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Process Evaluation Of A Community Asset Mapping Protocol For Diabetes Prevention And Management, Andrea Peterson Dec 2022

Process Evaluation Of A Community Asset Mapping Protocol For Diabetes Prevention And Management, Andrea Peterson

Capstone Experience

Prediabetes and type 2 diabetes mellitus (DM) are highly prevalent conditions with new diagnoses occurring each year (Centers for Disease Control and Prevention, 2022a). Type 2 DM negatively impacts many aspects of life, to include social, financial, cultural, and everyday living. Asset mapping is a useful tool to build upon existing resources to help community members identify and expand services based on understanding the interconnected systems that influence type 2 DM prevention, screening, education, and care management. An Asset Mapping Protocol was created and piloted through a rural community coalition in Nebraska. The protocol includes an activity for community stakeholders …


Diabetes Self-Management Education And Support: Understanding Knowledge And The Impact, Christina Dietz Dec 2022

Diabetes Self-Management Education And Support: Understanding Knowledge And The Impact, Christina Dietz

All Dissertations

Diabetes has reached epidemic proportions in the United States. To address this, many organizations employ diabetes self-management education and support (DSMES) programs to aid in managing the impact of increasing prevalence. The purpose of this dissertation is to examine the impact of two Upstate South Carolina DSMES programs on several process and outcome measures for adults with diabetes, while also identifying current primary care provider DSMES knowledge and perceptions in an Upstate South Carolina health system.

This dissertation found inconclusive results on the impact of DSMES on PCP utilization, retinal exam screening, nephropathy attention, HDL, LDL, TC, and TG. DSME …


Chronic Illness Education 2022: Diabetes Mellitus Education For Adults In Southeast Michigan, Muhammad Ahmed, Ahmad Kofahi, Caleb Richard, Hadi El Ammar, Huda Warsame, Janice Gibbons, Jodene Takahashi Sep 2022

Chronic Illness Education 2022: Diabetes Mellitus Education For Adults In Southeast Michigan, Muhammad Ahmed, Ahmad Kofahi, Caleb Richard, Hadi El Ammar, Huda Warsame, Janice Gibbons, Jodene Takahashi

Patient Education Projects

No abstract provided.


Chronic Illness Education 2022: Increasing Wound Care Vigilance In Adult Diabetic Patients With Neuropathy, Gowri Chandrashekar, Allen Zhang, Daniel Domin, Karis Tutuska, Sarah Bassett, Varsha Kumar Sep 2022

Chronic Illness Education 2022: Increasing Wound Care Vigilance In Adult Diabetic Patients With Neuropathy, Gowri Chandrashekar, Allen Zhang, Daniel Domin, Karis Tutuska, Sarah Bassett, Varsha Kumar

Patient Education Projects

No abstract provided.


Chronic Illness Education 2022: Developing A Hands-On Tool For Increased Accountability Amongst Diabetic Children, Kassandra Solrud, Bijan Sagman, Elena Carrillo, Gokturk Tepe, Itzick Nahmoud, Siena Snyder, William Crouch Sep 2022

Chronic Illness Education 2022: Developing A Hands-On Tool For Increased Accountability Amongst Diabetic Children, Kassandra Solrud, Bijan Sagman, Elena Carrillo, Gokturk Tepe, Itzick Nahmoud, Siena Snyder, William Crouch

Patient Education Projects

No abstract provided.


Chronic Illness Education 2022: Diabetes Management In Adults In The Detroit Area, David Asebiode, Chase Morrison, Erin Bybee, Isaiah Hough, Madison Graifman, Mehrnoosh Ghafouri Abbasabadi, Saranya Madan Sep 2022

Chronic Illness Education 2022: Diabetes Management In Adults In The Detroit Area, David Asebiode, Chase Morrison, Erin Bybee, Isaiah Hough, Madison Graifman, Mehrnoosh Ghafouri Abbasabadi, Saranya Madan

Patient Education Projects

No abstract provided.


Chronic Illness Education 2022: A Recipe For Healthy Living, Awad Maria, Andrew Gregory, Andrew Rabah, Kia Sweeney, Laura Aravena, Nicholas Livingston, Tabassum Chowdhury Sep 2022

Chronic Illness Education 2022: A Recipe For Healthy Living, Awad Maria, Andrew Gregory, Andrew Rabah, Kia Sweeney, Laura Aravena, Nicholas Livingston, Tabassum Chowdhury

Patient Education Projects

No abstract provided.


