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Barriers To Diabetes Care In Appalachia: Challenges Faced By Healthcare Providers, Megan Cullinan

Senior Honors Theses

Appalachia is a region of the United States that is characterized by high rates of poverty, low levels of education, elevated incidence of chronic disease, and inadequate healthcare. Compared to the national average, the area has an elevated incidence of Type 2 diabetes. Though this disease process is an issue that must be addressed by healthcare providers, these providers face many challenges and barriers to providing adequate care for this disease in the Appalachian population. Barriers to care include geography with limited transportation, an inadequate number of healthcare personnel, patient inability to afford healthcare, patient attitudes toward diabetes care, and …

How To Care For Patients With Diabetes, Tabitha Price

ETSU Faculty Works

Excerpt: More than 25.8 million people in the United States have diabetes. This metabolic disorder is associated with many health complications that result from microvascular and macrovascular diseases.

Educational Materials And Brief Counseling Improve Diabetes Knowledge And Self-Efficacy, Tamara K. Wellman

DNP Projects

Purpose: The purpose of this study was to see if education and counseling of the Appalachian individual with diabetes and a family member/friend would improve knowledge of the disease and self-efficacy of the patient in regard to their diabetes care.

Setting: The setting was one of eight primary care offices of Our Lady of Bellefonte Hospital, Bon Secours, located in the Ashland, Kentucky.

Design: A pilot study of descriptive, comparative design was used.

Subjects: Data were collected from a convenience sample of patients with type 2 diabetes (n=15) that were established at the primary care office and their family members/friends …

Commensal Microbiota And Its Impact On Health And Autoimmune Diabetets, Kyle James Wolf

All ETDs from UAB

Environmental exposures such as diet, use of antibiotics, and lifestyle have significant impact on the health of an individual. One mechanism that acts as a major pathway in these environmental exposures is the role intestinal commensal microbiota play in both metabolic and immunological responses. Metabolic pathways are altered through changes in metabolites provided by commensal microbiota; alterations in microbial make-up can have drastic impacts on metabolic function. Similarly, the development and maturation of the immune system is dependent on the intestinal microbes to induce tolerance and act as both an immune modulator as well as a barrier against pathogens. We …

Type 2 Diabetes Risk Among Asian Indians In The Us: A Pilot Study, Annie Thomas, Alyce Ashcraft

Nursing: School of Nursing Faculty Publications and Other Works

The purpose of this pilot study was to investigate type 2 diabetes risk among Asian Indians of Kerala ethnicity living in a West Texas County of the USA. The study used a descriptive correlational design with thirty-seven adult nondiabetic Asian Indian subjects between 20 and 70 years of age. The measurement included nonbiochemical indices of obesity, family history of type 2 diabetes, length of immigration in the US, history of hypertension, physical activity pattern, and fruit and vegetable intake. The majority of the subjects showed an increased nonbiochemical indices corresponding with overweight and obesity, placing them at risk for type …

Parent Distress In Life With A Child With Type 1 Diabetes, Lauren Nicole Johnson

USF Tampa Graduate Theses and Dissertations

Objective:

The purpose of this study was to highlight parent distress in diabetes, identify factors associated with distress and to show how public health and clinical professionals can assist parents in coping with their child's diabetes and living positively as a family unit.

Methods:

Parents of youth with diabetes (N = 41 qualitative, N = 332 quantitative) were engaged in focus groups, interviews, and survey research to understand their needs and stressors in life with a child with diabetes. Themes were examined in the qualitative data, and correlations and a regression model were run and analyzed from the quantitative data …

Dietary Patterns Associated With Alzheimer's Disease And Related Chronic Disease Risk: A Review, Samantha L. Gardener, Stephanie R. Rainey-Smith, Jennifer Keogh, Suzanne Mathieson, Ralph N. Martins

