Individual-, Community-, and Health System-Level Barriers to Optimal Type 2 Diabetes Care for Inner-City African Americans: An Integrative Review and Model Development.
Individual-, Community-, and Health System-Level Barriers to Optimal Type 2 Diabetes Care for Inner-City African Americans: An Integrative Review and Model Development.
复制标题
DOI：
10.1177/0145721719889338
复制
发表时间：
2020-02
期刊：
影响因子：
--
通讯作者：
Egede LE
中科院分区：
文献类型：
--
作者：
Campbell JA;Egede LE
本综合综述的目的是：(1)阐明市中心非洲裔美国人在2型糖尿病（T2DM）治疗中面临的独特障碍；(2)在个人、社区和卫生系统层面确定有效的干预措施/方案，以实现最佳的2型糖尿病护理；(3)整合2种行为模型和1种社会生态模型，构建针对非裔美国人的干预措施框架，优化2型糖尿病护理。按照PRISMA指南系统检索PubMed、PsychInfo和CINAHL。模型的整合基于社会生态模型的基本原则。搜索返回了1183篇文章。应用纳入标准合成46篇文献。发现了个体、社区和卫生系统层面的多重障碍。主要障碍包括缺乏知识、缺乏社会支持和自我管理支持。本综述中确定的干预措施表明，在市中心患有2型糖尿病的非裔美国人中，重点放在卫生系统层面，对解决个人和社区层面障碍的关注非常有限。最后的综合包括开发一个新的综合模型，以解释跨多个层面的护理障碍。这些发现强调了在实现健康公平和解决城市非洲裔美国人2型糖尿病护理的健康差异方面，政策、研究和实践之间可能出现的碎片化。新模型明确了发生在多个层次上的复杂障碍，是追求T2DM公平的重要一步。讨论了该模型在2017年《糖尿病自我管理教育与支持国家标准》中的应用。
The purpose of this integrative review is (1) to elucidate the unique barriers faced by inner-city African Americans for type 2 diabetes (T2DM) care; (2) to identify effective interventions/programs for optimal T2DM care at the individual, community, and health systems levels; and (3) to integrate 2 behavioral models and 1 social ecological model for framing interventions for inner-city African American to optimize T2DM care. PRISMA guidelines were followed to systematically search PubMed, PsychInfo, and CINAHL. Integration of models was based on underlying principles of social ecological models. The search returned 1183 articles. Forty-six articles were synthesized after applying inclusion criteria. Multiple barriers for the individual level, community level, and health system level were identified. Major barriers include lack of knowledge, lack of social support, and self-management support. Interventions identified in this review show that among inner-city African Americans with T2DM, the focus is placed at the health systems level, with very limited focus toward addressing individual- and community-level barriers. Final synthesis includes development of a new integrated model that explains barriers to care across multiple levels. These findings highlight the fragmentation that may be occurring between policy, research, and practice for achieving health equity and addressing health disparities for T2DM care among inner-city African Americans. The new model is an important step in the pursuit of equity in T2DM by specifying the complex barriers that occur across multiple levels. The application of this model using the 2017 National Standards for Diabetes–Self Management Education and Support are discussed.
登录
查看更多内容
影响因子：
16.2
作者：
Breton MC;Guénette L;Amiche MA;Kayibanda JF;Grégoire JP;Moisan J
通讯作者：
Moisan J
影响因子：
3.9
作者：
Beck, Joni;Greenwood, Deborah A.;Wang, Jing
通讯作者：
Wang, Jing
影响因子：
1.4
作者：
Dalewitz, J;Khan, N;Hershey, CO
通讯作者：
Hershey, CO
影响因子：
5.4
作者：
Auchincloss, Amy H.;Roux, Ana V. Diez;Bertoni, Alain G.
通讯作者：
Bertoni, Alain G.
影响因子：
16.2
作者：
Brown, AF;Gregg, EW;Beckles, GL
通讯作者：
Beckles, GL