NAU publications by CHER
Faculty & staff publications
NAU faculty and staff have the opportunity to publish their findings and knowledge as authors. CHER has many researchers that have been cited multiple times in major publications for their great work. The Center for Health Equity Research has accumulated all faculty publications into one, easy to navigate database.
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Camplain, Ricky; Lininger, Monica R; Baldwin, Julie A; II, Robert Trotter T Cardiovascular Risk Factors among Individuals Incarcerated in an Arizona County Jail Journal Article International Journal of Environmental Research and Public Health , 18 (13), 2021. @article{Camplain2021, title = {Cardiovascular Risk Factors among Individuals Incarcerated in an Arizona County Jail}, author = {Ricky Camplain and Monica R. Lininger and Julie A. Baldwin and Robert T. Trotter II}, url = {https://doi.org/10.3390/ijerph18137007}, doi = {10.3390/ijerph18137007}, year = {2021}, date = {2021-06-30}, journal = {International Journal of Environmental Research and Public Health }, volume = {18}, number = {13}, abstract = {We aimed to estimate the prevalence of cardiovascular risk factors, including hypertension, diabetes, high cholesterol, cigarette smoking, alcohol consumption, and obesity among a sample of individuals incarcerated in an Arizona county jail and compare prevalence estimates to a matched non-institutionalized population. From 2017–2018, individuals housed at a county jail completed a cross-sectional health survey. We estimated the prevalence of hypertension, diabetes, cholesterol, overweight/obesity, cigarette smoking, binge drinking, and self-reported health among individuals incarcerated. We compared prevalence estimates of cardiovascular risk factors to a matched sample of 2017–2018 NHANES participants. Overall, 35.9%, 7.7%, and 17.8% of individuals incarcerated in jail self-reported hypertension, diabetes, and high cholesterol, respectively. Of individuals incarcerated, 59.6% were overweight or obese and 36.8% self-reported fair or poor general health. Over half of individuals incarcerated reported ever smoking cigarettes (72.3%) and binge drinking (60.7%). Compared to a matched sample of NHANES participants, individuals incarcerated in jail had a statistically higher prevalence of cigarette smoking and binge drinking. Screening of cardiovascular risk factors and providing preventive measures and interventions, such as healthy eating, physical activity, or pharmacological adherence interventions, while individuals are incarcerated may contribute to the prevention and management of cardiovascular risk factors and, eventually, cardiovascular disease.}, keywords = {}, pubstate = {published}, tppubtype = {article} } We aimed to estimate the prevalence of cardiovascular risk factors, including hypertension, diabetes, high cholesterol, cigarette smoking, alcohol consumption, and obesity among a sample of individuals incarcerated in an Arizona county jail and compare prevalence estimates to a matched non-institutionalized population. From 2017–2018, individuals housed at a county jail completed a cross-sectional health survey. We estimated the prevalence of hypertension, diabetes, cholesterol, overweight/obesity, cigarette smoking, binge drinking, and self-reported health among individuals incarcerated. We compared prevalence estimates of cardiovascular risk factors to a matched sample of 2017–2018 NHANES participants. Overall, 35.9%, 7.7%, and 17.8% of individuals incarcerated in jail self-reported hypertension, diabetes, and high cholesterol, respectively. Of individuals incarcerated, 59.6% were overweight or obese and 36.8% self-reported fair or poor general health. Over half of individuals incarcerated reported ever smoking cigarettes (72.3%) and binge drinking (60.7%). Compared to a matched sample of NHANES participants, individuals incarcerated in jail had a statistically higher prevalence of cigarette smoking and binge drinking. Screening of cardiovascular risk factors and providing preventive measures and interventions, such as healthy eating, physical activity, or pharmacological adherence interventions, while individuals are incarcerated may contribute to the prevention and management of cardiovascular risk factors and, eventually, cardiovascular disease. |
King, Caroline; Atwood, Sidney; Lozada, Mia; Nelson, Adrianne Katrina; Brown, Chris; Sabo, Samantha; Curley, Cameron; Muskett, Olivia; Orav, Endel John; Shin, Sonya PLoS ONE, 13 (8), 2018. @article{King2018b, title = {Identifying risk factors for 30-day readmission events among American Indian patients with diabetes in the Four Corners region of the southwest from 2009 to 2016.}, author = {Caroline King and Sidney Atwood and Mia Lozada and Adrianne Katrina Nelson and Chris Brown and Samantha Sabo and Cameron Curley and Olivia Muskett and Endel John Orav and Sonya Shin}, editor = {Prabath W. B. Nanayakkara}, url = {https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0195476}, doi = {10.1371/journal.pone.0195476}, year = {2018}, date = {2018-08-02}, journal = {PLoS ONE}, volume = {13}, number = {8}, abstract = {OBJECTIVE: The objective of this study was to identify risk factors for 30-day readmission events for American Indian patients with diabetes in the southwest. RESEARCH DESIGN AND METHODS: Data from patients with diabetes admitted to Gallup Indian Medical Center between 2009 and 2016 were analyzed using logistic regression analyses. RESULTS: Of 2,660 patients, 394 (14.8%) patients had at least one readmission within 30 days of discharge. Older age (OR (95% CI) = 1.26, (1.17, 1.36)), longer length of stay (OR (95% CI) = 1.01, (1.0001, 1.0342)), and a history of substance use disorder (OR (95% CI) = 1.80, (1.25, 2.60)) were risk factors for 30-day readmission. An American Indian language preference was protective against readmission. CONCLUSIONS: Readmission events are complex and may reflect broad and interwoven disparities in community systems. Future research should work to support community-defined interventions to address both in hospital and external factors that impact risk factors for readmission.