Perceived Discrimination in Medical Care Settings on A1c Data From the All of Us Program.

Ya-Ching Huang, Ashley Kurian, Gang Han, Kelly Wilson
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Abstract

Approximately 11.3% of the U.S. population has diabetes, mostly type 2 diabetes (T2DM), and maintenance of A1c levels is vital to prevent complications among patients. Perceived discrimination in medical care settings (PDMS) affects patient care, while social support may mitigate its impact. This study aims to explore the influence of PDMS on A1c levels in T2DM patients using the All of Us Research Program, which collects health data from diverse individuals across the United States. Our study included 135 T2DM-diagnosed participants. Measures included demographic info, A1c data, self-rated health, social support, and perceived discrimination. Descriptive and multivariable regression analyses were conducted. Participants were predominantly older, female, non-Hispanic White, and had relatively high levels of education and above-average income levels. Most rated their health positively. Social support, including marital status, was considered. The average A1c level was 6.72 ± 1.54. Notably, 42% experienced high PDMS, correlating with poorer self-rated health. Multivariable regression revealed significant associations between A1c and follow-up time, age, marital status, and PDMS. Specifically, PDMS significantly correlates with poorer A1c, indicating a potential impact on diabetes management. Findings emphasize the need for tailored interventions and anti-discrimination guidelines in clinical practice. Insights from this study inform interventions mitigating discrimination and enhancing diabetes care. Health care providers fostering inclusive environments can improve patient trust and adherence to treatment, leading to better outcomes. Cultivating inclusive environments through health care providers improves patient outcomes. Diverse population inclusion in future studies is crucial.

来自我们所有人计划的A1c数据在医疗保健机构中的感知歧视
大约11.3%的美国人患有糖尿病,主要是2型糖尿病(T2DM),维持A1c水平对于预防患者并发症至关重要。感知歧视在医疗保健环境(PDMS)影响患者护理,而社会支持可以减轻其影响。本研究旨在利用我们所有人的研究项目,探讨PDMS对2型糖尿病患者A1c水平的影响,该项目收集了来自美国不同个体的健康数据。我们的研究纳入了135名诊断为t2dm的参与者。测量包括人口统计信息、糖化血红蛋白数据、自评健康、社会支持和感知歧视。进行了描述性和多变量回归分析。参与者主要是年龄较大,女性,非西班牙裔白人,教育水平相对较高,收入水平高于平均水平。大多数人对自己的健康状况评价积极。社会支持,包括婚姻状况也被考虑在内。平均A1c水平为6.72±1.54。值得注意的是,42%的人经历了较高的PDMS,这与较差的自我评价健康有关。多变量回归显示A1c与随访时间、年龄、婚姻状况和PDMS有显著相关性。具体而言,PDMS与较差的A1c显著相关,表明对糖尿病管理有潜在影响。研究结果强调在临床实践中需要有针对性的干预措施和反歧视指南。本研究的见解为干预减轻歧视和加强糖尿病护理提供了信息。卫生保健提供者营造包容的环境可以提高患者的信任和对治疗的依从性,从而产生更好的结果。通过卫生保健提供者培养包容的环境可改善患者的治疗效果。在未来的研究中纳入多样化的人群是至关重要的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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