A cross-sectional analysis of the relationship between diabetes and health access barriers in an urban First Nations population in Canada
A cross-sectional analysis of the relationship between diabetes and health access barriers in an urban First Nations population in Canada
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DOI：
10.1136/bmjopen-2017-018272
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发表时间：
2018-01-01
期刊：
影响因子：
2.9
通讯作者：
Rotondi, Michael A.
中科院分区：
文献类型：
--
作者：
Beckett, Michael;Firestone, Michelle A.;Rotondi, Michael A.
目的本研究采用应答者驱动抽样（respondent-driven sampling，RDS）的方法，从一个自称为加拿大城市原住民的人群中收集数据，探讨加拿大城市原住民人群中健康获取障碍与糖尿病之间的关系。由于RDS数据的回归建模没有明确的方法可用，因此使用两种逻辑回归建模方法，包括基于调查的逻辑和广义线性混合模型，来探索糖尿病与感兴趣的健康障碍之间的关系，包括获得医疗保健、食物、住房和社会经济因素。加拿大。参与者这项横断面研究使用了从我们的健康计数研究中收集的数据，该研究与De dwa da delis nye>s土著健康中心合作，该研究使用RDS招募了554名居住在汉密尔顿的原住民成年人。多变量回归技术显示，自我-据报告，在城市原住民中，糖尿病的诊断和缺乏文化上适当的护理（OR：12.10，95% CI 2.52至51.91）。也有一个趋势，糖尿病之间的关系，并没有在该地区的医生，感觉提供的医疗保健不足，缺乏可用的医疗保健服务在area.Conclusions城市第一民族的人谁觉得他们收到的卫生服务是暴动文化适当的更有可能患糖尿病，相比那些谁没有觉得他们收到的服务是文化上不合适的。建立更多的融合原住民文化和传统的医疗保健服务，可以改善城市原住民糖尿病患者获得护理和治疗的机会。
Objective This study explores the relationship between health access barriers and diabetes in an urban First Nations population in Canada.Design Data from a self-identified urban First Nations population were collected using respondent-driven sampling (RDS). As no clear approach for regression modelling of RDS data is available, two logistic regression modelling approaches, including survey-based logistic and generalised linear mixed models, were used to explore the relationship between diabetes and health barriers of interest, including access to healthcare, food, housing and socioeconomic factors.Setting Hamilton, Ontario, Canada.Participants This cross-sectional study used data collected from the Our Health Counts study, in partnership with the De dwa da delis nye>s Aboriginal Health Centre, which recruited 554 First Nations adults living in Hamilton using RDS.Results After adjusting for covariates, multivariable regression techniques showed a statistically significant relationship between a self-reported diagnosis of diabetes and a lack of culturally appropriate care among urban First Nations peoples (OR: 12.10, 95% Cl 2.52 to 51.91). There was also a trend towards a relationship between diabetes and not having a doctor available in the area, feeling that healthcare provided was inadequate and a lack of available healthcare services in the area.Conclusions Urban First Nations peoples who felt the health service they received was riot culturally appropriate were more likely to have diabetes, compared with those who did not feel the service they received was culturally inappropriate. Establishing more healthcare services that integrate First Nations cultures and traditions could improve access to care and the course of treatment for urban First Nations peoples living with diabetes.