Research outputs 2013

The world’s population is growing older due to improved healthcare and nutrition. As a result, Alzheimer’s disease (AD) prevalence is rapidly increasing. The focus of the current research climate is shifting from understanding AD pathology and diagnosis to primary prevention and intervention strategies. Diet represents one potential intervention strategy accessible to all. Accumulating evidence suggests diet plays a major role in risk and development of AD and AD-related chronic diseases of the periphery like cardiovascular disease (CVD) and diabetes. This paper reviews studies that have explored the relationship between “a priori” dietary patterns, AD and AD-related chronic disease risk. The …

Ethnic And Gender Differences In Psychosocial Factors In Native Hawaiian, Other Pacific Islanders, And Asian American Adults With Type 2 Diabetes, Jillian Inouye, Dongmei Li, James Davis, Richard Arakaki

Journal of Health Disparities Research and Practice

This study examined the differences between 207 Asians and Native Hawaiian, other Pacific Islanders (NHOPI) with type 2 diabetes among various psychosocial measures. Responses to five multivariable regression models including the Diabetes Quality of Life Questionnaire (DQOL) and Short Form -36® Health Survey (SF-36) were analyzed. Differences were determined by linear contrasts in the multivariate linear regression models after adjusted for multiple demographic and socioeconomic variables. Compared to Asians, NHOPIs perceived a lower impact of diabetes on their quality of life; highlighting differences in perceptions of self-efficacy and self-care activities. Females did better on their diet while males perceived better …

Selective Screening Of Type 2 Diabetes For Washoe County’S Hispanic Population, Linda M. Dunn

Nevada Journal of Public Health

Hispanic Americans with unrecognized, asymptomatic diabetes are more likely to experience poor quality of life and diabetic complications such as heart, eye and kidney disease than non-Hispanic whites of similar age. Multiple factors, such as cultural beliefs, lack of knowledge and limited access to health care, contribute to the fact that one-third of total diabetes among Hispanic Americans is undiagnosed. For Washoe County, Nevada, the actual percentage of adult Hispanics with diabetes may be almost 12%. In 2003, the Defeat Diabetes Screening Project provided three screenings targeting the Hispanic population in Reno and Sparks. Seventy-one percent of 348 screened were …

The Development Of A Diabetes Intervention And Community Education Program, Rosanne Schrieber Keathley Ph.D., Judy R. Sandlin Ph.D., David Ficklen Md, Karen Bilsing Bs

International Journal of Exercise Science: Conference Proceedings

Title: DEVELOPMENT OF A DIABETES INTERVENTION AND COMMUNITY EDUCATION PROGRAM

Author(s): Rosanne Keathley, PHD1, Judy Sandlin, PHD2, David Ficklen, MD3, Karen Bilsing, BS4

Affiliations: 1Health and Kinesiology, Sam Houston State University, 2 Human Resource and Development, Texas A & M University, 3 Chief Medical Officer, Huntsville Memorial Hospital, 4 Community Relations Manager, Huntsville Memorial Hospital

Purpose: Currently 25.8 million people (8.3%) in the US are living with diabetes. This study assessed the need for a diabetes intervention program through community health screenings. Method: Participants (N=323) completed a diabetes risk questionnaire with health screenings. Ages ranged between 17 …

The Responsible Patient: The Senior's Obligation To Conserve Medical Resources, Jeffrey B. Hammond

Marquette Elder's Advisor

No abstract provided.

Perceived Barriers To Healthy Lifestyle Activities In Midlife And Older Australian Women With Type 2 Diabetes, Amanda M. Mcguire, Debra Jane Anderson

International Nursing Research Congress (INRC)

Purpose: Type 2 diabetes is a leading cause of morbidity and mortality in midlife and older Australian women with known modifiable risk factors for type 2 diabetes including smoking, nutrition, physical activity and obesity. In Australia little research has been done to investigate the perceived barriers to healthy lifestyle activities in midlife and older women with type 2 diabetes. The primary aim of this study was to explore the level and type of perceived barriers to health promotion activities. The secondary aim was to explore the relationship of perceived barriers to smoking behaviour, fruit and vegetable intake, physical activity, and …

