Developing priorities to achieve health equity through diabetes translation research: A concept mapping study

Introduction: The goal of diabetes translation research is to advance research into practice and ensure equitable benefit from scientific evidence. This study uses concept mapping to inform and refine future directions of diabetes translation research with the goal of achieving health equity in diabetes prevention and control. Research design and methods: This study used concept mapping and input from a national network of diabetes researchers and public health practitioners. Concept mapping is a mixed-method, participant-based process. First, participants generated statements by responding to a focus prompt ( Results: Ten clusters were identified containing between 6 and 12 statements from 95 total generated statements. The ranges of average importance and feasibility ratings for clusters were fairly high and narrow (3.62-4.09; 3.10-3.93, respectively). Clusters with the most statements in the go-zone quadrant (above average importance/feasibility) were Conclusions: This study created a framework of 10 priority areas to guide current and future efforts in diabetes translation research to achieve health equity. Themes rated as highly important and feasible provide the basis to evaluate current research support. Future efforts should explore how to best support innovative-targets, those rated highly important but less feasible

Influence of home and school environments on specific dietary behaviors among postpartum, high-risk teens, 27 states, 2007-2009

INTRODUCTION: The objective of this study was to determine whether perceptions of the home and school food environments are related to food and beverage intakes of postpartum teens. METHODS: Our study was a baseline, cross-sectional analysis of 853 postpartum teens enrolled in a weight-loss intervention study across 27 states from 2007 through 2009. Eight-item scales assessed perceived accessibility and availability of foods and beverages in school and home environments. Associations between environments and intakes were assessed by using χ(2) and using logistic regression with generalized estimating equations (GEE), respectively. RESULTS: Overall, 52% of teens perceived their school food environment as positive, and 68% of teens perceived their home food environment as positive. A positive school environment was independently associated with fruit consumption and 100% fruit juice consumption. A positive home environment was independently associated with fruit, vegetable, and water consumption and infrequent consumption of soda and chips (χ(2) P < .05). Having only a positive school environment was associated with fruit consumption (GEE odds ratio [OR], 3.1; 95% confidence interval [CI], 1.5–6.5), and having only a positive home environment was associated with fruit (GEE OR, 2.9; 95% CI, 1.6–5.6), vegetable (GEE OR, 3.1; 95% CI, 1.5–6.2), and water (GEE OR, 2.6; 95% CI, 1.7–4.0) consumption and infrequent consumption of soda (GEE OR, 0.5; 95% CI, 0.3–0.7). Results for positive home and school environments were similar to those for positive home only. CONCLUSION: Home and school environments are related to dietary behaviors among postpartum teens, with a positive home environment more strongly associated with healthful behaviors

Local health department use of Twitter to disseminate diabetes information, United States

INTRODUCTION: Diabetes may affect one-third of US adults by 2050. Adopting a healthful diet and increasing physical activity are effective in preventing type 2 diabetes and decreasing the severity of diabetes-related complications. Educating and informing the public about health problems is a service provided by local health departments (LHDs). The objective of this study was to examine how LHDs are using social media to educate and inform the public about diabetes. METHODS: In June 2012 we used NVivo 10 to collect all tweets ever posted from every LHD with a Twitter account and identified tweets about diabetes. We used a 2010 National Association of County and City Health Officials survey to compare characteristics of LHDs that tweeted about diabetes with those that did not. Content analysis was used to classify each tweet topic. RESULTS: Of 217 LHDs with Twitter accounts, 126 had ever tweeted about diabetes, with 3 diabetes tweets being the median since adopting Twitter. LHDs tweeting about diabetes were in jurisdictions with larger populations and had more staff and higher spending than LHDs not tweeting about diabetes. They were significantly more likely to employ a public information specialist and provide programs in diabetes-related areas. There was also a weak positive association between jurisdiction diabetes rate and the percentage of all tweets that were about diabetes (r = .16; P = .049). CONCLUSION: LHDs are beginning to use social media to educate and inform their constituents about diabetes. An understanding of the reach and effectiveness of social media could enable public health practitioners to use them more effectively

Implications and Impacts of Awareness Sessions in a Work Site Health Promotion Program

The purpose of this study was to evaluate one phase of an extensive worksite health promotion program, developed multidisciplinary health care professionals. A single was conducted using the Cardiac Health Questionnaire. results to card: climate and implemented by group pre-post design T-test and chi-square indicated significant changes in attitude and knowledge related ovascular disease prevention. Perceptions of organizational and employee work place, also have The need for worksite concerns regarding issues of confidentiality in the implications for the development of such programs. health programs and the skills health professionals provide to their successful implementation, provide educational direction to the development of health occupations programs