}, keywords = {}, pubstate = {published}, tppubtype = {article} } OBJECTIVE: The objective of this study was to identify risk factors for 30-day readmission events for American Indian patients with diabetes in the southwest. RESEARCH DESIGN AND METHODS: Data from patients with diabetes admitted to Gallup Indian Medical Center between 2009 and 2016 were analyzed using logistic regression analyses. RESULTS: Of 2,660 patients, 394 (14.8%) patients had at least one readmission within 30 days of discharge. Older age (OR (95% CI) = 1.26, (1.17, 1.36)), longer length of stay (OR (95% CI) = 1.01, (1.0001, 1.0342)), and a history of substance use disorder (OR (95% CI) = 1.80, (1.25, 2.60)) were risk factors for 30-day readmission. An American Indian language preference was protective against readmission. CONCLUSIONS: Readmission events are complex and may reflect broad and interwoven disparities in community systems. Future research should work to support community-defined interventions to address both in hospital and external factors that impact risk factors for readmission. |
King, Caroline; Atwood, Sidney; Brown, Chris; Nelson, Adrianne Katrina; Lozada, Mia; Wei, Jennie; Merino, Maricruz; Curley, Cameron; Muskett, Olivia; Sabo, Samantha; Gampa, Vikas; Orav, John; Shin, Sonya Primary Care Diabetes, 12 (3), pp. 212-217, 2018. @article{King2018, title = {Primary care and survival among American Indian patients with diabetes in the Southwest United States: Evaluation of a cohort study at Gallup Indian Medical Center, 2009-2016}, author = {Caroline King and Sidney Atwood and Chris Brown and Adrianne Katrina Nelson and Mia Lozada and Jennie Wei and Maricruz Merino and Cameron Curley and Olivia Muskett and Samantha Sabo and Vikas Gampa and John Orav and Sonya Shin}, url = {https://www.primary-care-diabetes.com/article/S1751-9918(17)30184-5/fulltext}, year = {2018}, date = {2018-06-01}, journal = {Primary Care Diabetes}, volume = {12}, number = {3}, pages = {212-217}, abstract = {Objectives To evaluate the role of primary care healthcare delivery on survival for American Indian patients with diabetes in the southwest United States. Methods Data from patients with diabetes admitted to Gallup Indian Medical Center between 2009 and 2016 were analyzed using a log-rank test and Cox Proportional Hazards analyses. Results Of the 2661 patients included in analysis, 286 patients died during the study period. Having visited a primary care provider in the year prior to first admission of the study period was protective against all-cause mortality in unadjusted analysis (HR (95% CI) = 0.47 (0.31, 0.73)), and after adjustment. The log-rank test indicated there is a significant difference in overall survival by primary care engagement history prior to admission (p < 0.001). The median survival time for patients who had seen a primary care provider was 2322 days versus 2158 days for those who had not seen a primary care provider. Conclusions Compared with those who did not see a primary care provider in the year prior to admission, having seen a primary care provider was associated with improved survival after admission.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Objectives To evaluate the role of primary care healthcare delivery on survival for American Indian patients with diabetes in the southwest United States. Methods Data from patients with diabetes admitted to Gallup Indian Medical Center between 2009 and 2016 were analyzed using a log-rank test and Cox Proportional Hazards analyses. Results Of the 2661 patients included in analysis, 286 patients died during the study period. Having visited a primary care provider in the year prior to first admission of the study period was protective against all-cause mortality in unadjusted analysis (HR (95% CI) = 0.47 (0.31, 0.73)), and after adjustment. The log-rank test indicated there is a significant difference in overall survival by primary care engagement history prior to admission (p < 0.001). The median survival time for patients who had seen a primary care provider was 2322 days versus 2158 days for those who had not seen a primary care provider. Conclusions Compared with those who did not see a primary care provider in the year prior to admission, having seen a primary care provider was associated with improved survival after admission. |
