社会脆弱性和国家糖尿病预防计划的认可状况。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

American Journal of Preventive Medicine Pub Date : 2025-01-01 DOI:10.1016/j.amepre.2024.08.018

Taynara Formagini PhD , Daphnee Rodriguez BA , Ariba Rezwan MSW , Jeanean B. Naqvi PhD , Matthew James O'Brien MD , Boon Peng Ng PhD

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引用次数: 0

摘要

导言：根据特定的计划标准和结果，实施全国糖尿病预防计划的组织可获得待定、初步、全面或全面加分的认可状态。获得正式/全加认可对于组织持续开展项目和获得成本补偿至关重要，但贫困地区的组织在获得这一认可级别时可能会面临障碍。本研究探讨了县级社会脆弱性与国家 DPP 全面/全加认可地位之间的关联：利用 2022 年全国 DPP 注册表和 2018 年疾病预防控制中心社会脆弱性指数（SVI），创建了一个三级分类因变量（n=843）：没有组织获得全面/全加认可的县、至少有一个组织未获得全面/全加认可的县、所有组织均获得全面/全加认可的县。在对混杂因素进行调整后，在 2023 年对一个多叉 logit 模型进行了分析，以研究县一级的社会脆弱性指数与亲自全面/全面认可组织之间的关联：与社会脆弱性较低的县相比，社会脆弱性较高的县没有全/全加认可组织的几率明显更高。例如，与所有组织都获得疾控中心全面/全面加分认可相比，社会脆弱性较高的县没有组织获得全面/全面加分认可的几率要高出2.63倍（95% CI：1.55-4.47）：结论：研究结果表明，弱势社区中的组织在国家 DPP 认可状态方面存在差异。制定战略以确保社会弱势地区的组织至少获得完全认可地位，对于计划的可持续性和减少与糖尿病相关的健康差异至关重要。

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Social Vulnerability and National Diabetes Prevention Program Recognition Status

Introduction

The CDC National Diabetes Prevention Program (National DPP) aims to reduce the incidence of type 2 diabetes in the U.S. Organizations delivering the National DPP receive pending, preliminary, full, or full-plus recognition status based on specific program criteria and outcomes. Achieving full/full-plus recognition is critical for organizations to sustain the program and receive reimbursements to cover costs, but organizations in disadvantaged areas may face barriers to obtaining this level of recognition. This study examined the association between county-level social vulnerability and full/full-plus recognition status within the National DPP.

Methods

Using the 2022 National DPP registry and the 2018 CDC Social Vulnerability Index (SVI), a three-level categorical dependent variable was created (n=843): counties without organizations having full/full-plus recognition, counties with at least one organization not having full/full-plus recognition, and counties with all organizations having full/full-plus recognition. A multinomial logit model was analyzed in 2023 to examine the association between SVI and in-person full/full-plus recognition organizations at the county level, adjusting for confounders.

Results

Compared to counties with low social vulnerability, counties with higher social vulnerability had significantly higher odds of having no organizations with full/full-plus recognition. For example, counties with high SVI had 2.63 (95% CI: 1.55–4.47) times higher odds of having no organizations with full/full-plus recognition compared to having all organizations with full/full-plus CDC recognition.

Conclusions

The findings suggest disparities in the National DPP recognition status among organizations in vulnerable communities. Developing strategies to ensure organizations in high social vulnerability areas achieve at least full recognition status is critical for program sustainability and reducing diabetes-related health disparities.

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来源期刊

American Journal of Preventive Medicine 医学-公共卫生、环境卫生与职业卫生

CiteScore

8.60

自引率

1.80%

发文量

395

审稿时长

32 days

期刊介绍： The American Journal of Preventive Medicine is the official journal of the American College of Preventive Medicine and the Association for Prevention Teaching and Research. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health. Of particular emphasis are papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women''s health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and substance use disorders. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. Papers on health services research pertinent to prevention and public health are also published. The journal also publishes official policy statements from the two co-sponsoring organizations, review articles, media reviews, and editorials. Finally, the journal periodically publishes supplements and special theme issues devoted to areas of current interest to the prevention community.