1. Investing time in health: do socioeconomically disadvantaged patients spend more or less extra time on diabetes self-care?
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Shou En Lu, Richard S. Chung, Sarah L. Krein, Lisa Chan, Lucyna Lis, Edward W. Gregg, Ping Zhang, Ed Tierney, Assiamira Ferrara, Monica Girotra, Gloria L. Beckles, Stephen Crystal, Brenda Colley Gilbert, Joyce M. Lee, Arleen F. Brown, Catherine Kim, David Curb, Millie Trotter, Venkat Narayan, Carol M. Mangione, Dorothy A. Caputo, Ed Brizendine, Pin Wen Wang, Julie A. Schmittdiel, Kingsley U Onyemere, Bernice Moore, Adams Dudley, John D. Piette, Louise B. Russell, Connie S. Uratsu, Bob Gerzoff, Shay Clayton, Fatima Makki, Rebecca Niehus, Aaro E. Carroll, William Marrone, Ruth Baldino, Henry S. Kahn, David S. Kountz, Jennifer Goewey, Sanford A. Garfield, Rosina Everitte, Honghong Zhou, Thompson Tr, James P. Boyle, Mark R. Stevens, Linda S. Geiss, Glenda Ventura, Dori Bilik, Norman L. Lasser, William H. Herman, Andrew J. Karter, Michele Heisler, Kendrik Duru, Qimei He, Paris Roach, Jennifer Davis, Mary Hogan, Theodore J. Thompson, Neil Steers, Susan Ettner, Sonja Ross, Rui Li, Ray Burke, Leslie Faith Taub Morritt, Thomas Vogt, Stephen H. Schneider, Bix E. Swain, Shaista Malik, Matthew J. Bair, Jesse C. Crosson, Tiffany L. Gary, Carol Mangione, Jinan B. Saaddine, Xinli Li, Chien-Wen Tseng, Betsy L. Cadwell, Susan L. Ettner, Eve A. Kerr, Joseph V. Selby, Aruna V. Sarma, Larry Weller, John Hsu, Roberta Hilsdon, David G. Marrero, Norman Turk, Beth Waitzfelder, Susanna R. Williams, Elaine Quiter, Laura N. McEwen, Gabrielle J. Davis, Rodney A. Hayward, Monika M. Safford, Usha Subramanian, Ronald T. Ackermann, Gilbert C. Liu, and Martin F. Shapiro
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Adult ,Male ,Gerontology ,medicine.medical_specialty ,Time Factors ,Diabetes risk ,Adolescent ,Ethnic group ,Alternative medicine ,Article ,Interviews as Topic ,Young Adult ,Diabetes mellitus ,Diabetes Mellitus ,medicine ,Humans ,Poverty ,Socioeconomic status ,Aged ,business.industry ,Health Policy ,Public health ,Bayes Theorem ,Middle Aged ,medicine.disease ,Health Surveys ,United States ,Self Care ,Managed care ,Female ,business ,Algorithms ,Biomedical sciences - Abstract
Author(s): Ettner, Susan L; Cadwell, Betsy L; Russell, Louise B; Brown, Arleen; Karter, Andrew J; Safford, Monika; Mangione, Carol; Beckles, Gloria; Herman, William H; Thompson, Theodore J; TRIAD Study Group | Abstract: BackgroundResearch on self-care for chronic disease has not examined time requirements. Translating Research into Action for Diabetes (TRIAD), a multi-site study of managed care patients with diabetes, is among the first to assess self-care time.ObjectiveTo examine associations between socioeconomic position and extra time patients spend on foot care, shopping/cooking, and exercise due to diabetes.DataEleven thousand nine hundred and twenty-seven patient surveys from 2000 to 2001.MethodsBayesian two-part models were used to estimate associations of self-reported extra time spent on self-care with race/ethnicity, education, and income, controlling for demographic and clinical characteristics.ResultsProportions of patients spending no extra time on foot care, shopping/cooking, and exercise were, respectively, 37, 52, and 31%. Extra time spent on foot care and shopping/cooking was greater among racial/ethnic minorities, less-educated and lower-income patients. For example, African-Americans were about 10 percentage points more likely to report spending extra time on foot care than whites and extra time spent was about 3 min more per day.DiscussionExtra time spent on self-care was greater for socioeconomically disadvantaged patients than for advantaged patients, perhaps because their perceived opportunity cost of time is lower or they cannot afford substitutes. Our findings suggest that poorly controlled diabetes risk factors among disadvantaged populations may not be attributable to self-care practices.
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- 2009
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