Teufel-Shone, Nicolette; Jiang, Luohua; Rockwell, Jennifer; Chang, Jennifer; Beals, Janette; Bullock, Ann; Manson, Spero M Food choices and distress in reservation-based American Indians and Alaska Natives with type 2 diabetes Journal Article Public Health Nutrition, pp. 1-9, 2018. @article{Teufel-Shone2018, title = {Food choices and distress in reservation-based American Indians and Alaska Natives with type 2 diabetes}, author = {Nicolette Teufel-Shone and Luohua Jiang and Jennifer Rockwell and Jennifer Chang and Janette Beals and Ann Bullock and Spero M Manson}, url = {https://doi.org/10.1017/S1368980018000897}, doi = {10.1017/S1368980018000897}, year = {2018}, date = {2018-03-12}, journal = {Public Health Nutrition}, pages = {1-9}, abstract = {Objective: To examine the association between food choice and distress in a large national sample of American Indians/Alaska Natives (AI/AN) with type 2 diabetes. Design: Participants completed a sociodemographic survey, an FFQ and the Kessler-6 Distress Scale. Foods were identified as ‘healthy’ or ‘unhealthy’ using a classification grounded in the health education provided by the programme case managers; healthy and unhealthy food scores were calculated using reported intake frequencies. Pearson’s correlation coefficients for distress and food scores were calculated for all participants and by gender. Multiple linear regression models stratified by gender assessed the association between distress and food scores, controlling for sociodemographics and duration of type 2 diabetes. Setting: Rural AI reservations and AN villages. Subjects: AI/AN (n 2484) with type 2 diabetes. Results: Both males (34·9 %) and females (65·1 %) had higher healthy food scores than unhealthy scores. In bivariate analysis, distress level had a significant negative correlation with healthy food scores among female participants, but the association was not significant among males. Significant positive correlations between distress and unhealthy food scores were found in both genders. In the final multivariate models, healthy food scores were not significantly related to distress; however, unhealthy food scores showed significant positive relationships with distress for both genders (females: β = 0·078}, keywords = {}, pubstate = {published}, tppubtype = {article} } Objective: To examine the association between food choice and distress in a large national sample of American Indians/Alaska Natives (AI/AN) with type 2 diabetes. Design: Participants completed a sociodemographic survey, an FFQ and the Kessler-6 Distress Scale. Foods were identified as ‘healthy’ or ‘unhealthy’ using a classification grounded in the health education provided by the programme case managers; healthy and unhealthy food scores were calculated using reported intake frequencies. Pearson’s correlation coefficients for distress and food scores were calculated for all participants and by gender. Multiple linear regression models stratified by gender assessed the association between distress and food scores, controlling for sociodemographics and duration of type 2 diabetes. Setting: Rural AI reservations and AN villages. Subjects: AI/AN (n 2484) with type 2 diabetes. Results: Both males (34·9 %) and females (65·1 %) had higher healthy food scores than unhealthy scores. In bivariate analysis, distress level had a significant negative correlation with healthy food scores among female participants, but the association was not significant among males. Significant positive correlations between distress and unhealthy food scores were found in both genders. In the final multivariate models, healthy food scores were not significantly related to distress; however, unhealthy food scores showed significant positive relationships with distress for both genders (females: β = 0·078 |
Sabo, Samantha; Champion, Catalina Denman; Bell, Melanie L; Vucovich, Elsa Cornejo; Ingram, Maia; Valencia, Celina; del Vasquez, Maria Carmen Castro; Gonzalez-Fagoaga, Eduardo; de Zapien, Jill Geurnsey; Rosales, Cecilia B Meta Salud Diabetes study protocol: A cluster-randomized trial to reduce cardiovascular risk among a diabetic population of Mexico Journal Article BMJ Open, 8 (3), 2018. @article{Sabo2018, title = {Meta Salud Diabetes study protocol: A cluster-randomized trial to reduce cardiovascular risk among a diabetic population of Mexico}, author = {Samantha Sabo and Catalina Denman Champion and Melanie L Bell and Elsa Cornejo Vucovich and Maia Ingram and Celina Valencia and Maria Carmen Castro del Vasquez and Eduardo Gonzalez-Fagoaga and Jill Geurnsey de Zapien and Cecilia B Rosales}, url = {https://bmjopen.bmj.com/content/bmjopen/8/3/e020762.full.pdf}, doi = {10.1136/bmjopen-2017-020762}, year = {2018}, date = {2018-03-12}, journal = {BMJ Open}, volume = {8}, number = {3}, abstract = {Introduction Northern Mexico has among the highest rates of cardiovascular disease (CVD) and diabetes in the world. This research addresses core gaps in implementation science to develop, test and scale-up CVD risk-reduction interventions in diabetics through a national primary care health system. Methods and analysis The Meta Salud Diabetes (MSD) research project is a parallel two-arm cluster-randomized clinical behavioral trial based in 22 (n=22) health centers in Sonora, Mexico. MSD aims to evaluate the effectiveness of the MSD intervention for the secondary prevention of CVD risk factors among a diabetic population (n=320) compared with the study control of usual care. The MSD intervention consists of 2-hour class sessions delivered over a 13-week period providing educational information to encourage sustainable behavioral change to prevent disease complications including the adoption of physical activity. MSD is delivered within the context of Mexico’s national primary care health centre system by health professionals, including nurses, physicians and community health workers via existing social support groups for individuals diagnosed with chronic disease. Mixed models are used to estimate the effect of MSD by comparing cardiovascular risk, as measured by the Framingham Risk Score, between the trial arms. Secondary outcomes include hypertension, behavioral risk factors and psychosocial factors. Ethics and dissemination This work is supported by the National Institutes of Health, National Heart Lung and Blood Institute (1R01HL125996-01) and approved by the University of Arizona Research Institutional Review Board (Protocol 1508040144) and the Research Bioethics Committee at the University of Sonora. The first Internal Review Board approval date was 31 August 2015 with five subsequent approved amendments. This article refers to protocol V.0.2, dated 30 January 2017. Results will be disseminated via peer-reviewed publication and presentation at international conferences and will be shared through meetings with health systems officials.