Chronic Illness Education 2022: Addressing Risk Of Body Image And Eating Disorders In Adolescents With Type I Diabetes, Ahmad El-Moussa, Dhruva Kadiyala, Kavitha Mohanarajan, Kevin Kim, Michael Brennan, Rajaa Shoukfeh, Ruth Amoakohene Sep 2022

Chronic Illness Education 2022: Addressing Risk Of Body Image And Eating Disorders In Adolescents With Type I Diabetes, Ahmad El-Moussa, Dhruva Kadiyala, Kavitha Mohanarajan, Kevin Kim, Michael Brennan, Rajaa Shoukfeh, Ruth Amoakohene

Patient Education Projects

No abstract provided.


Chronic Illness Education 2022: Type Ii Diabetes Management In Adults: Medications And Community Resources, Varag Abed, Camila Arellano, Carolyn Baldwin, Ethan Ervin, Haya Beydoun, Mahnoor Ayub, Yoshio Wagner Sep 2022

Chronic Illness Education 2022: Type Ii Diabetes Management In Adults: Medications And Community Resources, Varag Abed, Camila Arellano, Carolyn Baldwin, Ethan Ervin, Haya Beydoun, Mahnoor Ayub, Yoshio Wagner

Patient Education Projects

No abstract provided.


Chronic Illness Education 2022: Helping Patients Access Low-Cost Diabetes Supplies And Medications, Iyanna Peppers, Laial Baltaji, Lucas Edgren, Lyndsay Archer, Molly Wilson Sep 2022

Chronic Illness Education 2022: Helping Patients Access Low-Cost Diabetes Supplies And Medications, Iyanna Peppers, Laial Baltaji, Lucas Edgren, Lyndsay Archer, Molly Wilson

Patient Education Projects

No abstract provided.


Webinars As A Tool For Increasing Awareness Of Diabetes Prevention And Management Programs, Cindy Jenkins, Carrie Durward, April Litchford, Catherine Hansen, Annette Prall, Caitlyn Jasumback Sep 2022

Webinars As A Tool For Increasing Awareness Of Diabetes Prevention And Management Programs, Cindy Jenkins, Carrie Durward, April Litchford, Catherine Hansen, Annette Prall, Caitlyn Jasumback

Outcomes and Impact Quarterly

Stakeholders sought to reduce the burden of preventable diabetes among adults in Utah via a “Food as Medicine” webinar series. The “Food as Medicine” webinar series sought to increase awareness of and enrollment in public diabetes programs. Evaluation results from the webinar series indicated an increase in awareness of diabetes programs and nutrition information needed to improve personal diabetes management.


Efficacy Of Various Interventions For Achieving Target Hba1c Levels For Patients With Type Ii Diabetes Mellitus And On Exogenous Insulin, Caitlin S. Welch, Archie Troxel Aug 2022

Efficacy Of Various Interventions For Achieving Target Hba1c Levels For Patients With Type Ii Diabetes Mellitus And On Exogenous Insulin, Caitlin S. Welch, Archie Troxel

Longitudinal Scholar's Project

Objective: To learn the rates at which patients at UT Family Medicine–St. Francis (UTFM–SF) with type II diabetes mellitus are being prescribed recommended medications—namely metformin, sodium-glucose cotransporter 2 (SGLT2) inhibitors, and glucagon-like peptide 1 receptor agonists (GLP1RAs)—whether these rates correspond to the severity of hyperglycemia (as indicated by HbA1C level). A secondary goal of the study was to investigate if HbA1C levels are being checked at recommended intervals.

Methods: A retrospective chart review was conducted using records of patients seen at the clinic in the previous four years between the ages of 18 and 65 who had visits with ICD …


Estimating The Health Effects Of Adding Bicycle And Pedestrian Paths At The Census Tract Level: Multiple Model Comparison, Ross J. Gore, Christopher Lynch, Craig Jordan, Andrew Collins, R. Michael Robinson, Gabrielle Fuller, Pearson Ames, Prateek Keerthi, Yash Kandukuri Aug 2022

Estimating The Health Effects Of Adding Bicycle And Pedestrian Paths At The Census Tract Level: Multiple Model Comparison, Ross J. Gore, Christopher Lynch, Craig Jordan, Andrew Collins, R. Michael Robinson, Gabrielle Fuller, Pearson Ames, Prateek Keerthi, Yash Kandukuri

VMASC Publications

Background: Adding additional bicycle and pedestrian paths to an area can lead to improved health outcomes for residents over time. However, quantitatively determining which areas benefit more from bicycle and pedestrian paths, how many miles of bicycle and pedestrian paths are needed, and the health outcomes that may be most improved remain open questions.

