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内城区2型糖尿病美国人的生活质量的影响

目的

这项研究的目的是检查城市中非裔美国人患有2型糖尿病的个人，社区和卫生系统因素与生活质量的关联。

方法

分析了一项横断面研究的主要数据，该研究以241名内城区2型糖尿病的非洲裔美国人为样本。进行了纸质调查，其中使用SF-12来捕获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了相关协变量之后，使用了四种回归方法（顺序回归，逐步选择以及向后和向前选择以及所有可能的子集回归）来检验个人，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，受过高中教育的程度较低且患有严重抑郁症的MCS的生活质量得分较低。在所有4种回归方法中，被雇用与PCS的生活质量得分较高呈正相关。对于所有报告有创伤史的人，PCS在所有4种回归方法中均较高。在卫生系统一级，通常的护理来源与通过3种回归方法获得的更好的PCS相关。

结论

这些结果凸显了影响内城区非裔美国人2型糖尿病生活质量的关键因素，这些人可能是该人群进行干预的目标。但是，还需要进行其他研究来了解可能推动许多这种关系的现有途径。