Purpose

The purpose of this study is to examine the association of individual, community, and health system factors on quality of life among inner-city African Americans with type 2 diabetes.

Methods

Primary data from a cross-sectional study with a community sample of 241 inner-city African Americans with type 2 diabetes were analyzed. Paper-based surveys were administered in which the SF-12 was used to capture the physical component (PCS) and mental component (MCS) of quality of life. Four regression approaches (sequential, stepwise with backward and forward selection, and all possible subsets regression) were used to examine the influence of individual, community, and health system factors on PCS and MCS after adjusting for relevant covariates using a conceptual framework.

Results

In fully adjusted models, having less than a high school education and having major depression were associated with lower quality-of-life scores for MCS across all 4 regression approaches. Being employed was positively associated with better quality-of-life scores for PCS across all 4 regression approaches. PCS was higher across all 4 regression approaches for those reporting a history of trauma. At the health systems level, usual source of care was associated with better PCS across 3 regression approaches.

Conclusions

These results highlight key factors that influence quality of life among inner-city African Americans with type 2 diabetes that could be targets for interventions in this population. However, additional research is needed to understand existing pathways that may be driving many of these relationships.

中文翻译：

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量化个人、社区和卫生系统因素对患有 2 型糖尿病的内城非裔美国人生活质量的影响

目的

本研究的目的是检查个人、社区和卫生系统因素与患有 2 型糖尿病的内城非裔美国人的生活质量之间的关联。

方法

对一项横断面研究的主要数据进行了分析，该研究对 241 名患有 2 型糖尿病的内城非裔美国人的社区样本进行了分析。进行了纸质调查，其中使用 SF-12 来捕捉生活质量的身体成分 (PCS) 和精神成分 (MCS)。在使用概念框架调整相关协变量后，使用四种回归方法（顺序、逐步向后和向前选择，以及所有可能的子集回归）来检查个人、社区和卫生系统因素对 PCS 和 MCS 的影响。

结果

在完全调整的模型中，在所有 4 种回归方法中，受教育程度低于高中和患有重度抑郁症与 MCS 的生活质量得分较低有关。在所有 4 种回归方法中，受雇与 PCS 更好的生活质量得分呈正相关。对于报告有创伤史的人，所有 4 种回归方法的 PCS 均较高。在卫生系统层面，在 3 种回归方法中，常规护理来源与更好的 PCS 相关。

结论

这些结果突出了影响内城 2 型糖尿病非裔美国人生活质量的关键因素，这些因素可能成为该人群干预的目标。然而，需要更多的研究来了解可能驱动许多这些关系的现有途径。