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Introduction Northern Mexico has among the highest rates of cardiovascular disease (CVD) and diabetes in the world. This research addresses core gaps in implementation science to develop, test and scale-up CVD risk-reduction interventions in diabetics through a national primary care health system. Methods and analysis The Meta Salud Diabetes (MSD) research project is a parallel two-arm cluster-randomized clinical behavioral trial based in 22 (n=22) health centers in Sonora, Mexico. MSD aims to evaluate the effectiveness of the MSD intervention for the secondary prevention of CVD risk factors among a diabetic population (n=320) compared with the study control of usual care. The MSD intervention consists of 2-hour class sessions delivered over a 13-week period providing educational information to encourage sustainable behavioral change to prevent disease complications including the adoption of physical activity. MSD is delivered within the context of Mexico’s national primary care health centre system by health professionals, including nurses, physicians and community health workers via existing social support groups for individuals diagnosed with chronic disease. Mixed models are used to estimate the effect of MSD by comparing cardiovascular risk, as measured by the Framingham Risk Score, between the trial arms. Secondary outcomes include hypertension, behavioral risk factors and psychosocial factors. Ethics and dissemination This work is supported by the National Institutes of Health, National Heart Lung and Blood Institute (1R01HL125996-01) and approved by the University of Arizona Research Institutional Review Board (Protocol 1508040144) and the Research Bioethics Committee at the University of Sonora. The first Internal Review Board approval date was 31 August 2015 with five subsequent approved amendments. This article refers to protocol V.0.2, dated 30 January 2017. Results will be disseminated via peer-reviewed publication and presentation at international conferences and will be shared through meetings with health systems officials. |
Reinschmidt, Kerstin M; Teufel-Shone, Nicolette; Bradford, Gail; Drummond, Rebecca L; Torres, Emma; Redondo, Floribella; Elenes, Jo Jean; Sanders, Alicia; Gastelum, Sylvia; Moore-Monroy, Martha; Barajas, Salvador; Fernandez, Lourdes; Alvidrez, Rosy; de Zapien, Jill Guernsey; Staten, Lisa K Taking a broad approach to public health program adaptation: adapting a family-based diabetes education program Journal Article The Journal of Primary Prevention, 31 (1-2), pp. 69-83, 2010. @article{Reinschmidt2010, title = {Taking a broad approach to public health program adaptation: adapting a family-based diabetes education program}, author = {Kerstin M Reinschmidt and Nicolette Teufel-Shone and Gail Bradford and Rebecca L Drummond and Emma Torres and Floribella Redondo and Jo Jean Elenes and Alicia Sanders and Sylvia Gastelum and Martha Moore-Monroy and Salvador Barajas and Lourdes Fernandez and Rosy Alvidrez and Jill Guernsey de Zapien and Lisa K Staten}, url = {https://www.ncbi.nlm.nih.gov/pubmed/20140646}, doi = {10.1007/s10935-010-0208-6}, year = {2010}, date = {2010-04-01}, journal = {The Journal of Primary Prevention}, volume = {31}, number = {1-2}, pages = {69-83}, abstract = {Diabetes health disparities among Hispanic populations have been countered with federally funded health promotion and disease prevention programs. Dissemination has focused on program adaptation to local cultural contexts for greater acceptability and sustainability. Taking a broader approach and drawing on our experience in Mexican American communities at the U.S.-Mexico Border, we demonstrate how interventions are adapted at the intersection of multiple cultural contexts: the populations targeted, the community- and university-based entities designing and implementing interventions, and the field team delivering the materials. Program adaptation involves negotiations between representatives of all contexts and is imperative in promoting local ownership and program sustainability.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Diabetes health disparities among Hispanic populations have been countered with federally funded health promotion and disease prevention programs. Dissemination has focused on program adaptation to local cultural contexts for greater acceptability and sustainability. Taking a broader approach and drawing on our experience in Mexican American communities at the U.S.-Mexico Border, we demonstrate how interventions are adapted at the intersection of multiple cultural contexts: the populations targeted, the community- and university-based entities designing and implementing interventions, and the field team delivering the materials. Program adaptation involves negotiations between representatives of all contexts and is imperative in promoting local ownership and program sustainability. |