Depression and poverty among African American women at risk for type 2 diabetes

Poverty is associated with negative health outcomes, including depression. Little is known about the specific elements of poverty that contribute to depression, particularly among African American women at risk for type 2 diabetes. This study examined the relationships of economic and social resources to depression among African American women at high risk for the development of type 2 diabetes (N = 181) using the Conservation of Resources theory as a conceptual framework. Women were assessed at 3 time points in conjunction with a dietary change intervention. At baseline, 40% of women reported clinically significant depression, and 43.3% were below the poverty line. Depressed women reported fewer economic assets and greater economic distress than nondepressed peers. Multivariate logistic regression analyses indicated that nonwork status, lack of home ownership, low appraisal of one’s economic situation, low self-esteem, and increased life events were significantly associated with depression at baseline. Longitudinal multivariate logistic regression models indicated that income, home ownership, future economic appraisal, life events, and self-esteem predicted depression trajectories at Time 3. These results speak to the multifaceted sources of stress in the lives of poor African American women. Interventions that address the economic and social factors associated with depression are needed

Smoking and diabetes

Celem tego artykułu jest podsumowanie danych z literatury dotyczących palenia tytoniu i cukrzycy w odniesieniu do czynników ryzyka, skuteczności i efektywności ekonomicznej różnych metod zrywania z nałogiem oraz ich znaczenia klinicznego. Dokonano przeglądu ponad 200 prac, ze szczególnym uwzględnieniem publikacji, które ukazały się w ciągu ostatnich 10 lat. Włączono tu również badania, które obejmowały chorych na cukrzycę, ale wyniki dotyczące tej grupy pacjentów nie zostały opublikowane oddzielnie. Szczególnie interesujące są prace prowadzone wyłącznie wśród chorych na cukrzycę. Wyniki badań zarówno przekrojowych, jak i prospektywnych są zgodne &#8212; palenie tytoniu powoduje zwiększenie ryzyka powikłań z grupy makro- i mikroangiopatii oraz jest przyczyną przedwczesnego zgonu. Istnieje wiele cennych prac dotyczących zaprzestania palenia tytoniu, a ich wyniki potwierdzają efektywność ekonomiczną postępowania prowadzonego w gabinetach lekarskich. Szczególnie dotyczy to rozwiązań systemowych, w ramach których problem palenia tytoniu stanowi zagadnienie omawiane podczas rutynowych wizyt u lekarza. Jednocześnie choremu oferowana jest porada i wsparcie już po zaprzestaniu palenia. Chociaż informacji dotyczących skuteczności postępowania, które ma skłonić chorego na cukrzycę do zaprzestania palenia, jest niewiele, nie ma powodów, aby sądzić, że postępowanie takie będzie mniej lub bardziej skuteczne w tej grupie pacjentów. Biorąc pod uwagę skalę zjawiska, wpływ na chorobowość i powikłania cukrzycy oraz korzyści płynące z zaprzestania palenia tytoniu, należy z całą pewnością zwiększyć częstość porad na ten temat wśród chorych na cukrzycęThe objective of this review is to summarize the literature on diabetes and smoking related to epidemiological risks, efficacy and cost-effectiveness of different cessation approaches, and implications for clinical practice. Over 200 studies were reviewed, with special emphasis placed on publications within the past 10 years. Intervention studies that included patients with diabetes but did not report results separately by disease are included. Diabetesspecific studies are highlighted. There are consistent results from both cross-sectional and prospective studies showing enhanced risk for micro- and macrovascular disease, as well as premature mortality from the combination of smoking and diabetes. The general cessation literature is extensive, generally well-designed, and encouraging regarding the impact of cost-effective practical office-based interventions. In particular, system-based approaches that make smoking a routine part of office contacts and provide multiple prompts, advice, assistance, and follow-up support are effective. Although there is minimal information on the effectiveness of cessation interventions specifically for people with diabetes, there is no reason to assume that cessation intervention would be more or less effective in this population. There is a clear need to increase the frequency of smoking cessation advice and counseling for patients with diabetes given the strong and consistent data on smoking prevalence; combined risks of smoking and diabetes for morbidity, mortality, and several complications; and the proven efficacy and cost-effectiveness of cessation strategies

Depression and Poverty Among African-American Women at Risk for Type 2 Diabetes

Poverty is associated with negative health outcomes, including depression. Little is known about the specific elements of poverty that contribute to depression, particularly among African- American women at risk for type 2 diabetes. This study examined the relationships of economic and social resources to depression among African-American women at high risk for the development of type 2 diabetes (N=181) using the Conservation of Resources (COR) theory as a conceptual framework. Women were assessed at three time points in conjunction with a dietary change intervention. At baseline, 40% of women reported clinically significant depression and 43.3% were below the poverty line. Depressed (CESD total score \u3e 16) women reported fewer economic assets and greater economic distress than non-depressed peers. Multivariate logistic regression analyses indicated that non-work status, lack of home ownership, low appraisal of economic situation, low self-esteem, and increased life events were significantly associated with depression at baseline. Longitudinal multivariate logistic regression models indicated that income, home ownership, future economic appraisal, life events and self-esteem predicted depression trajectories at Time 3. These results speak to the multifaceted sources of stress in the lives of poor African-American women. Interventions that address the economic and social factors associated with depression are needed