Objective: Our work provides and evaluates a methodology that offers actionable insight for city-level planners, public health officials, and decision makers tasked with the question “To what extent will adding specified bicycle and pedestrian path mileage to a census tract improve residents’ health outcomes over time?” …


Quantile Differences In The Age-Related Decline In Cardiorespiratory Fitness Between Sexes In Adults Without Type 2 Diabetes Mellitus In The United States, Andrew Ortaglia, Melissa Stansbury, Michael David Wirth, Xuemei Sui, Matteo Bottai Aug 2022

Quantile Differences In The Age-Related Decline In Cardiorespiratory Fitness Between Sexes In Adults Without Type 2 Diabetes Mellitus In The United States, Andrew Ortaglia, Melissa Stansbury, Michael David Wirth, Xuemei Sui, Matteo Bottai

Faculty Publications

Objective: To comprehensively assess the extent to which the decline in cardiorespiratory fitness (CRF) with age differs between sexes. Participants and Methods: This study used data from the Aerobics Center Longitudinal Study, conducted between September 1974 and August 2006, consisting primarily of White adults from middle-to-upper socioeconomic strata restricted to adults without type 2 diabetes mellitus (33,742 men and 9,415 women). Quantile regression models were used to estimate the differences in age-associated changes in CRF between the sexes, estimated using a maximal treadmill test. Results: For adults aged up to 45 years, significant differences in slopes relating to age and …


Assessing Nutritional Health Knowledge In Sharing Clinic Patients With Diabetes, Minden Huntrods May 2022

Assessing Nutritional Health Knowledge In Sharing Clinic Patients With Diabetes, Minden Huntrods

Capstone Experience

Effective diabetes prevention and management relies on nutritional behaviors, thus a basic level of health knowledge is important for patients with diabetes and their caregivers in their quest to acquire acute glycemic control and minimize negative health outcomes (Ley et al., 2014). The purpose of this study was to assess the nutrition-related health knowledge of patients living with diabetes who are seen at the UNMC Sharing Clinic by use of a verbal questionnaire. This nutritional health knowledge assessment was a quantitative, prospective, survey-based study utilizing descriptive statistics. Approximately 86% of patients were proficient in food group and nutritious foods knowledge …


Prevention Of Diabetes-Related Hospital Readmission Following Initial Diagnosis Of Diabetes In Patients Over The Age Of Fifty: A Scoping Review, Nathan Miller Dnp, Agacnp, Fnp, Jasmine Harris Dnp, Fnp, Michael Clardy Dnp, Agacnp, Diana Dedmon Dnp, Acnp, Fnp-Bc Apr 2022

Prevention Of Diabetes-Related Hospital Readmission Following Initial Diagnosis Of Diabetes In Patients Over The Age Of Fifty: A Scoping Review, Nathan Miller Dnp, Agacnp, Fnp, Jasmine Harris Dnp, Fnp, Michael Clardy Dnp, Agacnp, Diana Dedmon Dnp, Acnp, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background: By reviewing multiple studies related to the treatment of patients with new diagnoses of diabetes, this scoping review will endeavor to determine which interventions, when implemented for patients over 50 years old which are newly diagnosed with type 2 diabetes, can decrease the likelihood of hospital readmission related to diabetes within 90 days when compared with those patients who did not receive or participate in follow-up.

Methods: For resources to be eligible to review they had to be from 2015 or after. Studies selected included patients over the age of 50 newly diagnosed with type 2 diabetes subject to …


Review Of Diabetes Among Aboriginal And Torres Strait Islander People, Katherine Ride, Samantha Burrow Apr 2022

Review Of Diabetes Among Aboriginal And Torres Strait Islander People, Katherine Ride, Samantha Burrow

Journal of the Australian Indigenous HealthInfoNet

Diabetes is the fastest growing chronic disease condition globally. Type 2 diabetes in particular, has reached epidemic proportions, with the greatest burden falling on socially disadvantaged groups and Indigenous peoples.

