Effects of family and neighborhood risks on glycemic control among young black adolescents with type 1 diabetes: Findings from a multi-center study.
Effects of family and neighborhood risks on glycemic control among young black adolescents with type 1 diabetes: Findings from a multi-center study.
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DOI：
10.1111/pedi.13176
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发表时间：
2021-05
影响因子：
3.4
通讯作者：
Worley J
中科院分区：
文献类型：
--
作者：
Ellis DA;Cutchin MP;Templin T;Carcone AI;Evans M;Weissberg-Benchell J;Buggs-Saxton C;Boucher-Berry C;Miller JL;Al Wazeer M;Gharib J;Mehmood Y;Worley J
虽然已经确定了导致 1 型糖尿病儿童健康差异的个人和家庭风险因素，但关于社区风险因素对血糖控制影响的研究仍然有限，特别是在少数样本中。这项横断面研究以患有 1 型糖尿病的城市年轻黑人青少年（平均年龄 = 13.4 + 1.7）为样本，测试了家庭冲突、邻里逆境与血糖结果 (HbA1c) 之间的关联，以及邻里逆境是否调节了家庭冲突与 HbA1c 之间的关系。参与者 (N=128) 是从美国两个主要大都市的五个儿科糖尿病诊所招募的。通过自我报告问卷（糖尿病家庭冲突量表；DFCS）来衡量与糖尿病相关的家庭冲突。邻里逆境是根据美国人口普查数据在人口普查区块组层面计算的。逆境指标用于计算每个参与者的邻里逆境指数（NAI）。家庭收入中位数为 25,000 美元，表明 SES 样本较低。在多元回归分析中，在控制儿童年龄、家庭社会经济状况和胰岛素管理方案后，DFCS 和 NAI 对血糖控制均具有显着且独立的影响（分别为 β=.174、P=.034 和 β=.226 P=.013）。 NAI 和 DFCS 相互作用对 HbA1c 影响的测试发现，邻里逆境没有显着的调节作用。即使在社会经济处于显着劣势的背景下，社区逆境程度的变化也可以预测患有 1 型糖尿病的年轻黑人青少年与糖尿病相关的健康结果。提供者应评估健康的社会决定因素，例如可能影响青少年维持最佳血糖控制能力的社区资源。
While individual and family risk factors that contribute to health disparities in children with type 1 diabetes have been identified, studies on the effects of neighborhood risk factors on glycemic control are limited, particularly in minority samples. This cross-sectional study tested associations between family conflict, neighborhood adversity and glycemic outcomes (HbA1c) in a sample of urban, young Black adolescents with type 1 diabetes(mean age=13.4 + 1.7), as well as whether neighborhood adversity moderated the relationship between family conflict and HbA1c. Participants (N=128) were recruited from five pediatric diabetes clinics in two major metropolitan US cities. Diabetes-related family conflict was measured via self-report questionnaire (Diabetes Family Conflict Scale; DFCS). Neighborhood adversity was calculated at the census block group level based on US census data. Indictors of adversity were used to calculate a neighborhood adversity index (NAI) for each participant. Median family income was $25,000, suggesting a low SES sample. In multiple regression analyses, DFCS and NAI both had significant, independent effects on glycemic control (β=.174, P=.034 and β=.226 P=.013, respectively) after controlling for child age, family socioeconomic status and insulin management regimen. Tests of effects of the NAI and DFCS interaction on HbA1c found no significant moderating effects of neighborhood adversity. Even within contexts of significant socioeconomic disadvantage, variability in degree of neighborhood adversity predicts diabetes-related health outcomes in young Black adolescents with type 1 diabetes. Providers should assess social determinants of health such as neighborhood resources that may impact adolescents’ ability to maintain optimal glycemic control.
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影响因子：
3.1
作者：
Beyers, JM;Bates, JE;Dodge, KA
通讯作者：
Dodge, KA
影响因子：
7.6
作者：
Hood, Korey K.;Beavers, Daniel P.;Lawrence, Jean M.
通讯作者：
Lawrence, Jean M.
影响因子：
4.9
作者：
Liese AD;Puett RC;Lamichhane AP;Nichols MD;Dabelea D;Lawson AB;Porter DE;Hibbert JD;D'Agostino RB Jr;Mayer-Davis EJ
通讯作者：
Mayer-Davis EJ
影响因子：
3.4
作者：
Coulon SJ;Velasco-Gonzalez C;Scribner R;Park CL;Gomez R;Vargas A;Stender S;Zabaleta J;Clesi P;Chalew SA;Hempe JM
通讯作者：
Hempe JM
影响因子：
7.6
作者：
Ingerski, Lisa M.;Anderson, Barbara J.;Hood, Korey K.
通讯作者：
Hood, Korey K.