEP groupings. In situations where groups with lower SEP had booked more sessions (e.g. unemployed bookings of dietary education), these were predominantly translated into equal or more participated sessions among persons with high SEP. Regarding physical training, considerably more booked and participated sessions were delivered to women with lower SEP and ethnic minorities. This study is unique, in the sense that it is the first of its kind to analyze data on diabetes-management programs, systematically collected by primary healthcare workers. Our results suggest that specific elements of the program together with a higher number of booked sessions promoted vulnerable women to participate in more physical training sessions. In closing, these findings have the potential to provide motivation and ideas for policymakers and health professionals in how to design equitable type 2 diabetes management activities.
本文旨在研究种族和社会经济因素（SEP）与2型糖尿病疾病管理项目的提供及参与情况之间的关联。2016年至2021年期间，哥本哈根市有3464人被转诊至2型糖尿病管理项目。个性化计划包括多种活动；项目咨询、饮食教育、电话沟通、患者教育和体育锻炼。我们使用泊松回归模型估计了教育程度、收入、公民身份、就业情况和原籍国与预约及参与活动数量之间的关联。总共安排了55394节项目课程。在SEP分组之间，预约的饮食教育、项目咨询、电话沟通和患者教育方面存在细微差异。在SEP较低的群体预约了更多课程的情况下（例如失业者预约饮食教育），这些课程在SEP较高的人群中主要转化为同等或更多的参与课程。在体育锻炼方面，SEP较低的女性和少数族裔预约并参与的课程要多得多。这项研究具有独特性，因为它是同类研究中首个分析由初级医疗工作者系统收集的糖尿病管理项目数据的研究。我们的结果表明，该项目的特定要素以及更多的预约课程促使弱势女性参与更多的体育锻炼课程。最后，这些发现有可能为政策制定者和健康专业人员在如何设计公平的2型糖尿病管理活动方面提供动力和思路。