This review focuses primarily on type 2 diabetes among Aboriginal and Torres Strait Islander people, which is responsible for the majority of cases of diabetes in this population. It provides general information on the social and cultural context of diabetes, and the behavioural and biomedical factors that contribute to diabetes among Aboriginal and Torres Strait Islander people.

This review provides detailed information on:

  • the extent of diabetes among Aboriginal and …


Using Digital Storytelling To Assess Patient Experience With Management Of Diabetes In Everyday Life (Model) Study Intervention, Arati Joshi Apr 2022

Using Digital Storytelling To Assess Patient Experience With Management Of Diabetes In Everyday Life (Model) Study Intervention, Arati Joshi

Longitudinal Scholar's Project

African Americans are disproportionately affected by obesity-associated diabetes compared to their White counterparts. While social determinants of health may contribute to their poor health outcomes, studies have shown that pragmatic primary care-based interventions can be effective in improving the management of obesity-associated diabetes. The Management of Diabetes in Everyday Life (MODEL) is a pragmatic randomized comparative effectiveness trial of three approaches (health coaching, text-messaging, and enhanced usual care) to supporting medically underserved African American patients with uncontrolled diabetes in improving their self-care decisions. The purpose of this study is to assess the effect of the MODEL program participation on the …


Evaluation Of A Hands-On Cooking Class And Its Effects On Self-Efficacy In Relation To Healthy Eating In Type 2 Diabetics, Codi A. Jenshak-Gorzinski Mar 2022

Evaluation Of A Hands-On Cooking Class And Its Effects On Self-Efficacy In Relation To Healthy Eating In Type 2 Diabetics, Codi A. Jenshak-Gorzinski

DNP Scholarly Projects

The prevalence of Type 2 diabetes is alarming and poses a great threat to U.S. national health. Chronic diabetes can lead to serious conditions such as heart attack and stroke, and can result in premature mortality (World Health Organization, 2018). Diabetes can be prevented or treated by eating a healthy diet. Cooking classes are a potential way to improve American’s knowledge of nutritional principles and help them become confident that they have the capacity to eat a healthy diet. The purpose of this DNP project was to determine if participation in cooking classes enhanced self-efficacy as it pertains to healthy …


“If I Were To Suffer A Stroke Right Now, The First Place That I Should Be Taken To Is The Traditional Healer”: Community Beliefs And Health-Seeking Practices For Noncommunicable Diseases In Rural Kwazulu-Natal, South Africa, Herbert Chikafu, Innocent Tinashe Mutero Dr., Moses John Chimbari Prof. Jan 2022

“If I Were To Suffer A Stroke Right Now, The First Place That I Should Be Taken To Is The Traditional Healer”: Community Beliefs And Health-Seeking Practices For Noncommunicable Diseases In Rural Kwazulu-Natal, South Africa, Herbert Chikafu, Innocent Tinashe Mutero Dr., Moses John Chimbari Prof.

The Qualitative Report

T

The burden of chronic noncommunicable diseases in rural South Africa is exacerbated by delayed health-seeking. This study explored awareness, beliefs and health-seeking behaviour relating to diabetes, hypertension and cardiovascular diseases in Ingwavuma, a poor rural community in the uMkhanyakude district of KwaZulu-Natal, South Africa. Eight gender and age-stratified Focus Group Discussions (FGD) were conducted in isiZulu using a pre-tested FGD guide with seventy-six participants. Thematic analysis was done to discern views on access to care for noncommunicable diseases. Findings revealed limited awareness of hypertension, diabetes, and cardiovascular-related disease burden. The community practices medical plurality, and consultation with traditional healers …


Sex Differences In The Association Of Sibship Size And Position In Sibship With Lipid Profile During Adolescence: A Cross-Sectional Study, Ali H. Ziyab, Mohammad Almari, Anwar Mohammad, Abdullah Al-Taiar, Wilfried Karmaus Jan 2022

Sex Differences In The Association Of Sibship Size And Position In Sibship With Lipid Profile During Adolescence: A Cross-Sectional Study, Ali H. Ziyab, Mohammad Almari, Anwar Mohammad, Abdullah Al-Taiar, Wilfried Karmaus