2021 |
Camplain, Ricky; Lininger, Monica R; Baldwin, Julie A; II, Robert Trotter T Cardiovascular Risk Factors among Individuals Incarcerated in an Arizona County Jail Journal Article International Journal of Environmental Research and Public Health , 18 (13), 2021. @article{Camplain2021, title = {Cardiovascular Risk Factors among Individuals Incarcerated in an Arizona County Jail}, author = {Ricky Camplain and Monica R. Lininger and Julie A. Baldwin and Robert T. Trotter II}, url = {https://doi.org/10.3390/ijerph18137007}, doi = {10.3390/ijerph18137007}, year = {2021}, date = {2021-06-30}, journal = {International Journal of Environmental Research and Public Health }, volume = {18}, number = {13}, abstract = {We aimed to estimate the prevalence of cardiovascular risk factors, including hypertension, diabetes, high cholesterol, cigarette smoking, alcohol consumption, and obesity among a sample of individuals incarcerated in an Arizona county jail and compare prevalence estimates to a matched non-institutionalized population. From 2017–2018, individuals housed at a county jail completed a cross-sectional health survey. We estimated the prevalence of hypertension, diabetes, cholesterol, overweight/obesity, cigarette smoking, binge drinking, and self-reported health among individuals incarcerated. We compared prevalence estimates of cardiovascular risk factors to a matched sample of 2017–2018 NHANES participants. Overall, 35.9%, 7.7%, and 17.8% of individuals incarcerated in jail self-reported hypertension, diabetes, and high cholesterol, respectively. Of individuals incarcerated, 59.6% were overweight or obese and 36.8% self-reported fair or poor general health. Over half of individuals incarcerated reported ever smoking cigarettes (72.3%) and binge drinking (60.7%). Compared to a matched sample of NHANES participants, individuals incarcerated in jail had a statistically higher prevalence of cigarette smoking and binge drinking. Screening of cardiovascular risk factors and providing preventive measures and interventions, such as healthy eating, physical activity, or pharmacological adherence interventions, while individuals are incarcerated may contribute to the prevention and management of cardiovascular risk factors and, eventually, cardiovascular disease.}, keywords = {}, pubstate = {published}, tppubtype = {article} } We aimed to estimate the prevalence of cardiovascular risk factors, including hypertension, diabetes, high cholesterol, cigarette smoking, alcohol consumption, and obesity among a sample of individuals incarcerated in an Arizona county jail and compare prevalence estimates to a matched non-institutionalized population. From 2017–2018, individuals housed at a county jail completed a cross-sectional health survey. We estimated the prevalence of hypertension, diabetes, cholesterol, overweight/obesity, cigarette smoking, binge drinking, and self-reported health among individuals incarcerated. We compared prevalence estimates of cardiovascular risk factors to a matched sample of 2017–2018 NHANES participants. Overall, 35.9%, 7.7%, and 17.8% of individuals incarcerated in jail self-reported hypertension, diabetes, and high cholesterol, respectively. Of individuals incarcerated, 59.6% were overweight or obese and 36.8% self-reported fair or poor general health. Over half of individuals incarcerated reported ever smoking cigarettes (72.3%) and binge drinking (60.7%). Compared to a matched sample of NHANES participants, individuals incarcerated in jail had a statistically higher prevalence of cigarette smoking and binge drinking. Screening of cardiovascular risk factors and providing preventive measures and interventions, such as healthy eating, physical activity, or pharmacological adherence interventions, while individuals are incarcerated may contribute to the prevention and management of cardiovascular risk factors and, eventually, cardiovascular disease. |
2018 |
King, Caroline; Atwood, Sidney; Lozada, Mia; Nelson, Adrianne Katrina; Brown, Chris; Sabo, Samantha; Curley, Cameron; Muskett, Olivia; Orav, Endel John; Shin, Sonya PLoS ONE, 13 (8), 2018. @article{King2018b, title = {Identifying risk factors for 30-day readmission events among American Indian patients with diabetes in the Four Corners region of the southwest from 2009 to 2016.}, author = {Caroline King and Sidney Atwood and Mia Lozada and Adrianne Katrina Nelson and Chris Brown and Samantha Sabo and Cameron Curley and Olivia Muskett and Endel John Orav and Sonya Shin}, editor = {Prabath W. B. Nanayakkara}, url = {https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0195476}, doi = {10.1371/journal.pone.0195476}, year = {2018}, date = {2018-08-02}, journal = {PLoS ONE}, volume = {13}, number = {8}, abstract = {OBJECTIVE: The objective of this study was to identify risk factors for 30-day readmission events for American Indian patients with diabetes in the southwest. RESEARCH DESIGN AND METHODS: Data from patients with diabetes admitted to Gallup Indian Medical Center between 2009 and 2016 were analyzed using logistic regression analyses. RESULTS: Of 2,660 patients, 394 (14.8%) patients had at least one readmission within 30 days of discharge. Older age (OR (95% CI) = 1.26, (1.17, 1.36)), longer length of stay (OR (95% CI) = 1.01, (1.0001, 1.0342)), and a history of substance use disorder (OR (95% CI) = 1.80, (1.25, 2.60)) were risk factors for 30-day readmission. An American Indian language preference was protective against readmission. CONCLUSIONS: Readmission events are complex and may reflect broad and interwoven disparities in community systems. Future research should work to support community-defined interventions to address both in hospital and external factors that impact risk factors for readmission.