A Modified Behavior Risk Factor Surveillance System to Assess Diabetes Self-management Behaviors and Diabetes Care in Monterrey Mexico: A Cross-sectional Study
AuthorMcEwen, Marylyn Morris
Elizondo-Pereo, Rogelio Andrès
Pasvogel, Alice E.
AffiliationUniv Arizona, Coll Nursing
Univ Arizona, Mel & Enid Zuckerman Coll Publ Hlth
Keywordstype 2 diabetes
type 2 diabetes mellitus
behavioral risk factor surveillance system
MetadataShow full item record
PublisherFRONTIERS MEDIA SA
CitationA Modified Behavior Risk Factor Surveillance System to Assess Diabetes Self-management Behaviors and Diabetes Care in Monterrey Mexico: A Cross-sectional Study 2017, 5 Frontiers in Public Health
JournalFrontiers in Public Health
Rights© 2017 McEwen, Elizondo-Pereo, Pasvogel, Meester, Vargas-Villarreal and González-Salazar. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY).
Collection InformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at email@example.com.
AbstractType 2 diabetes mellitus (T2DM) is one of the leading causes of death from worldwide non-communicable diseases. The prevalence of diabetes in the Mexico (MX)-United States border states exceeds the national rate in both countries. The economic burden of diabetes, due to decreased productivity, disability, and medical costs, is staggering and increases significantly when T2DM-related complications occur. The purpose of this study was to use a modified behavioral risk factor surveillance system (BRFSS) to describe the T2DM self-management behaviors, diabetes care, and health perception of a convenience sample of adults with T2DM in Monterrey, MX. This cross-sectional study design, with convenience sampling, was conducted with a convenience sample (n = 351) of adults in the metropolitan area of Monterrey, MX who self-reported a diagnosis of T2DM. Potential participants were recruited from local supermarkets. Twenty-six diabetes and health-related items were selected from the BRFSS and administered in face-to-face interviews by trained data collectors. Data analysis was conducted using descriptive statistics. The mean age was 47 years, and the mean length of time with T2DM was 12 years. The majority was taking oral medication and 34% required insulin. Daily self-monitoring of feet was performed by 56% of the participants; however, only 8.8% engaged in blood glucose self-monitoring. The mean number of health-care provider visits was 9.09 per year, and glycated hemoglobin level (HbA1c) was assessed 2.6 times per year. Finally, only 40.5% of the participants recalled having a dilated eye exam. We conclude the modified BRFSS survey administered in a face-to-face interview format is an appropriate tool for assessing engagement in T2DM self-management behaviors, diabetes care, and health perception. Extension of the use of this survey in a more rigorous design with a larger scale survey is encouraged.
NoteOpen Access Journal.
VersionFinal published version
SponsorsPuentes Consortium; Consejo Nacional De Ciencia y Tecnologia de Mexico
- Prevalence of selected risk behaviors and chronic diseases--Behavioral Risk Factor Surveillance System (BRFSS), 39 steps communities, United States, 2005.
- Authors: Ramsey F, Ussery-Hall A, Garcia D, McDonald G, Easton A, Kambon M, Balluz L, Garvin W, Vigeant J, Centers for Disease Control and Prevention (CDC).
- Issue date: 2008 Oct 31
- Analysis of behavior risk factor surveillance system data to assess the health of Hispanics with diabetes in US-Mexico border communities.
- Authors: McEwen MM, Lin PC, Pasvogel A
- Issue date: 2013 Nov-Dec
- Surveillance for certain health behaviors among states and selected local areas--behavioral risk factor surveillance system, United States, 2004.
- Authors: Hughes E, McCracken M, Roberts H, Mokdad AH, Valluru B, Goodson R, Dunn E, Elam-Evans L, Giles W, Jiles R
- Issue date: 2006 Jul 14
- Surveillance of certain health behaviors and conditions among states and selected local areas --- Behavioral Risk Factor Surveillance System, United States, 2009.
- Authors: Li C, Balluz LS, Okoro CA, Strine TW, Lin JM, Town M, Garvin W, Murphy W, Bartoli W, Valluru B, Centers for Disease Control and Prevention (CDC).
- Issue date: 2011 Aug 19
- Prevalence of selected risk behaviors and chronic diseases and conditions-steps communities, United States, 2006-2007.
- Authors: Cory S, Ussery-Hall A, Griffin-Blake S, Easton A, Vigeant J, Balluz L, Garvin W, Greenlund K, Centers for Disease Control and Prevention (CDC).
- Issue date: 2010 Sep 24
Showing items related by title, author, creator and subject.