The Influence Of Social Contextual Conditions And Basic Psychological Need Fulfillment On Self-Management And Emotional Distress Among Urban African American Adults With Type-2 Diabetes Mellitus : A Mixed Methods Study., Sula Marie Hood

Electronic Theses and Dissertations

Introduction: African Americans are disproportionally diagnosed with Type-2 diabetes, and have been observed to have poor self-management, which increases risk of complications. Social influences are commonly associated with diabetes-related outcomes. Purpose: The purpose of the study was to assess whether and how socio-contextual factors influence self-management and emotional distress in urban African American adults living with type-2 diabetes, as well as to assess whether social support facilitate relatedness need fulfillment within this population. The study also sought to gain an understanding of the psychosocial support needs and preferences of urban African American adults living with type-2 diabetes. Methods: The descriptive …

Food Deserts And Their Association With Obesity And Diabetes In Ohio, Alexis Holmes, Detra Thompson

Master of Public Health Program Student Publications

Objective- The purpose of this study was to explore the association of food access, and availability, on prevalence of diabetes and obesity in Ohio census tracts designated as food deserts.

Methods- County and census tract-level data were combined from the USDA Food Environment Atlas and USDA Food Desert Locator respectively. Statistical analysis was conducted using IBM Statistical Package for Social Sciences (SPSS). Non-normally distributed variables were assessed using the Mann-Whitney nonparametric U-test and Spearman’s correlation coefficient. Significance was considered at the p

Results- The mean rate of obesity and diabetes in Ohio in food deserts are 29.5% and 10.7%, when …

Equal Care, Unequal Outcomes: Experiences Of A Reach 2010 Community, Diane Neal, Barbara Carlson, Carolyn Jenkins, Gayenell Magwood

Journal of Health Disparities Research and Practice

Diabetes is growing in prevalence and costs. Guidelines for care have been available since 1983, yet diabetes care and outcomes remain less than ideal. CDC’s Racial and Ethnic Approaches to Community Health 2010 (REACH 2010) identified diabetes in African Americans as a priority for action. This article documents the activities, interventions, and current progress of the REACH 2010 diabetes coalition formed in Charleston and Georgetown counties, South Carolina, in reducing health care disparities and describes next steps for improving outcomes. The Chronic Care Model guided many of the implementation activities, and chart audits were used to document outcomes. Ambulatory care …

So That The People May Live (Hecel Lena Oyate Ki Nipi Kte): Lakota And Dakota Elder Women As Reservoirs Of Life And Keepers Of Knowledge About Health Protection And Diabetes Prevention, Dawn W. Satterfield, John E. Shield, John Buckley, Sally T. Alive

Journal of Health Disparities Research and Practice

Around the world, Type 2 diabetes is on the rise, affecting adults and youth from societies in the throes of industrialization. Over time, uncontrolled diabetes can leave in its wake people facing renal failure, blindness, and heart disease, and communities daunted by new, chaotic phenomena. Westernized lifestyles are a recognized explanation for the escalating prevalence. The web of causation, however, may be broader and thicker, woven by complex interactions with environmental, sociological, and historical roots. The purpose of this participatory ethnographic study was to document, understand, and support Lakota and Dakota elder women’s beliefs and knowledge about health protection and …

Community-Based Partnerships For Improving Chronic Disease Management, James Plumb, Laura Carson Weinsten, Rickie Brawer, Kevin Scott

Department of Family & Community Medicine Faculty Papers

With the growing burden of chronic disease, the medical and public health communities are re-examining their roles and opportunities for more effective prevention and clinical interventions. The potential to significantly improve chronic disease prevention and have an impact on morbidity and mortality from chronic conditions is enhanced by adopting strategies that incorporate a social ecology perspective, realigning the patient-physician relationship, integrating population health perspectives into the Chronic Care Model, and effectively engaging communities using established principles of community engagement.

Copyright © 2012 Elsevier Inc. All rights reserved.