}, keywords = {}, pubstate = {published}, tppubtype = {article} } OBJECTIVE: The objective of this study was to identify risk factors for 30-day readmission events for American Indian patients with diabetes in the southwest. RESEARCH DESIGN AND METHODS: Data from patients with diabetes admitted to Gallup Indian Medical Center between 2009 and 2016 were analyzed using logistic regression analyses. RESULTS: Of 2,660 patients, 394 (14.8%) patients had at least one readmission within 30 days of discharge. Older age (OR (95% CI) = 1.26, (1.17, 1.36)), longer length of stay (OR (95% CI) = 1.01, (1.0001, 1.0342)), and a history of substance use disorder (OR (95% CI) = 1.80, (1.25, 2.60)) were risk factors for 30-day readmission. An American Indian language preference was protective against readmission. CONCLUSIONS: Readmission events are complex and may reflect broad and interwoven disparities in community systems. Future research should work to support community-defined interventions to address both in hospital and external factors that impact risk factors for readmission. |
King, Caroline; Atwood, Sidney; Brown, Chris; Nelson, Adrianne Katrina; Lozada, Mia; Wei, Jennie; Merino, Maricruz; Curley, Cameron; Muskett, Olivia; Sabo, Samantha; Gampa, Vikas; Orav, John; Shin, Sonya Primary Care Diabetes, 12 (3), pp. 212-217, 2018. @article{King2018, title = {Primary care and survival among American Indian patients with diabetes in the Southwest United States: Evaluation of a cohort study at Gallup Indian Medical Center, 2009-2016}, author = {Caroline King and Sidney Atwood and Chris Brown and Adrianne Katrina Nelson and Mia Lozada and Jennie Wei and Maricruz Merino and Cameron Curley and Olivia Muskett and Samantha Sabo and Vikas Gampa and John Orav and Sonya Shin}, url = {https://www.primary-care-diabetes.com/article/S1751-9918(17)30184-5/fulltext}, year = {2018}, date = {2018-06-01}, journal = {Primary Care Diabetes}, volume = {12}, number = {3}, pages = {212-217}, abstract = {Objectives To evaluate the role of primary care healthcare delivery on survival for American Indian patients with diabetes in the southwest United States. Methods Data from patients with diabetes admitted to Gallup Indian Medical Center between 2009 and 2016 were analyzed using a log-rank test and Cox Proportional Hazards analyses. Results Of the 2661 patients included in analysis, 286 patients died during the study period. Having visited a primary care provider in the year prior to first admission of the study period was protective against all-cause mortality in unadjusted analysis (HR (95% CI) = 0.47 (0.31, 0.73)), and after adjustment. The log-rank test indicated there is a significant difference in overall survival by primary care engagement history prior to admission (p < 0.001). The median survival time for patients who had seen a primary care provider was 2322 days versus 2158 days for those who had not seen a primary care provider. Conclusions Compared with those who did not see a primary care provider in the year prior to admission, having seen a primary care provider was associated with improved survival after admission.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Objectives To evaluate the role of primary care healthcare delivery on survival for American Indian patients with diabetes in the southwest United States. Methods Data from patients with diabetes admitted to Gallup Indian Medical Center between 2009 and 2016 were analyzed using a log-rank test and Cox Proportional Hazards analyses. Results Of the 2661 patients included in analysis, 286 patients died during the study period. Having visited a primary care provider in the year prior to first admission of the study period was protective against all-cause mortality in unadjusted analysis (HR (95% CI) = 0.47 (0.31, 0.73)), and after adjustment. The log-rank test indicated there is a significant difference in overall survival by primary care engagement history prior to admission (p < 0.001). The median survival time for patients who had seen a primary care provider was 2322 days versus 2158 days for those who had not seen a primary care provider. Conclusions Compared with those who did not see a primary care provider in the year prior to admission, having seen a primary care provider was associated with improved survival after admission. |