After receiving language concordant, individual health education interventions, do Spanish speaking, diabetic inpatients at a safety net hospital demonstrate acquired diabetes self-management competency as measured by pre-training and post training evaluation of key, diabetes self-management knowledge?Cagle, Jonathan; The University of Arizona College of Medicine - Phoenix; Abdollahi, Shagyegh (The University of Arizona., 2018-03-28)The purpose of this research was to assess the quality of the inpatient, health education diabetes program as it relates to primary Spanish speaking patients. Complications from diabetes account for huge personal and financial costs. There is substantial evidence supporting the use of targeted diabetes education to reduce complications but we need to know if our education interventions are valid. In order to accomplish this by auditing the knowledge of a sample of inpatient diabetics before and after receiving the standard MMC Spanish language diabetes education interventions via Spanish language pre and post surveys (standardized by the previously validated SKILLD survey). Demographic and clinical data were analyzed and all significant data (p value <0.05) were considered for their importance. The data demonstrated that in all 10 items on the survey, overall patients were able to demonstrate significant improvement in survey scores. Additionally, comparisons of demographic data demonstrated that being less than 50 years old was associated with improved survey scores. This indicates overall benefit of the training program as well as possible insight into need for more aggressive training for patients greater than 50 years in age.
Racial and ethnic disparities in the control of cardiovascular disease risk factors in Southwest American veterans with type 2 diabetes: the Diabetes Outcomes in Veterans StudyWendel, Christopher; Shah, Jayendra; Duckworth, William; Hoffman, Richard; Mohler, M. J.; Murata, Glen; Southern Arizona VA Health Care System, Tucson, AZ, 85723, USA; University of Arizona College of Medicine, Tucson, AZ, 85724, USA; Carl T. Hayden VA Medical Center, Phoenix, AZ, 85012, USA; New Mexico VA Health Care System, Albuquerque, NM, 87108, USA; et al. (BioMed Central, 2006)BACKGROUND:Racial/ethnic disparities in cardiovascular disease complications have been observed in diabetic patients. We examined the association between race/ethnicity and cardiovascular disease risk factor control in a large cohort of insulin-treated veterans with type 2 diabetes.METHODS:We conducted a cross-sectional observational study at 3 Veterans Affairs Medical Centers in the American Southwest. Using electronic pharmacy databases, we randomly selected 338 veterans with insulin-treated type 2 diabetes. We collected medical record and patient survey data on diabetes control and management, cardiovascular disease risk factors, comorbidity, demographics, socioeconomic factors, psychological status, and health behaviors. We used analysis of variance and multivariate linear regression to determine the effect of race/ethnicity on glycemic control, insulin treatment intensity, lipid levels, and blood pressure control.RESULTS:The study cohort was comprised of 72 (21.3%) Hispanic subjects (H), 35 (10.4%) African Americans (AA), and 226 (67%) non-Hispanic whites (NHW). The mean (SD) hemoglobin A1c differed significantly by race/ethnicity: NHW 7.86 (1.4)%, H 8.16 (1.6)%, AA 8.84 (2.9)%, p = 0.05. The multivariate-adjusted A1c was significantly higher for AA (+0.93%, p = 0.002) compared to NHW. Insulin doses (unit/day) also differed significantly: NHW 70.6 (48.8), H 58.4 (32.6), and AA 53.1 (36.2), p < 0.01. Multivariate-adjusted insulin doses were significantly lower for AA (-17.8 units/day, p = 0.01) and H (-10.5 units/day, p = 0.04) compared to NHW. Decrements in insulin doses were even greater among minority patients with poorly controlled diabetes (A1c greater than or equal to] 8%). The disparities in glycemic control and insulin treatment intensity could not be explained by differences in age, body mass index, oral hypoglycemic medications, socioeconomic barriers, attitudes about diabetes care, diabetes knowledge, depression, cognitive dysfunction, or social support. We found no significant racial/ethnic differences in lipid or blood pressure control.CONCLUSION:In our cohort, insulin-treated minority veterans, particularly AA, had poorer glycemic control and received lower doses of insulin than NHW. However, we found no differences for control of other cardiovascular disease risk factors. The diabetes treatment disparity could be due to provider behaviors and/or patient behaviors or preferences. Further research with larger sample sizes and more geographically diverse populations are needed to confirm our findings.
Health beliefs of insulin dependent diabetics and non-insulin dependent diabeticsWoodtli, Anne; Wortell, Linda Harbaugh (The University of Arizona., 1987)The descriptive study which explored the insulin dependent diabetics' and non-insulin dependent diabetics' perceptions of susceptibility to diabetic complications, severity of diabetes, and benefits of and barriers to preventive measures. The Wortell Diabetic Perception Scale was developed by the researcher for this study, and administered to a convenience sample of 71 subjects. The Subjects' age ranged from 22 to 80 years. There were 33 females and 38 males in the sample. Forty three percent of the diabetics were classified as insulin dependent diabetics and 57% as non-insulin dependent diabetics. Findings indicated that insulin dependent diabetics perceived diabetes to be significantly more severe than did non-insulin dependent diabetics. No significant difference was found to exist between the insulin dependent diabetics and non-insulin dependent diabetics with regards to perceived susceptibility to diabetic complications, and benefits of and barriers to preventive measures.