Engaging Rural And Urban Appalachians In Research Using A Community-Based Participatory Research Approach, Laureen H. Smith, Jessica Valenzuela, Robert L. Ludke

PRISM: A Journal of Regional Engagement

Appalachians are particularly vulnerable to chronic diseases as documented by recent national studies that have identified disproportionally higher rates of cancer, diabetes, heart disease and premature mortality for this population. Evidence-based interventions to reduce rates of diabetes and obesity among adults and children have been ineffective among Appalachians where multiple factors including poor living conditions, limited health information, lifestyle behaviors, and lack of access to health care interact to increase the prevalence of these problems. However, there is growing evidence that Community-Based Participatory Research (CBPR) conducted through community-academic partnerships can lead to significant health and social impact in communities faced …

Racial And Ethnic Differences In Cardiovascular Disease Risk Factors In U.S. Older Women: Findings From Behavioral Risk Factor Surveillance Survey, 2003 & 2004, Anita K. Kurian, Kristine Lykens, Sejong Bae, Karan P. Singh

Journal of Health Disparities Research and Practice

The purpose of this study was to examine racial and ethnic variations in the modifiable CVD risk factors in older women (65 years and older). The study data was drawn from the merged 2003 and 2004 national Behavioral Risk Factor Surveillance Survey (BRFSS). Multinomial regression analyses for indicator outcome and multiple logistic regression analyses for binary outcomes were performed to determine the relationship between each of the six dependent variable and the independent variables. Compared to older white women, older black women had significantly higher odds of hypertension, diabetes and obesity. No significant association was found between Hispanics and hypertension. …

The Use Of Provider Audit And Feedback On Improving Hypertension Control In The Type 2 Diabetic Population, Kara Painton

Evidence-Based Practice Project Reports

As the seventh leading cause of death, diabetes affects more than 25 million Americans and contributes to major cardiovascular diseases and complications (CDC, 2011). The cost of care for these Americans is astounding: $174 billion dollars was spent on diabetes care in 2007 (ADA, 2011). Furthermore, an estimated 75% of patients with type 2 diabetes have concomitant hypertension, and nearly one-half of these patients have uncontrolled hypertension (Thomas & Kodack, 2011; USDHHS, 2011). An initial chart audit at an outpatient, rural clinic in east central Illinois revealed that 90% of the type 2 diabetic population had concomitant hypertension, and only …

Inpatient Glycemic Management: Glucose Control Relationship With Hospital Variables, Discharge Planning And Education, Crisamar Javellana-Anunciado Phd, Fnp-Bc, Rn

Dissertations

This dissertation study examined the relationship of glucose control with clinical outcomes, costs, discharge planning and education. Extant studies showed that hyperglycemia, in the presence or absence of a diabetes diagnosis, is prevalent in hospitalized patients. Hyperglycemia is found in one-third of all hospital admissions and is linked to poor clinical outcomes and increased healthcare costs. Furthermore, clinical evidence suggests that lack of discharge coordination associated with medical errors and readmission. This entire body of work contains three distinct sections: Two manuscripts and a grant proposal. The two manuscripts in this study were based on more current retrospective data at …

Bigpic: Bridging Income Generation With Provision Of Incentives For Care, Sonak Pastakia

Changing World Conference

No abstract provided.

Pharmacists Form The Frontline Against Disparities In Diabetes, Joshua Gauthier

XULAneXUS

No abstract provided.