Teufel-Shone, Nicolette; Jiang, Luohua; Rockwell, Jennifer; Chang, Jennifer; Beals, Janette; Bullock, Ann; Manson, Spero M Food choices and distress in reservation-based American Indians and Alaska Natives with type 2 diabetes Journal Article Public Health Nutrition, pp. 1-9, 2018. @article{Teufel-Shone2018, title = {Food choices and distress in reservation-based American Indians and Alaska Natives with type 2 diabetes}, author = {Nicolette Teufel-Shone and Luohua Jiang and Jennifer Rockwell and Jennifer Chang and Janette Beals and Ann Bullock and Spero M Manson}, url = {https://doi.org/10.1017/S1368980018000897}, doi = {10.1017/S1368980018000897}, year = {2018}, date = {2018-03-12}, journal = {Public Health Nutrition}, pages = {1-9}, abstract = {Objective: To examine the association between food choice and distress in a large national sample of American Indians/Alaska Natives (AI/AN) with type 2 diabetes. Design: Participants completed a sociodemographic survey, an FFQ and the Kessler-6 Distress Scale. Foods were identified as ‘healthy’ or ‘unhealthy’ using a classification grounded in the health education provided by the programme case managers; healthy and unhealthy food scores were calculated using reported intake frequencies. Pearson’s correlation coefficients for distress and food scores were calculated for all participants and by gender. Multiple linear regression models stratified by gender assessed the association between distress and food scores, controlling for sociodemographics and duration of type 2 diabetes. Setting: Rural AI reservations and AN villages. Subjects: AI/AN (n 2484) with type 2 diabetes. Results: Both males (34·9 %) and females (65·1 %) had higher healthy food scores than unhealthy scores. In bivariate analysis, distress level had a significant negative correlation with healthy food scores among female participants, but the association was not significant among males. Significant positive correlations between distress and unhealthy food scores were found in both genders. In the final multivariate models, healthy food scores were not significantly related to distress; however, unhealthy food scores showed significant positive relationships with distress for both genders (females: β = 0·078}, keywords = {}, pubstate = {published}, tppubtype = {article} } Objective: To examine the association between food choice and distress in a large national sample of American Indians/Alaska Natives (AI/AN) with type 2 diabetes. Design: Participants completed a sociodemographic survey, an FFQ and the Kessler-6 Distress Scale. Foods were identified as ‘healthy’ or ‘unhealthy’ using a classification grounded in the health education provided by the programme case managers; healthy and unhealthy food scores were calculated using reported intake frequencies. Pearson’s correlation coefficients for distress and food scores were calculated for all participants and by gender. Multiple linear regression models stratified by gender assessed the association between distress and food scores, controlling for sociodemographics and duration of type 2 diabetes. Setting: Rural AI reservations and AN villages. Subjects: AI/AN (n 2484) with type 2 diabetes. Results: Both males (34·9 %) and females (65·1 %) had higher healthy food scores than unhealthy scores. In bivariate analysis, distress level had a significant negative correlation with healthy food scores among female participants, but the association was not significant among males. Significant positive correlations between distress and unhealthy food scores were found in both genders. In the final multivariate models, healthy food scores were not significantly related to distress; however, unhealthy food scores showed significant positive relationships with distress for both genders (females: β = 0·078 |
Sabo, Samantha; Champion, Catalina Denman; Bell, Melanie L; Vucovich, Elsa Cornejo; Ingram, Maia; Valencia, Celina; del Vasquez, Maria Carmen Castro; Gonzalez-Fagoaga, Eduardo; de Zapien, Jill Geurnsey; Rosales, Cecilia B Meta Salud Diabetes study protocol: A cluster-randomized trial to reduce cardiovascular risk among a diabetic population of Mexico Journal Article BMJ Open, 8 (3), 2018. @article{Sabo2018, title = {Meta Salud Diabetes study protocol: A cluster-randomized trial to reduce cardiovascular risk among a diabetic population of Mexico}, author = {Samantha Sabo and Catalina Denman Champion and Melanie L Bell and Elsa Cornejo Vucovich and Maia Ingram and Celina Valencia and Maria Carmen Castro del Vasquez and Eduardo Gonzalez-Fagoaga and Jill Geurnsey de Zapien and Cecilia B Rosales}, url = {https://bmjopen.bmj.com/content/bmjopen/8/3/e020762.full.pdf}, doi = {10.1136/bmjopen-2017-020762}, year = {2018}, date = {2018-03-12}, journal = {BMJ Open}, volume = {8}, number = {3}, abstract = {Introduction Northern Mexico has among the highest rates of cardiovascular disease (CVD) and diabetes in the world. This research addresses core gaps in implementation science to develop, test and scale-up CVD risk-reduction interventions in diabetics through a national primary care health system. Methods and analysis The Meta Salud Diabetes (MSD) research project is a parallel two-arm cluster-randomized clinical behavioral trial based in 22 (n=22) health centers in Sonora, Mexico. MSD aims to evaluate the effectiveness of the MSD intervention for the secondary prevention of CVD risk factors among a diabetic population (n=320) compared with the study control of usual care. The MSD intervention consists of 2-hour class sessions delivered over a 13-week period providing educational information to encourage sustainable behavioral change to prevent disease complications including the adoption of physical activity. MSD is delivered within the context of Mexico’s national primary care health centre system by health professionals, including nurses, physicians and community health workers via existing social support groups for individuals diagnosed with chronic disease. Mixed models are used to estimate the effect of MSD by comparing cardiovascular risk, as measured by the Framingham Risk Score, between the trial arms. Secondary outcomes include hypertension, behavioral risk factors and psychosocial factors. Ethics and dissemination This work is supported by the National Institutes of Health, National Heart Lung and Blood Institute (1R01HL125996-01) and approved by the University of Arizona Research Institutional Review Board (Protocol 1508040144) and the Research Bioethics Committee at the University of Sonora. The first Internal Review Board approval date was 31 August 2015 with five subsequent approved amendments. This article refers to protocol V.0.2, dated 30 January 2017. Results will be disseminated via peer-reviewed publication and presentation at international conferences and will be shared through meetings with health systems officials.