US Ethnic Group Differences in Family Member Support for People With Diabetes in the 2nd Diabetes Attitudes, Wishes and Needs (DAWN2) Study

Using Continuous Glucose Monitoring and Data Sharing to Encourage Collaboration Among Older Adults With Type 1 Diabetes and Their Care Partners: Qualitative Descriptive Study

BACKGROUND

Persons with diabetes use continuous glucose monitoring (CGM) to self-manage their diabetes. Care partners (CPs) frequently become involved in supporting persons with diabetes in the management of their diabetes. However, persons with diabetes and CP dyads may require more communication and problem-solving skills regarding how to share and respond to CGM data.

OBJECTIVE

The purpose of this study was to describe the experiences of persons with diabetes and CPs who participated in the Share "plus" intervention, which addresses dyadic communication strategies, problem-solving, and action planning to promote sharing of CGM data among the dyad.

METHODS

Ten dyads participated in the Share "plus" telehealth intervention. Participants were interviewed during and after the Share "plus" intervention. Thematic analysis was used to analyze interview data.

RESULTS

During postsession interviews, dyads described feeling a sense of shared responsibility yet viewed the persons with diabetes as ultimately responsible for the disease. Additionally, dyads shared that communication patterns improved and were able to recognize the negative aspects of previously established communication patterns. Dyads reported communication focused on hypoglycemia episodes while also differing in the frequency they reviewed CGM data and set alerts. Overall, dyads expressed positive reactions to the Share "plus" intervention.

CONCLUSIONS

Share "plus" was helpful in promoting positive CGM-related communication among dyads and encouraged more CP support. CPs play an important role in supporting older adults with type 1 diabetes. Communication strategies help support dyad involvement in CGM data sharing and self-management among persons with diabetes.

Motives for spousal involvement in a Partner's diabetes management: Considering the role of gender and links to diet-related involvement

Using data from 148 middle-aged and older adult spouses whose partners had type 2 diabetes, we sought to examine spouses' motives for involvement in their partners' diabetes management and whether these motives were related to common types of diabetes-related spousal involvement; we also sought to understand gender differences in these dynamics. Spouses indicated being motivated to be involved in their partners' diabetes management due to altruistic motives to the greatest extent and egoistic motives to the least extent. Results from multivariable regression analyses that controlled for gender, marital quality, and spouses' own conditions requiring dietary changes revealed that all types of motives were related to the frequency of providing diet-related spousal support, whereas only egoistic motives were related to the frequency of exerting diet-related spousal control. We did not find gender differences in any motives nor in associations with spousal involvement. Findings have potential implications for couples-oriented chronic illness interventions.

Socio-demographic predictors of food security among rural households in Langai district in Plateau-Nigeria: a cross-sectional study

Introduction

household food insecurity is a critical social determinant of health globally. There is a rising global prevalence of food insecurity which affects households' access to food of adequate quantity and quality. This study assessed the level of food security and its socio-demographic determinants among rural households.

Methods

this is a cross-sectional community survey among 201 rural households in Langai district representing a total population of 1,284. Reported food security was assessed using Food Consumption Scores and Coping Strategy Index. Data were analysed with SPSS 21. Analysis was done to assess the level of food-security associated factors. Multivariable analysis was done to assess determinants of food security. P-value <0.05 is considered significant.

Results

forty-three percent of all households have a total income greater than the national minimum wage. Overall, 21.4% are quality-food insecure (FCS), 6.5% have severe coping behaviour (CSI-food insecure) and 34.8% are highly economically vulnerable to food insecurity. Significant predictors of household food security include women earning than the basic monthly wage (AOR: 4.29 [95%CI: 1.34-13.71]; p=0.014); those without marital partners (AOR: 4.91 [95%CI: 1.01-23.90]; p=0.049); smaller household size (≤ 5) (AOR: 2.69 [95%CI: 1.16-6.24]; p=0.021); and those not receiving financial support (AOR: 2.68 [95%CI: 1.17-6.13]; p=0.020).

Conclusion

almost a quarter of all households' experience food insecurity with more than one-third being highly vulnerable to food insecurity. Efforts should be made to cushion the effect of global food insecurity among vulnerable populations and improve livelihood through improved agricultural practices to have sustainable and equitable food security.

Racial and Ethnic Disparities in Healthcare Rating, Diabetes Self-efficacy, and Diabetes Management Among Non-pregnant Women of Childbearing Age: Does Socioeconomic Status Matter?

OBJECTIVE

Patient perceptions of healthcare ratings, diabetes self-efficacy, and diabetes management play a role in diabetes-related outcomes, particularly among women of childbearing age. Guided by a modified Interaction Model of Client Health Behavior framework, the objective was to compare differences in perceptions of health care ratings, diabetes self-efficacy, and diabetes management among non-Hispanic Black, Hispanic, and non-Hispanic White women of childbearing age.

METHODS

The sample comprised 7 years (2012-2018) of Medical Expenditure Panel Survey data. The sample was limited to women of childbearing age (18-45 years) who have ever been told they had diabetes (n = 691; weighted n = 932,426). Dependent variables were health care rating, diabetes self-efficacy, and diabetes care management. The key independent variable was race/ethnicity (non-Hispanic Black, Hispanic, non-Hispanic White). We adjusted for sociodemographic characteristics and perceived health status using multiple linear and multivariable logistic regressions.

RESULTS

Non-Hispanic Black women (41.6%) self-reported their health status as fair or poor (44.9%) compared to non-Hispanic White (33.3%) and Hispanic (37.6%). In adjusted models, non-Hispanic Black women had 46% lower odds (95% CI = 0.31, 0.94) of reporting high health care ratings compared to non-Hispanic White women. Non-Hispanic Black women had 43% lower odds (95% CI = 0.35, 0.95) and Hispanic women had 47% lower odds (95% CI = 0.34, 0.80) of reporting higher levels of diabetes care management than non-Hispanic White women.

CONCLUSIONS

This study provides important information regarding diabetes health care ratings, self-efficacy, and self-management behaviors. Because of the increasing prevalence of diabetes among women of childbearing age, it is important to improve health care particularly for racial/ethnic minority women with diabetes.