Diabetes Cooking Schools Improve Knowledge And Skills In Making Healthful Food Choices, Martha Archuleta, Dawn Vanleeuwen, Karen Halderson, Linda Wells, Margaret Ann Bock

Journal of Extension

Rates of type 2 diabetes are increasing nationally and in New Mexico, particularly in ethnic minorities. A key self-care area with challenging barriers is healthy eating. The New Mexico Cooperative Extension Service conducts diabetes cooking schools statewide together with community health providers. The study reported here determined if this education was effective in people with type 2 diabetes and their family members. Self-report surveys showed that knowledge and behaviors significantly improved (p

Barriers To Diabetes Self-Management In African American Women, Christine Little-Gregory

Nursing Theses and Capstone Projects

Diabetes is a global epidemic and is a leading cause of disease-related death. In the United States, diabetes is the most common chronic disease affecting 23.6 million Americans or 7.8% of the population (Centers for Disease Control, 2010a). African American women have the highest prevalence of diabetes. Health promotion in the form of diabetes self-management is the key to reducing this urgent disparity. This descriptive study sought to identify barriers to diabetes self-management and identify relationships associated with self-management in this population. This study was conducted using a convenience sampling of African American women with diabetes who were surveyed to …

Self-Care Agency And Self-Care Practice Of Adult African Americans With Type 2 Diabetes, Martha Eddings

Nursing Theses and Capstone Projects

The purpose of the study was to identify and examine the concepts of self-care agency and self-care practice of African American adults diagnosed with type 2 diabetes, living in the local community. The research questions addressed were: 1) What is the self-care agency of adult African Americans diagnosed with type 2 diabetes? 2) What is the self-care practice of adult African Americans diagnosed with type 2 diabetes? 3) Is there a relationship between self-care agency and self-care practice in adult African Americans diagnosed with type 2 diabetes? The Denyes Self-Care Agency Instrument (DSCAI-90) and the Denyes Self-Care Practice Instrument (DSCPI-90) …

Cultural Diabetes, Keri E. Noll

Electronic Theses and Dissertations

Diabetes has become a cultural problem across America, but particularly in the Midwest and Southern regions. For my film, I explored these two areas and compared the food and exercise culture to one of the healthier regions, the West. Having moved from Indiana to Colorado, I used my own personal experiences to analyze why people in the Midwest struggle with diabetes and obesity at such a higher rate than those nearer to the Pacific Ocean. Through a series of interviews with close friends and observational analysis of each state, I came to learn something very important about health: our food …

Factors That Influence Food Access In The United States: A Snapshot Of Food Access In Ohio And Kentucky, Maimouna Falls

Master of Public Health Program Student Publications

Background: The United States is one the richest countries in the world with a Gross Domestic Product (GDP) per capita of $48,442, yet many communities lack access to affordable nutritious food. Access to food impacts health outcomes such as obesity and diabetes. The purpose of this study was to determine the association between food access and rates of obesity and diabetes in the states of Ohio and Kentucky.

Methods: County level food access data from 120 counties in Kentucky and 88 counties in Ohio were obtained from the USDA website. The dataset included demographic variables and poverty rates. Food access …

The Role Of Vascular Endothelial Growth Factor At The Blood-Brain Barrier In Diabetes, Aileen J. Marcelo

Theses, Dissertations and Capstones

Diabetes is a risk factor for stroke and vascular dementia. Clinical studies using gadolinium-magnetic resonance imaging techniques have shown diabetic patients exhibit a permeability increase at the blood-brain barrier (BBB) (Starr et al, 2003). The BBB, a vascular interface at the level of brain microvascular vessels, functions to provide nutrients and oxygen from the peripheral circulation, mediates waste efflux from the brain, and protects the brain from toxins. These functions are due to the presence of tight junction proteins. Animal studies have shown increased BBB permeability is due to a decrease in these proteins (Hawkins et al, 2007). Based on …

Type 2 Diabetes And Insomnia: Impact On Metabolic Control, Cheryl Lee Tannas

Wayne State University Dissertations

Diabetes is one of the most serious health challenges in the United States, affecting nearly 21 million Americans. The goal of diabetes management is to maintain the blood glucose close to normal to prevent diabetic complications and therefore extending life expectancy and improving quality of life. Research now indicates a relationship of the quantity and quality of sleep to glycemic control in type 2 diabetics. No research on the impact of insomnia on diabetes prevention and/or management was found in the literature. The purpose of this 11 week intervention study was to examine the effects of participation in Cognitive Behavioral …