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Introduction Northern Mexico has among the highest rates of cardiovascular disease (CVD) and diabetes in the world. This research addresses core gaps in implementation science to develop, test and scale-up CVD risk-reduction interventions in diabetics through a national primary care health system. Methods and analysis The Meta Salud Diabetes (MSD) research project is a parallel two-arm cluster-randomized clinical behavioral trial based in 22 (n=22) health centers in Sonora, Mexico. MSD aims to evaluate the effectiveness of the MSD intervention for the secondary prevention of CVD risk factors among a diabetic population (n=320) compared with the study control of usual care. The MSD intervention consists of 2-hour class sessions delivered over a 13-week period providing educational information to encourage sustainable behavioral change to prevent disease complications including the adoption of physical activity. MSD is delivered within the context of Mexico’s national primary care health centre system by health professionals, including nurses, physicians and community health workers via existing social support groups for individuals diagnosed with chronic disease. Mixed models are used to estimate the effect of MSD by comparing cardiovascular risk, as measured by the Framingham Risk Score, between the trial arms. Secondary outcomes include hypertension, behavioral risk factors and psychosocial factors. Ethics and dissemination This work is supported by the National Institutes of Health, National Heart Lung and Blood Institute (1R01HL125996-01) and approved by the University of Arizona Research Institutional Review Board (Protocol 1508040144) and the Research Bioethics Committee at the University of Sonora. The first Internal Review Board approval date was 31 August 2015 with five subsequent approved amendments. This article refers to protocol V.0.2, dated 30 January 2017. Results will be disseminated via peer-reviewed publication and presentation at international conferences and will be shared through meetings with health systems officials. |
2010 |
Reinschmidt, Kerstin M; Teufel-Shone, Nicolette; Bradford, Gail; Drummond, Rebecca L; Torres, Emma; Redondo, Floribella; Elenes, Jo Jean; Sanders, Alicia; Gastelum, Sylvia; Moore-Monroy, Martha; Barajas, Salvador; Fernandez, Lourdes; Alvidrez, Rosy; de Zapien, Jill Guernsey; Staten, Lisa K Taking a broad approach to public health program adaptation: adapting a family-based diabetes education program Journal Article The Journal of Primary Prevention, 31 (1-2), pp. 69-83, 2010. @article{Reinschmidt2010, title = {Taking a broad approach to public health program adaptation: adapting a family-based diabetes education program}, author = {Kerstin M Reinschmidt and Nicolette Teufel-Shone and Gail Bradford and Rebecca L Drummond and Emma Torres and Floribella Redondo and Jo Jean Elenes and Alicia Sanders and Sylvia Gastelum and Martha Moore-Monroy and Salvador Barajas and Lourdes Fernandez and Rosy Alvidrez and Jill Guernsey de Zapien and Lisa K Staten}, url = {https://www.ncbi.nlm.nih.gov/pubmed/20140646}, doi = {10.1007/s10935-010-0208-6}, year = {2010}, date = {2010-04-01}, journal = {The Journal of Primary Prevention}, volume = {31}, number = {1-2}, pages = {69-83}, abstract = {Diabetes health disparities among Hispanic populations have been countered with federally funded health promotion and disease prevention programs. Dissemination has focused on program adaptation to local cultural contexts for greater acceptability and sustainability. Taking a broader approach and drawing on our experience in Mexican American communities at the U.S.-Mexico Border, we demonstrate how interventions are adapted at the intersection of multiple cultural contexts: the populations targeted, the community- and university-based entities designing and implementing interventions, and the field team delivering the materials. Program adaptation involves negotiations between representatives of all contexts and is imperative in promoting local ownership and program sustainability.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Diabetes health disparities among Hispanic populations have been countered with federally funded health promotion and disease prevention programs. Dissemination has focused on program adaptation to local cultural contexts for greater acceptability and sustainability. Taking a broader approach and drawing on our experience in Mexican American communities at the U.S.-Mexico Border, we demonstrate how interventions are adapted at the intersection of multiple cultural contexts: the populations targeted, the community- and university-based entities designing and implementing interventions, and the field team delivering the materials. Program adaptation involves negotiations between representatives of all contexts and is imperative in promoting local ownership and program sustainability. |