Community & Environmental Health Faculty Publications

Background. Epidemiologic studies have reported associations of sibship size and position of the child in the sibship with multiple health outcomes, including adiposity and diabetes. However, little is known about sibling effects on lipids. Hence, this study sought to evaluate associations of the number of total, older, and younger siblings with lipid profile among adolescents. Methods. In a cross-sectional study among high school students aged 14 to 19 years, lipid levels were measured in capillary blood. Parents reported the number of siblings (total, older, and younger). Geometric means of lipids were calculated, and linear regression was used to estimate the …


Medicine Adherence As A Determinant Of Complication Development In Diabetes And Hypertension Patients On A Medical Aid Scheme In Zimbabwe, Tsitsi Moyo Jan 2022

Medicine Adherence As A Determinant Of Complication Development In Diabetes And Hypertension Patients On A Medical Aid Scheme In Zimbabwe, Tsitsi Moyo

Walden Dissertations and Doctoral Studies

Pharmacotherapy is a significant component of chronic disease management; its efficacy depends on long term, correct, and consistent use; however, medicine adherence rates remain low. The cost of medicines is considered a significant barrier to adherence, especially in low-income settings. This quantitative cross-sectional study was conducted using data from Cimas Medical Aid Society collected between 2015 and 2019. The purpose of the study was to determine the extent of the association between medicine adherence, complication development, and cost of care among diabetic and hypertensive patients while controlling for age and gender on a population that does not experience cost barriers …


Racial And Ethnic Disparities In Diabetes-Related Healthcare Service Use In The United States, 2016–2020, Gaole Song Jan 2022

Racial And Ethnic Disparities In Diabetes-Related Healthcare Service Use In The United States, 2016–2020, Gaole Song

CGU Theses & Dissertations

Diabetes is a serious public health issue in the United States. As one of the leading causes of death, the prevalence of diabetes has increased steadily and leads to an enormous medical and societal burden each year. Compared to non-Hispanic White adults, racial/ethnic minority adults have a higher risk to develop diabetes and its complications. Proper healthcare service use is important for reducing the prevalence of diabetes and the risk of complications. However, minority populations receive a lower quality healthcare service and have greater barriers to diabetes self-management. To get a better understanding of racial disparities in diabetes-related healthcare service …


Diabetes Self-Management Education In The Urban Low Socioeconomic Status Senior Population, Heather Santa Barbara Jan 2022

Diabetes Self-Management Education In The Urban Low Socioeconomic Status Senior Population, Heather Santa Barbara

Walden Dissertations and Doctoral Studies

This exploratory quantitative study used a survey design to address a gap in the literature concerning primary care team perceptions about diabetes care for urban low socioeconomic status seniors with diabetes. Diabetes is a chronic health problem that is often managed in primary care offices, and primary care teams are often the first source of education and support for patients. Standards of management for seniors with diabetes has changed to eliminate tight control of glucose levels, and primary care team members may have differing perceptions about diabetes care depending upon their role in the primary care team and years of …


Effective Management Of Diabetes Mellitus Type Ii In A Military Treatment Facility, Jozy Merizier Smarth Jan 2022

Effective Management Of Diabetes Mellitus Type Ii In A Military Treatment Facility, Jozy Merizier Smarth

Walden Dissertations and Doctoral Studies

In the United States, 34 million people have diabetes and 79 million have prediabetes. Currently, one in nine Americans are diagnosed with diabetes and it is projected that one in five will have diabetes by 2025 and one in three by 2050. The practice-focused question answered by this project addressed the question if implementing a staff education program improved staff’s knowledge about self-management education and intent for providers and staff to promote a formal diabetes self-management education (DSME) program in an overseas military treatment facility. The site has 47% of empaneled beneficiaries with diabetes mellitus Type II with an elevated …


Weight Management Clinical Practice Guidelines For The Obese, Pre-Diabetic, And Diabetic Population, Dawn Williams Jan 2022

Weight Management Clinical Practice Guidelines For The Obese, Pre-Diabetic, And Diabetic Population, Dawn Williams

Walden Dissertations and Doctoral Studies

AbstractDiabetes is among chronic or lifestyle-related illnesses posing health care challenges at epidemic proportions, pressuring health care systems infrastructure for positive outcome-driven practices and sustainable costs, as continued research suggests that obese people are up to 80 times more likely to develop type 2 diabetes. In June 2021, a weight-loss and wellness center serving this high-risk population established recommended guidelines for Hemoglobin A1C (HbA1C) screening and education. During the initial 3 months of implementation, data findings captured 37% in a total of 220 with elevated HbA1C levels. The gap in practice is that the Wellness Center did not have a …


Medicine Adherence As A Determinant Of Complication Development In Diabetes And Hypertension Patients On A Medical Aid Scheme In Zimbabwe, Tsitsi Moyo Jan 2022

Medicine Adherence As A Determinant Of Complication Development In Diabetes And Hypertension Patients On A Medical Aid Scheme In Zimbabwe, Tsitsi Moyo

Walden Dissertations and Doctoral Studies

Pharmacotherapy is a significant component of chronic disease management; its efficacy depends on long term, correct, and consistent use; however, medicine adherence rates remain low. The cost of medicines is considered a significant barrier to adherence, especially in low-income settings. This quantitative cross-sectional study was conducted using data from Cimas Medical Aid Society collected between 2015 and 2019. The purpose of the study was to determine the extent of the association between medicine adherence, complication development, and cost of care among diabetic and hypertensive patients while controlling for age and gender on a population that does not experience cost barriers …


Incidence And Potential Co-Morbidities In Facial Pigmentary Demarcation Lines In Indian Populations, Lakkireddygari Sujana, Savitha L. Beergouder, Alekhya Rallapalli, Sujatha Alla, Prasanthi Chidipudi Jan 2022

Incidence And Potential Co-Morbidities In Facial Pigmentary Demarcation Lines In Indian Populations, Lakkireddygari Sujana, Savitha L. Beergouder, Alekhya Rallapalli, Sujatha Alla, Prasanthi Chidipudi

Engineering Management & Systems Engineering Faculty Publications

Background: The most noticeable part of human body is face. The obvious boundaries on the skin known as Pigmentary Demarcation Lines (PDL) found over face and have clear borders of abrupt transition between more hyper-pigmented skin and areas of normal skin pigmentation due to differences in melanocyte distribution that may be influenced by multiple factors. Facial pigmentary demarcation lines (PDL) directly reflect on patient’s physical appearance and self-image as they may contribute to dysmorphism and even central to depressive illness in susceptible individuals posing cosmetic concern for the patient and a challenge for dermatologist. Therefore, it is important for early …


Impact Of Public Health Nurse Training On Their Perception To Provide Hypertension And Diabetes Care To Patients In Their Communities., Stephen Goggans, Jean O'Connor, Elena A. Wood, Elizabeth Sacksteder Laclair, Kathryn Martin, Paul Wallach Jan 2022

Impact Of Public Health Nurse Training On Their Perception To Provide Hypertension And Diabetes Care To Patients In Their Communities., Stephen Goggans, Jean O'Connor, Elena A. Wood, Elizabeth Sacksteder Laclair, Kathryn Martin, Paul Wallach

Journal of the Georgia Public Health Association

To evaluate the impact of protocol training by a medical school and public health department on nurses’ perceptions to deliver care to patients with hypertension and diabetes.

Training was delivered using the Georgia Diabetes and Hypertension Nurse protocols for public health nurses. A survey was developed and distributed post training to participants. The training included lectures, workshops, case discussions, simulation, and physical examination practice on standardized patients. Participants were asked about perceptions, both before and after training completion regarding frequency in changing practice and confidence in treating hypertension and diabetes for six items.

Perceived levels of confidence for all questionnaire …


Adverse Childhood Events And Protective Health Behaviors Among Adults With Diabetes Or Diabetes With Comorbid Heart Disease, Ciara Michelle Rukse Jan 2022

Adverse Childhood Events And Protective Health Behaviors Among Adults With Diabetes Or Diabetes With Comorbid Heart Disease, Ciara Michelle Rukse

Walden Dissertations and Doctoral Studies

Diabetes is a prevalent and costly chronic condition that can lead to other comorbid conditions such as heart disease. Disease management is essential but can be stressful and complicated, especially for individuals who have developed maladaptive behaviors in response to exposure to adverse childhood events (ACEs), which are chronic stressors that impact physiological and psychological development. There is limited research on the potential relationship between childhood adversity and engagement in protective health behaviors among U.S. populations with diabetes or diabetes with comorbid heart disease. The ACEs pyramid was the theoretical framework of this quantitative cross-sectional study concerning morbidity and early …